Now showing items 21-40 of 13199

    • UMB's Got Talent

      Badie, Jen; Emmel, Mark (2020-12-17)
      In an effort to entertain the UMB campus as well as show off campus talent during COVID-19, the University Student Governtment Association, Faculty and Staff Senates hosted UMB's Got Talent. The virtual show occurred December 17, 2020 and included 10 student, staff, and faculty performers including a comedic juggler, dancers, and musicians.
    • Comparative Analysis of Genome of Ehrlichia sp. HF, a Model Bacterium to Study Fatal Human Ehrlichiosis

      Lin, Mingqun; Xiong, Qingming; Chung, Matthew; Daugherty, Sean C; Nagaraj, Sushma; Sengamalay, Naomi; Ott, Sandra; Godinez, Al; Tallon, Luke J; Sadzewicz, Lisa; et al. (Springer Nature, 2021-01-06)
      Background: The genus Ehrlichia consists of tick-borne obligatory intracellular bacteria that can cause deadly diseases of medical and agricultural importance. Ehrlichia sp. HF, isolated from Ixodes ovatus ticks in Japan [also referred to as I. ovatus Ehrlichia (IOE) agent], causes acute fatal infection in laboratory mice that resembles acute fatal human monocytic ehrlichiosis caused by Ehrlichia chaffeensis. As there is no small laboratory animal model to study fatal human ehrlichiosis, Ehrlichia sp. HF provides a needed disease model. However, the inability to culture Ehrlichia sp. HF and the lack of genomic information have been a barrier to advance this animal model. In addition, Ehrlichia sp. HF has several designations in the literature as it lacks a taxonomically recognized name. Results: We stably cultured Ehrlichia sp. HF in canine histiocytic leukemia DH82 cells from the HF strain-infected mice, and determined its complete genome sequence. Ehrlichia sp. HF has a single double-stranded circular chromosome of 1,148,904 bp, which encodes 866 proteins with a similar metabolic potential as E. chaffeensis. Ehrlichia sp. HF encodes homologs of all virulence factors identified in E. chaffeensis, including 23 paralogs of P28/OMP-1 family outer membrane proteins, type IV secretion system apparatus and effector proteins, two-component systems, ankyrin-repeat proteins, and tandem repeat proteins. Ehrlichia sp. HF is a novel species in the genus Ehrlichia, as demonstrated through whole genome comparisons with six representative Ehrlichia species, subspecies, and strains, using average nucleotide identity, digital DNA-DNA hybridization, and core genome alignment sequence identity. Conclusions: The genome of Ehrlichia sp. HF encodes all known virulence factors found in E. chaffeensis, substantiating it as a model Ehrlichia species to study fatal human ehrlichiosis. Comparisons between Ehrlichia sp. HF and E. chaffeensis will enable identification of in vivo virulence factors that are related to host specificity, disease severity, and host inflammatory responses. We propose to name Ehrlichia sp. HF as Ehrlichia japonica sp. nov. (type strain HF), to denote the geographic region where this bacterium was initially isolated. © 2021, The Author(s).
    • Application of systems dynamics and group model building to identify barriers and facilitators to acute care delivery in a resource limited setting

      Muttalib, Fiona; Ballard, Ellis; Langton, Josephine; Malone, Sara; Fonseca, Yudy; Hansmann, Andreas; Remy, Kenneth; Hovmand, Peter; Doctor, Allan (Springer Nature, 2021-01-06)
      Background: Group model building (GMB) is a method to facilitate shared understanding of structures and relationships that determine system behaviors. This project aimed to determine the feasibility of GMB in a resource-limited setting and to use GMB to describe key barriers and facilitators to effective acute care delivery at a tertiary care hospital in Malawi. Methods: Over 1 week, trained facilitators led three GMB sessions with two groups of healthcare providers to facilitate shared understanding of structures and relationships that determine system behaviors. One group aimed to identify factors that impact patient flow in the paediatric special care ward. The other aimed to identify factors impacting delivery of high-quality care in the paediatric accident and emergency room. Synthesized causal maps of factors influencing patient care were generated, revised, and qualitatively analyzed. Results: Causal maps identified patient condition as the central modifier of acute care delivery. Severe illness and high volume of patients were identified as creating system strain in several domains: (1) physical space, (2) resource needs and utilization, (3) staff capabilities and (4) quality improvement. Stress in these domains results in worsening patient condition and perpetuating negative reinforcing feedback loops. Balancing factors inherent to the current system included (1) parental engagement, (2) provider resilience, (3) ease of communication and (4) patient death. Perceived strengths of the GMB process were representation of diverse stakeholder viewpoints and complex system synthesis in a visual causal pathway, the process inclusivity, development of shared understanding, new idea generation and momentum building. Challenges identified included time required for completion and potential for participant selection bias. Conclusions: GMB facilitated creation of a shared mental model, as a first step in optimizing acute care delivery in a paediatric facility in this resource-limited setting. © 2020, The Author(s).
    • Policy statement from the Society for Healthcare Epidemiology of America (SHEA): Only medical contraindications should be accepted as a reason for not receiving all routine immunizations as recommended by the Centers for Disease Control and Prevention

      Weber, David J; Talbot, Thomas R; Weinmann, Allison; Mathew, Trini; Heil, Emily; Stenehjem, Edward; Duncan, Robert; Gross, Alan; Stinchfield, Patricia; Baliga, Christopher; et al. (Cambridge University Press, 2020-09-17)
      SHEA endorses adhering to the recommendations by the CDC and ACIP for immunizations of all children and adults. All persons providing clinical care should be familiar with these recommendations and should routinely assess immunization compliance of their patients and strongly recommend all routine immunizations to patients. All healthcare personnel (HCP) should be immunized against vaccine-preventable diseases as recommended by the CDC/ACIP (unless immunity is demonstrated by another recommended method). SHEA endorses the policy that immunization should be a condition of employment or functioning (students, contract workers, volunteers, etc) at a healthcare facility. Only recognized medical contraindications should be accepted for not receiving recommended immunizations. ©
    • Immature defense mechanisms mediate the relationship between childhood trauma and onset of bipolar disorder

      Wang, Leilei; Yin, Yi; Bian, Qingtao; Zhou, Yanfang; Huang, Junchao; Zhang, Ping; Chen, Song; Fan, Hongzhen; Cui, Yimin; Luo, Xingguang; et al. (Elsevier B.V., 2020-10-15)
    • Impact of Diabetes and Insulin Use on Prognosis in Patients With Resected Pancreatic Cancer: An Ancillary Analysis of NRG Oncology RTOG 9704

      Bitterman, Danielle S; Winter, Kathryn A; Hong, Theodore S; Fuchs, Charles S; Regine, William F; Abrams, Ross A; Safran, Howard; Hoffman, John P; Benson, Al B; Kasunic, Timothy; et al. (Elsevier Inc., 2020-08-26)
      Purpose: Diabetes mellitus (DM) has been proposed to be tumorigenic; however, prior studies of the association between DM and survival are conflicting. The goal of this ancillary analysis of RTOG 9704, a randomized controlled trial of adjuvant chemotherapy in pancreatic cancer, was to determine the prognostic effects of DM and insulin use on survival. Methods and Materials: Eligible patients from RTOG 9704 with available data on DM and insulin use were included. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan-Meier method, and variable levels were compared using log-rank test. Cox proportional hazards models were created to assess the associations among DM, insulin use, and body mass index phenotypes on outcomes. Results: Of 538 patients enrolled from 1998 to 2002, 238 patients were eligible with analyzable DM and insulin use data. Overall 34% of patients had DM and 66% did not. Of patients with DM, 64% had insulin-dependent DM, and 36% had non–insulin-dependent DM. On univariable analysis, neither DM nor insulin dependence were associated with OS or DFS (P >.05 for all). On multivariable analysis, neither DM, insulin use, nor body mass index were independently associated with OS or DFS. Nonwhite race (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.35-3.50; P =.0014), nodal involvement (HR, 1.74; 95% CI, 1.24-2.45; P =.0015), and carbohydrate antigen 19-9 (CA19-9) ≥90 U/mL (HR, 3.61; 95% CI, 2.32-5.63; P <.001) were associated with decreased OS. Nonwhite race (HR, 1.67; 95% CI, 1.05-2.63; P =.029) and CA19-9 ≥90 U/mL (HR, 2.86; 95% CI, 1.85-4.40; P <.001) were associated with decreased DFS. Conclusions: DM and insulin use were not associated with OS or DFS in patients with pancreatic cancer in this study. Race, nodal involvement, and increased CA19-9 were significant predictors of outcomes. These data might apply to the more modern use of neoadjuvant therapies for potentially resectable pancreatic cancer.
    • Medications in Post-Acute and Long-Term Care: Challenges and Controversies

      Sloane, Philip D; Brandt, Nicole J; Cherubini, Antonio; Dharmarajan, T S; Dosa, David; Hanlon, Joseph T; Katz, Paul; Koopmans, Raymond T C M; Laird, Rosemary D; Petrovic, Mirko; et al. (American Medical Association, 2020-11-27)
    • Adjustments for oral fluid quality and collection methods improve prediction of circulating tetanus antitoxin: Approaches for correcting antibody concentrations detected in a non-invasive specimen

      Garrison-Desany, Henri; Ochieng, Benard Omondi; Odiere, Maurice R; Kuo, Helen; Gibson, Dustin G; Were, Joyce; Kagucia, E Wangeci; Pasetti, Marcela F; Kim, Hani; Reymann, Mardi; et al. (Elsevier Ltd., 2020-11-27)
      Objectives: To examine whether anti-tetanus toxoid (anti-TT) immunoglobulin G (IgG) levels measured in oral fluid and adjusted for collection difficulties and specimen quality are associated with total IgG and anti-TTIgG in oral fluid and assess if statistical adjustment for them improves prediction of anti-TT IgG in serum. Methods: 267 children, ages 12 to 15 months, enrolled in the M-SIMU randomized controlled trial participated in this nested cross-sectional analysis. Venous blood and oral fluid (OF) specimens were collected, and OF collection difficulties such as crying or gagging were recorded. OF volume was documented and total IgG was measured in OF specimens and anti-TT IgG was measured in OF and serum by enzyme immunoassay (EIA). Collection difficulties, volume and sociodemographic characteristics were assessed in relation to total IgG and anti-TT IgG in OF via multivariate regression. These models were extended to evaluate the association between anti-TT IgG in OF and in serum. A prediction model was developed to adjust anti-TT IgG in OF estimates as proxy for serum. Results: Blood in the specimen, sores in the mouth and crying were positively associated with total IgG concentration while high oral fluid volume and sucking on the swab were inversely associated. None were significant predictors of anti-TT IgG in OF after adjusting for total IgG (geometric mean [GM] ratio: 1.99; 95% confidence interval: 1.78–2.24) and vaccination history (GM ratio: 2.44; 95% CI: 1.98–3.01). When predicting anti-TT IgG levels in serum with OF, total IgG modified the effect of anti-TT IgG in OF. Conclusions: Anti-TT IgG in OF is a good proxy for levels in serum, after controlling for total IgG in the specimen and other variables. Post hoc adjustments for OF volume and total IgG concentration are an important consideration when conducting serosurveys with oral fluid.
    • Robust control of a system with a pneumatic spring

      Kim, Dongwon; Lee, Jinoh (Elsevier Ltd., 2020-11-01)
      Recently, series elasticity has been realized using pneumatics in human-robot interaction systems. Pneumatic circuits provide not only a flexible power transmission, but also the elastic element in a series elastic actuator (SEA). Pneumatic series elastic systems involve more than twice the number of parameters that influence system behaviors in comparison with rigid robotic systems. In this study, a position controller that eliminates the need of identifying a system model by employing the time delay estimation (TDE) technique is proposed for pneumatic SEA systems. The TDE technique is effective in compensating for system dynamics and all uncertainties involved in system behaviors without imposing computation load. TDE error is cancelled out through a learning way, which improves control performance and leads to asymptotic stability. A simulation study demonstrates the robustness of the proposed controllers against uncertainties imposed on the motor system as well as uncertainties on the end-effector. The simulation shows the efficacy of the learning compensation for TDE error.
    • EAP and COVID-19: Impact of COVID Lockdown in Spain & Latin America

      Lardani, Andrea; Sanchez-Escobar, Elena (EAPA, 2021-01)
      The COVID-19 pandemic has demanded that employee assistance professionals deal with abrupt changes in the workplace, differences that may include the experiencing and managing of new emotions. What is the psychological impact of a worldwide lockdown on workers? How are they coping with remote work? What do they need from their employers? Are there differences between Spanish and Latin-American responses? Our organizations collected and analyzed 693 questionnaires to answer these very questions. This article will present key results analysis as well as discuss how EAPs are responding to this unprecedented time. One point is clear: EAPs need to show companies that well-being policies are more important than ever.
    • EAP and COVID-19: COVID-19 Changes Needn’t be Negative

      Antonissen, Dirk (EAPA, 2021-01)
      Nearly twenty years ago, former EAPA CEO John Maynard wrote in this magazine: “Employee Assistance is the application of knowledge about behaviour and behavioural health to make accurate assessments, followed by appropriate action to improve the productivity and healthy functioning of the workplace” (Maynard, 2004). Indeed, two decades later, improving the productivity and healthy functioning of the workplace remains a challenge – even more so in light of COVID-19 restrictions in which remote work (telework) has become the new workplace standard. Telework marks a radical change for many employers and employees, and this certainly includes Europe. But change does not have to be negative. Notwithstanding all the troubles that COVID-19 brought to workplaces, many employees seem to appreciate some of the adaptations that came with lockdown and obligatory home and telework.
    • Optimization of RG1-VLP vaccine performance in mice with novel TLR4 agonists

      Zacharia, Athina; Harberts, Erin; Valencia, Sarah M; Myers, Breana; Sanders, Chelsea; Jain, Akshay; Larson, Nicholas R; Middaugh, C Russell; Picking, William D; Difilippantonio, Simone; et al. (Elsevier Ltd., 2020-12-10)
      Current human papilloma virus (HPV) vaccines provide substantial protection against the most common HPV types responsible for oral and anogenital cancers, but many circulating cancer-causing types remain that lack vaccine coverage. The novel RG1-VLP (virus-like particle) vaccine candidate utilizes the HPV16-L1 subunit as a backbone to display an inserted HPV16-L2 17–36 a.a. “RG1” epitope; the L2 RG1 epitope is conserved across many HPV types and the generation of cross-neutralizing antibodies (Abs) against which has been demonstrated. In an effort to heighten the immunogenicity of the RG1-VLP vaccine, we compared in BALB/c mice adjuvant formulations consisting of novel bacterial enzymatic combinatorial chemistry (BECC)-derived toll-like receptor 4 (TLR4) agonists and the aluminum hydroxide adjuvant Alhydrogel. In the presence of BECC molecules, consistent improvements in the magnitude of Ab responses to both HPV16-L1 and the L2 RG1 epitope were observed compared to Alhydrogel alone. Furthermore, neutralizing titers to HPV16 as well as cross-neutralization of pseudovirion (PsV) types HPV18 and HPV39 were augmented in the presence of BECC agonists as well. Levels of L1 and L2-specific Abs were achieved after two vaccinations with BECC/Alhydrogel adjuvant that were equivalent to or greater than levels achieved with 3 vaccinations with Alhydrogel alone, indicating that the presence of BECC molecules resulted in accelerated immune responses that could allow for a decreased dose schedule for VLP-based HPV vaccines. In addition, dose-sparing studies indicated that adjuvantation with BECC/Alhydrogel allowed for a 75% reduction in antigen dose while still retaining equivalent magnitudes of responses to the full VLP dose with Alhydrogel. These data suggest that adjuvant optimization of HPV VLP-based vaccines can lead to rapid immunity requiring fewer boosts, dose-sparing of VLPs expensive to produce, and the establishment of a longer-lasting humoral immunity.
    • Adaptive Capacity Key EAP Strategies for the New Year

      Gorter, Jeff (EAPA, 2021-01)
      It goes without saying that 2020 was a year like no other. An unprecedented series of chal- lenges included the COVID-19 pandemic, civil unrest, widespread economic distress, catastrophic wildfires, a record-setting hurricane season, and the most divisive election cycle in memory. If it feels like you have been running a marathon, it’s because you have! But employee assistance professionals are no strangers to chaos. Dealing with the unexpected, responding to crisis, and managing the human side of business challenges are core competencies of any top-tier EAP, and EA professionals have answered the call in amazing and creative ways, as always.
    • Buyer beware: inflated claims of sensitivity for rapid COVID-19 tests

      Fitzpatrick, Meagan C; Pandey, Abhishek; Wells, Chad R; Sah, Pratha; Galvani, Alison P (Elsevier Ltd., 2020-12-14)
    • Completeness of Medical Records of Trauma Patients Admitted to the Emergency Unit of a University Hospital, Upper Egypt

      Mohammed, Zeinab; Arafa, Ahmed; Senosy, Shaimaa; El-Morsy, El-Morsy Ahmed; El-Bana, Emad; Saleh, Yaseen; Hirshon, Jon Mark (MDPI AG, 2020-12-24)
      Trauma records in Egyptian hospitals are widely suspected to be inadequate for developing a practical and useful trauma registry, which is critical for informing both primary and secondary prevention. We reviewed archived paper records of trauma patients admitted to the Beni-Suef University Hospital in Upper Egypt for completeness in four domains: demographic data including contact information, administrative data tracking patients from admission to discharge, clinical data including vital signs and Glasgow Coma Scale scores, and data describing the causal traumatic event (mechanism of injury, activity at the time of injury, and location/setting). The majority of the 539 medical records included in the study had significant deficiencies in the four reviewed domains. Overall, 74.3% of demographic fields, 66.5% of administrative fields, 55.0% of clinical fields, and just 19.9% of fields detailing the causal event were found to be completed. Critically, oxygen saturation, arrival time, and contact information were reported in only 7.6%, 25.8%, and 43.6% of the records, respectively. Less than a fourth of the records provided any details about the cause of trauma. Accordingly, the current, paper-based medical record system at Beni-Suef University Hospital is insufficient for the development of a practical trauma registry. More efforts are needed to develop efficient and comprehensive documentation of trauma data in order to inform and improve patient care. © 2020 by the authors. Li-censee MDPI, Basel, Switzerland.
    • Insulin Resistance in Skeletal Muscle of Chronic Stroke

      Ryan, Alice S; Hafer-Macko, Charlene; Ortmeyer, Heidi K (MDPI AG, 2020-12-26)
      A stroke can lead to reduced mobility affecting skeletal muscle mass and fatty infiltration which could lead to systemic insulin resistance, but this has not been examined and the mechanisms are currently unknown. The objective was to compare the effects of in vivo insulin on skeletal muscle glycogen synthase (GS) activity in paretic (P) and nonparetic (NP) skeletal muscle in chronic stroke, and to compare to nonstroke controls. Participants were mild to moderately disabled adults with chronic stroke (n = 30, 60 ± 8 years) and sedentary controls (n = 35, 62 ± 8 years). Insulin sensitivity (M) and bilateral GS activity were determined after an overnight fast and during a hyperinsulinemic-euglycemic clamp. Stroke subjects had lower aerobic capacity than controls, but M was not significantly different. Insulin-stimulated activities of GS (independent, total, fractional), as well as absolute differences (insulin minus basal) and the percent change (insulin minus basal, relative to basal) in GS activities, were all significantly lower in P versus NP muscle. Basal GS fractional activity was 3-fold higher, and the increase in GS fractional activity during the clamp was 2-fold higher in control versus P and NP muscle. Visceral fat and intermuscular fat were associated with lower M. The effect of in vivo insulin to increase GS fractional activity was associated with M in control and P muscle. A reduction in insulin action on GS in paretic muscle likely contributes to skeletal muscle-specific insulin resistance in chronic stroke.
    • Extracellular Vesicles from Red Blood Cells and Their Evolving Roles in Health, Coagulopathy and Therapy

      Thangaraju, Kiruphagaran; Neerukonda, Sabari Nath; Katneni, Upendra; Buehler, Paul W (MDPI AG, 2020-12-25)
      Red blood cells (RBCs) release extracellular vesicles (EVs) including both endosome-de-rived exosomes and plasma-membrane-derived microvesicles (MVs). RBC-derived EVs (RBCEVs) are secreted during erythropoiesis, physiological cellular aging, disease conditions, and in response to environmental stressors. RBCEVs are enriched in various bioactive molecules that facilitate cell to cell communication and can act as markers of disease. RBCEVs contribute towards physiological adaptive responses to hypoxia as well as pathophysiological progression of diabetes and genetic non-malignant hematologic disease. Moreover, a considerable number of studies focus on the role of EVs from stored RBCs and have evaluated post transfusion consequences associated with their exposure. Interestingly, RBCEVs are important contributors toward coagulopathy in hematological disorders, thus representing a unique evolving area of study that can provide insights into molecular mechanisms that contribute toward dysregulated hemostasis associated with several disease conditions. Relevant work to this point provides a foundation on which to build further studies focused on unraveling the potential roles of RBCEVs in health and disease. In this review, we provide an analysis and summary of RBCEVs biogenesis, composition, and their biological function with a special emphasis on RBCEV pathophysiological contribution to coagulopathy. Further, we consider potential therapeutic applications of RBCEVs. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
    • Strategies for the successful implementation of plasma-based NSCLC genotyping in clinical practice

      Aggarwal, Charu; Rolfo, Christian D; Oxnard, Geoffrey R; Gray, Jhanelle E; Sholl, Lynette M; Gandara, David R (Springer Nature, 2020-09-11)
      Upfront tumour genotyping is now considered an essential step in guiding treatment decision-making in the management of patients with advanced-stage non-small-cell lung cancer (NSCLC) in light of the ever-expanding toolbox of targeted therapies and immune-checkpoint inhibitors. However, genotyping of tumour biopsy samples is not feasible for all patients and, therefore, genomic analysis of circulating tumour DNA (ctDNA) has emerged as a compelling non-invasive option. Current guidelines universally recommend genotyping and support the use of ctDNA testing in certain settings, although they often omit the detail necessary for integrating these tests into clinical care on an individual basis. In this Perspective, we describe the rationale, promise and challenges associated with ctDNA-based NSCLC genotyping and suggest a framework for the implementation of these assays into routine clinical practice. We also offer considerations for the interpretation of ctDNA genotyping results, which, particularly when using next-generation sequencing panels, can be nuanced. Through the addition of this new approach to clinical practice, we propose that oncologists might finally be able to utilize effective genotyping in nearly all patients with advanced-stage NSCLC. © 2020, Springer Nature Limited.
    • Adiposity, Physical Function, and Their Associations With Insulin Resistance, Inflammation, and Adipokines in CKD

      Navaneethan, Sankar D; Kirwan, John P; Remer, Erick M; Schneider, Erika; Addeman, Bryan; Arrigain, Susana; Horwitz, Ed; Fink, Jeffrey C; Lash, James P; McKenzie, Charles A; et al. (Elsevier Ltd., 2020-08-13)
      Mean age of the study population was 64.3 years; 41% were women, and mean estimated glomerular filtration rate was 53.2±14.6 (SD) mL/min/1.73m2. More than 85% were overweight or obese, and 40% had diabetes. Higher VAT volume, SAT volume, and liver proton density fat fraction were associated with lower levels of total and high-molecular-weight adiponectin, higher levels of leptin and insulin resistance, and lower high-density lipoprotein cholesterol and higher serum triglyceride levels. A slower 400-m walk time was associated only with higher levels of leptin, total adiponectin, plasma IL-6, and TNFR1 and did not modify the associations between fat measures and cardiometabolic risk factors.