Blue Zones And Longevity, Edward F. Ansello

Director's Editorials from Age in Action

We can embrace the generalizable characteristics of Blue Zones: a plant-based diet, friendships, spiritual or religious grounding, awareness of and immersion in our community, physical activity as a regular, normalized part of our daily routine, and, more philosophically, an opening up to our own sense of place and purpose.

Dementia-Friendly Resources, Edward F. Ansello

Director's Editorials from Age in Action

While dementia caregiving challenges continue for individual caregivers and communities, Alzpossible.org and Dementia Friendly America (dfamerica.org) can offer immediate support and a hopeful vision.

Interprofessional Geriatrics: Improving The Health Of Older Adults, Edward F. Ansello

Director's Editorials from Age in Action

We have received a five-year award (2019-2024) from the federal Health Resources and Services Administration (HRSA) to grow our Virginia Geriatric Education Center (VGEC) project, which aims to improve health outcomes across Virginia for older adults by developing a healthcare workforce that maximizes patient and family engagement, integrating geriatrics and primary care, and demonstrating measurable impact.

The Mason Music & Memory Initiative (M3i), Catherine J. Tompkins, Emily S. Ihara, Megumi Inoue, Christi Clark, Kristen Suthers Rumrill

Case Studies from Age in Action

Educational Objectives

1. Explain the benefits of a nonpharmacological intervention, such as the M3I, for persons with dementia.

2. Describe the work of M3I and its collaboration with students and faculty throughout the state.

3.Highlight lessons learned and future directions for the M3I.

Virginianavigator/Gwep Community Outreach Training For Older Adults, Caregivers, And Service Programs, Adrienne Johnson, Kim Tarantino

Case Studies from Age in Action

Educational Objectives

1. Demonstrate how VirginiaNavigator (VN) can support self-care and connecting with community resources.

2. Discuss how VN can assist service providers who work with older adults and their families.

3. Explain how VN relates to six focus areas of the Geriatrics Workforce Enhancement Program (GWEP) to improve the well-being of older adults.

The Senior Mentoring Program At Vcu’S School Of Medicine, Leland H. Waters, Madeline Mcintyre

Case Studies from Age in Action

Educational Objectives

1. To demonstrate the value of senior mentoring in geriatrics education for medical students.

2. To provide a framework for positively influencing student attitudes toward older adults.

3. To describe the underlying human relationships that contribute to patient-centered care.

4. To describe effective verbal and non-verbal skills to establish and build relationships.

Care Transitions: Empowering Older Adults With Post-Hospital Interventions, Karen Moeller

Case Studies from Age in Action

Educational Objectives

1. Understand how Care Transitions Interventions® (CTI®) can decrease hospital readmission rates among older adults, ages 60 and over.

2. Recognize how CTI® services assist older adults to stay in their homes after hospitalization for 30 days or more without unnecessary readmissions.

3. Appreciate examples of ways Senior Connections, The Capital Area Agency on Aging, collaborates with community partners.

4. Identify how Senior Connections refers older adults and caregivers to community resources for effective utilization and outcomes.

Potential Applications Of Capsaicinoids In Small Cell Lung Cancer Therapy, Jamie Rae Friedman

Theses, Dissertations and Capstones

Lung cancer continues to be the leading cause of cancer related mortality worldwide. Lung cancer is not a single disease but an umbrella that encompasses two major classifications, nonsmall cell lung cancer (NSCLC) and small cell lung cancer (SCLC). SCLC represents about 15- 20% of all lung cancer cases and is almost exclusively diagnosed in smokers. Typically, patients will respond very well to first line treatment, but face inevitable relapse. The fact that SCLC still carries a grim 5-year survival rate of less than 5% highlights the lack of advancement in treatment options to effectively improve patient response and survival. …

The Utilization Of Telehealth/ Telemedicine In Cardiology In Rural Areas, Sophia Noplis, Jocelyn Stout

Theses, Dissertations and Capstones

Introduction: Telecardiology has been defined as a way of practicing cardiology through the utilization of telecommunications and a more cost-effective way to deliver cardiac care. As a subset of telemedicine, telecardiology has functioned to bring providers to underserved communities through technological mechanisms. Rural regions have turned to telemedicine and tapped into a network of clinical institutions exchanging practitioners and patients to emphasize value-based instead of volume-based care.

Methodology: The methodology of this qualitative study was a literature review having used mixed methodologies. Five electronic databases and government websites were utilized, and one semi-structured interview with an expert in …

The Effect Of Patient Education On Oral Contraceptive Adherence Rates, Brook M. Anderson, Anmol G. Clairmont, Lydia Lutz

All Electronic Theses and Dissertations

We would like to acknowledge our project chair, Jeanne Szarzynski, PA-C, for dedicating her time, expertise, leadership and patience to truly guide the success of our research project. We appreciate her incredible insight, knowledge and skill in literature as well as clinical research to support our research project. Recognition to Barbara Leafblad, CNM, is also appropriate for her time and effort as a reader throughout the project. A very special thank you is appropriated to Lisa Naser, PA-C, and Wallace Boeve, PA-C, for lending their time and professional skills to editing this paper and providing invaluable feedback, with their help, …

Retrospective Review Of The Patient Cases At A Major Trauma Center In Nairobi, Kenya And Implications For Emergency Care Development, Julie Saleeby, Justin G. Myers, Karen Ekernas, Katherine Hunold, Ali Wangara, Alice Maingi, Peyton Wilson, Vincent Mutiso, Sarah Zamamiri, Daniel Bacon, Wes Davis, John Suder, Yash Agrawal, Ogar Ogar, Ian B.K. Martin, Stephen Dunlop

Faculty & Staff Scholarship

Introduction

Low- and middle-income countries (LMICs) are continuing to experience a “triple burden” of disease - traumatic injury, non-communicable diseases (NCDs), and communicable disease with maternal and neonatal conditions (CD&Ms). The epidemiology of this triad is not well characterised and poses significant challenges to resource allocations, administration, and education of emergency care providers. The data collected in this study provide a comprehensive description of the emergency centre at Kenya's largest public tertiary care hospital.

Methods

This study is a retrospective chart review conducted at Kenyatta National Hospital of all patient encounters over a four-month period. Data were collected from financial …

Mutations In Arl2bp, A Protein Required For Ciliary Microtubule Structure, Cause Syndromic Male Infertility In Humans And Mice, Abigal R. Moye, Nicola Bedoni, Jessica G. Cunningham, Urikhan Sanzhaeva, Eric S. Tucker, Peter Mathers, Virginie G. Peter, Mathieu Quinodoz, Liliana P. Paris, Luisa Coutinho-Santos, Pedro Camacho, Madeleine G. Purcell, Abbie C. Winkelmann, James A. Foster, Elena N. Pugacheva, Carlo Rivolta, Visvanathan Ramamurthy

Faculty & Staff Scholarship

Cilia are evolutionarily conserved hair-like structures with a wide spectrum of key biological roles, and their dysfunction has been linked to a growing class of genetic disorders, known collectively as ciliopathies. Many strides have been made towards deciphering the molecular causes for these diseases, which have in turn expanded the understanding of cilia and their functional roles. One recently-identified ciliary gene is ARL2BP, encoding the ADP-Ribosylation Factor Like 2 Binding Protein. In this study, we have identified multiple ciliopathy phenotypes associated with mutations in ARL2BP in human patients and in a mouse knockout model. Our research demonstrates that spermiogenesis …

Investigational Monoclonal Antibodies In The Treatment Of Multiple Myeloma: A Systematic Review Of Agents Under Clinical Development, Ahmad Iftikhar, Hamza Hassan, Nimra Iftikhar, Adeela Mushtaq, Atif Sohail, Nathaniel Rosko, Rajshekhar Chakraborty, Faryal Razzaq, Sonia Sandeep, Jason Neil Valent, Abraham Sebastian Kanate, Faiz Anwer

Faculty & Staff Scholarship

Background: Immunotherapy for multiple myeloma (MM) has been the focus in recent years due to its myeloma-specific immune responses. We reviewed the literature on non-Food and Drug Administration (FDA) approved monoclonal antibodies (mAbs) to highlight future perspectives. We searched PubMed, EMBASE, Web of Science, Cochrane Library and ClinicalTrials.gov to include phase I/II clinical trials. Data from 39 studies (1906 patients) were included. Of all the agents, Isatuximab (Isa, anti-CD38) and F50067 (anti-CXCR4) were the only mAbs to produce encouraging results as monotherapy with overall response rates (ORRs) of 66.7% and 32% respectively. Isa showed activity when used in combination with …

Protease-Mediated Growth Of Staphylococcus Aureus On Host Proteins Is Opp3 Dependent, Mckenzie K. Lehman, Austin S. Nuxoll, Kelsey J. Yamada, Tammy Kielian, Steven D. Carson, Paul D. Fey

Journal Articles: Pathology and Microbiology

Staphylococcus aureus has the ability to cause infections in multiple organ systems, suggesting an ability to rapidly adapt to changing carbon and nitrogen sources. Although there is little information about the nutrients available at specific sites of infection, a mature skin abscess has been characterized as glucose depleted, indicating that peptides and free amino acids are an important source of nutrients for the bacteria. Our studies have found that mutations in enzymes necessary for growth on amino acids, including pyruvate carboxykinase (ΔpckA) and glutamate dehydrogenase (ΔgudB), reduced the ability of the bacteria to proliferate within a …

Progressive Hypoxia-On-A-Chip: An In Vitro Oxygen Gradient Model For Capturing The Effects Of Hypoxia On Primary Hepatocytes In Health And Disease, Young Bok Abraham Kang, Jinsu Eo, Beyza Bulutoglu, Martin L. Yarmush, O. Berk Usta

Faculty Publications - Biomedical, Mechanical, and Civil Engineering

Oxygen is vital to the function of all tissues including the liver and lack of oxygen, that is, hypoxia can result in both acute and chronic injuries to the liver in vivo and ex vivo. Furthermore, a permanent oxygen gradient is naturally present along the liver sinusoid, which plays a role in the metabolic zonation and the pathophysiology of liver diseases. Accordingly, here, we introduce an in vitro microfluidic platform capable of actively creating a series of oxygen concentrations on a single continuous microtissue, ranging from normoxia to severe hypoxia. This range approximately captures both the physiologically relevant oxygen gradient …

Perceptions Of Risk Of Health Disparities Amid Previously Identified Political Corruption And Ageism In Slovakia, Marta N. Lukacovic, Deborah D. Sellnow-Richmond, Monika Durechova

International Crisis and Risk Communication Conference

This study examines the role of traditional versus new media’s impact on citizens’ perceptions of risk within elder care. We analyzed survey data from 112 Slovak citizens regarding their social network activity and perceptions of corruption, ageism, and health disparities in the Slovak elder care system. Previous research (Lukacovic, Sellnow-Richmond, & Durechova, under contract) identified three prominent sociopolitical issues present in the Slovak medical system among Slovak UGC discourse regarding Slovak healthcare inequity: corruption, threats to dignity, and discrimination. Here, we examined the extent to which social media users perceive the prevalence and subsequent risk of experiencing health disparities within …

Eustachian Tube Foreign Body With Endoscopic-Assisted Surgical Removal, Phillip R. Purnell, Adam Bender Heine, Habib Zalzal, Abdul R. Tarabishy, Adam Casis

Faculty & Staff Scholarship

Abstract

Objectives. Foreign bodies of the external and middle ear are not uncommon; however, foreign bodies in the eustachian tube are rare. Here we describe the presentation, imaging, and endoscopic-assisted surgical management of a case of eustachian tube foreign body. Methods. A 34-year-old male was seen for evaluation of foreign body of the left eustachian tube while working with metal at a machine shop. Imaging and surgical management are highlighted and review of available literature regarding foreign bodies of the eustachian tube is presented. Results. A CT scan revealed a foreign body present approximately 1 cm into …

Traumatic Bladder Ruptures: A Ten-Year Review At A Level 1 Trauma Center, John Barnard, Tyler Overholt, Ali Hajiran, Chad Crigger, Morris Jessop, Jennifer Knight, Chad Morley

Faculty & Staff Scholarship

Abstract

Bladder rupture occurs in only 1.6% of blunt abdominopelvic trauma cases. Although rare, bladder rupture can result in significant morbidity if undiagnosed or inappropriately managed. AUA Urotrauma Guidelines suggest that urethral catheter drainage is a standard of care for both extraperitoneal and intraperitoneal bladder rupture regardless of the need for surgical repair. However, no specific guidance is given regarding the length of catheterization. The present study seeks to summarize contemporary management of bladder trauma at our tertiary care center, assess the impact of length of catheterization on bladder injuries and complications, and develop a protocol for management of bladder …

Melatonin Prevents Osteoarthritis-Induced Cartilage Degradation Via Targeting Microrna-140, Yijian Zhang, Jun Lin, Xinfeng Zhou, Xi Chen, Angela Carley Chen, Bin Pi, Guoquing Pan, Ming Pei, Huilin Yang, Tao Liu, Fan He

Faculty & Staff Scholarship

Abstract

Osteoarthritis (OA) is characterized by the progressive destruction of articular cartilage, which is involved in the imbalance between extracellular matrix (ECM) synthesis and degradation. MicroRNA-140-5p (miR-140) is specifically expressed in cartilage and plays an important role in OA-induced matrix degradation. The aim of this study was to investigate (1) whether intra-articular injection of melatonin could ameliorate surgically induced OA in mice and (2) whether melatonin could regulate matrix-degrading enzymes at the posttranscriptional level by targeting miR-140. In an in vitro OA environment induced by interleukin-1 beta (IL-1β), melatonin treatment improved cell proliferation of human chondrocytes, promoted the …

Cecal Perforation In The Setting Of Campylobacter Jejuni Infection, Seema Jain, Weston Betrner, Dane Olevian, Dhiraj Yadav

Faculty & Staff Scholarship

Campylobacter infection is the leading cause of bacterial gastroenteritis worldwide, yet life-threatening complications are extremely rare. We present a 32-year-old previously healthy man who presented with dysentery from Campylobacter jejuni, which was complicated by cecal perforation and secondary bacterial peritonitis.

Acute Levodopa Dosing Around-The-Clock Ameliorates Rem Sleep Without Atonia In Hemiparkinsonian Rats, Vishakh Iyer, Quynh Vo, Anthony Mell, Siven Chinniah, Ashley Zenerovitz, Kala Venkiteswaran, Allen R. Kunselman, Jidong Fang, Thyagarajan Subramanian

Faculty & Staff Scholarship

• Article
• Open Access
• Published: 29 November 2019

Acute levodopa dosing around-the-clock ameliorates REM sleep without atonia in hemiparkinsonian rats

• Vishakh Iyer,
• Quynh Vo,
• Anthony Mell,
• Siven Chinniah,
• Ashley Zenerovitz,
• Kala Venkiteswaran,
• Allen R. Kunselman,
• Jidong Fang &
• Thyagarajan Subramanian

npj Parkinson's Disease volume 5, Article number: 27 (2019) Cite this article

• 594 Accesses

• 2 Altmetric

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Abstract

Rapid-eye-movement (REM) sleep without atonia (RSWA), a marker of REM sleep behavior disorder (RBD), is frequently comorbid with Parkinson’s disease (PD). Although rodent models are commonly used for studying PD, the neurobiological and behavioral correlates of …

Impact Of Fibronectin Knockout On Proliferation And Differentiation Of Human Infrapatellar Fat Pad-Derived Stem Cells, Yiming Wang, Yawen Fu, Zuoqin Yan, Xiao-Bing Zhang, Ming Pei

Faculty & Staff Scholarship

Fibronectin plays an essential role in tissue development and regeneration. However, the effects of fibronectin knockout (FN1-KO) on stem cells’ proliferation and differentiation remain unknown. In this study, CRISPR/Cas9 generated FN1-KO in human infrapatellar fat pad-derived stem cells (IPFSCs) was evaluated for proliferation ability including cell cycle and surface markers as well as stemness gene expression and for differentiation capacity including chondrogenic and adipogenic differentiation. High passage IPFSCs were also evaluated for proliferation and differentiation capacity after expansion on decellularized ECM (dECM) deposited by FN1-KO cells. Successful FN1-KO in IPFSCs was confirmed by Sanger sequencing and Inference of CRISPR Edits …

Improving Exposure For Transoral Oropharyngeal Surgery With The Floor Of Mouth Window: A Cadaveric Feasibility Study, Jefferson Chung, Adam Bender-Heine, H. Wayne Lambert

Faculty & Staff Scholarship

Background: Transoral robotic and laser surgery is rising in popularity due to the increasing incidence of Human Papilloma Virus (HPV) related oropharyngeal cancer. However, adequate exposure of the tongue base remains a major hurdle in many cases. This study introduces a novel surgical technique called the Floor of Mouth Window, which can be used to improve tongue base exposure at the time of transoral surgery. Methods: This is a preclinical anatomic cadaver study. Seven fresh cadavers were used for this study. Exposure of the tongue base was compared between conventional mouth gags – the Feyh-Kastenbauer and McIvor – and our …

Safety And Long-Term Efficacy Of Thoracoscopic Epicardial Ablation In Patients With Paroxysmal Atrial Fibrillation: A Retrospective Study, John Johnkoski, Bryan Miles, Anna Sudbury, Mohammed Osman, Muhammad Bilal Munir, Sudarshan Balla, Mina M. Benjamin

Faculty & Staff Scholarship

Background: The aim of this study is to report the long-term efficacy and safety of thoracoscopic epicardial left atrial ablation (TELA) in patients with paroxysmal atrial fibrillation (AF). Methods: This was a retrospective review of medical records. We included all patients diagnosed with paroxysmal AF who underwent TELA at our institution between 04/2011 and 06/2017. TELA included pulmonary vein isolation, LA dome lesions and LA appendage exclusion. All (n = 55) patients received an implantable loop recorder (ILR), 30 days post-operatively. Antiarrhythmic and anticoagulation therapy were discontinued at 90 and 180 days postoperatively, respectively, if patients were free of AF …

Surgical Correction Of Aortic Regurgitation Using A Haart 300™ Rigid Aortic Ring: A Novel Method To Standardize Aortic Valve Repair, Radoslaw Gocol, Marek Jasiński, Damian Hudziak, Jaroslaw Bis, Aleksandra Żak, Piotr Duraj, Magdalena Mizia, J. Scott Rankin, Marek A. Deja

Faculty & Staff Scholarship

No abstract provided.

Increased Dementia Mortality In West Virginia Counties With Mountaintop Removal Mining?, A. K. Salm, Michael J. Benson

Faculty & Staff Scholarship

(MTM), a practice that has been ongoing in some counties of West Virginia (WV) USA since the 1970s. PM inhalation has been linked to central nervous system pathophysiology, including cognitive decline and dementia. Here we compared county dementia mortality statistics in MTM vs. non-MTM WV counties over a period spanning 2001–2015. We found significantly elevated age-adjusted vascular or unspecified dementia mortality/100,000 population in WV MTM counties where, after adjusting for socioeconomic variables, dementia mortality was 15.60 (±3.14 Standard Error of the Mean (S.E.M.)) times higher than that of non-MTM counties. Further analyses with satellite imaging data revealed a highly significant …

Unusual Presentation Of Recurrent Gallstone Ileus: A Case Report And Literature Review, Osayande Osagiede, Paula Pacurari, Dorin Colibaseanu, Nezar Jrebi

Faculty & Staff Scholarship

Background. Gallstone ileus (GSI) is a rare form of small bowel obstruction (SBO) in patients with cholelithiasis, which is often poorly managed. Enhanced abdominal computed tomography (CT) with contrast is considered the most helpful diagnostic tool, as it is highly sensitive, specific, and accurate. We report an interesting case of recurrent GSI that was not detected by CT but diagnosed intraoperatively. Case Presentation. A 49-year-old female with a previous history of choledocholithiasis and ERCP presented to the emergency department following episodes of sudden cramping, epigastric pain, and nausea. An abdominal CT revealed evidence of SBO with clear evidence of GSI …

Unforeseen Computed Tomography Resimulation For Initial Radiation Planning: Associated Factors And Clinical Impact, April Metzger, Paul Renz, Shaakir Hasan, Stephen Karlovits, Jason Sohn, Steven Gresswell

Faculty & Staff Scholarship

Purpose: Repeat computed tomography (CT) simulation is problematic because of additional expense of clinic resources, patient inconvenience, additional radiation exposure, and treatment delay. We investigated the factors and clinical impact of unplanned CT resimulations in our network. Methods and Materials: We used the billing records of 18,170 patients treated at 5 clinics. A total of 213 patients were resimulated before their first treatment. The disease site, location, use of 4- dimensional CT (4DCT), contrast, image fusion, and cause for resimulation were recorded. Odds ratios determined statistical significance. Results: Our total rate of resimulation was 1.2%. Anal/colorectal (P < .001) and head and neck (P < .001) disease sites had higher rates of resimulation. Brain (P Z .001) and lung/thorax (P Z .008) had lower rates of resimulation. The most common causes for resimulation were setup change (11.7%), change in patient anatomy (9.8%), and rectal filling (8.5%). The resimulation rate for 4DCTs was 3.03% compared with 1.0% for non-4DCTs (P < .001). Median time between simulations was 7 days. Conclusions: The most common sites for resimulation were anal/colorectal and head and neck, largely because of change in setup or changes in anatomy. The 4DCT technique correlated with higher resimulation rates. The resimulation rate was 1.2%, and median treatment delay was 7 days. Further studies are warranted to limit the rate of resimulation.

The Patient Selection Criteria For Veno-Arterial Extracorporeal Mechanical Oxygenation, Sandeep Banga, Abhiram Challa, Avani R. Patel, Shantanu Singh, Vamsi K. Emani

Faculty & Staff Scholarship

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) plays a crucial role in the management of patients with refractory cardiac and pulmonary dysfunction by providing temporary mechanical hemodynamic and respiratory support. However, the paucity of guidelines on indications for administering it and the failure to timely initiate VA-ECMO often result in a high in-hospital mortality rate and poor six-month outcomes after VA-ECMO deployment. Due to ethical issues, randomized controlled studies with VA-ECMO have not been conducted so that no recommended evidence-based guidelines exist for VA-ECMO patientselection criteria. Therefore, the indication for administering the device depends solely on expert opinion after reviewing the literature. …

Acute Psychosis Following 1,1-Difluoroethane Inhalation, Clara B. Novotny, Sarah Irvin, Eduardo D. Espiridion

Faculty & Staff Scholarship

Inhalants are often abused due to their ability to acutely induce feelings of euphoria. Difluoroethane is a toxic lipophilic hydrocarbon that crosses the blood-brain barrier and inhibits the central nervous system. Studies have shown the cardiac, renal, and respiratory effects it has when abused; however, our literature review yielded no previous report of acute psychosis after difluoroethane inhalation. In order to prevent poor outcomes by missed diagnosis, we present a case of difluoroethane-induced acute psychosis.