Retroviruses like HIV-1 enter the nucleus of immune cells to infect people, but it has been uncle... more Retroviruses like HIV-1 enter the nucleus of immune cells to infect people, but it has been unclear how a relatively large virus can pass through the nuclear envelope or its small nuclear pores. We found a previously unknown pathway of entry, in which a virus-containing package causes invaginations to form in the nuclear envelope. Our work reveals new drug targets for limiting viral infections.
Metastases are responsible for the vast majority of cancer deaths, yet most therapeutic efforts h... more Metastases are responsible for the vast majority of cancer deaths, yet most therapeutic efforts have focused on targeting and interrupting tumor growth rather than impairing the metastatic process. Traditionally, cancer metastasis is attributed to the dissemination of neoplastic cells from the primary tumor to distant organs through blood and lymphatic circulation. A thorough understanding of the metastatic process is essential to develop new therapeutic strategies that improve cancer survival. Since Paget’s original description of the “Seed and Soil” hypothesis over a hundred years ago, alternative theories and new players have been proposed. In particular, the role of extracellular vesicles (EVs) released by cancer cells and their uptake by neighboring cells or at distinct anatomical sites has been explored. Here, we will outline and discuss these alternative theories and emphasize the horizontal transfer of EV-associated biomolecules as a possibly major event leading to cell tran...
Firearm related mortality in the USA surpassed all other developed countries. This study hypothes... more Firearm related mortality in the USA surpassed all other developed countries. This study hypothesizes that injury patterns, weapon type, and mortality differ between suicide groups as opposed to homicide. The American College of Surgeons National Trauma Database was queried from January 2017 to December 2019. All firearm related injuries were included, and weapon type was abstracted. Differences between homicide and suicide groups by sex, age, race, and injury severity were compared using a Mann–Whitney test for numerical data and Fisher’s exact test for categorical data. The association between weapon type and mortality relative to suicide as opposed to homicide was assessed in Fisher’s exact tests. Significance was defined as p < 0.05. There were 100,031 homicide and 11,714 suicide subjects that met inclusion criteria. Homicides were mostly assault victims (97.6%), male (88%), African–American (62%), had less severe injury (mean (ISS) 12.07) and a median age of 20 years old (IQ...
Objectives Intracranial pressure (ICP) monitoring is recommended for severe traumatic brain injur... more Objectives Intracranial pressure (ICP) monitoring is recommended for severe traumatic brain injuries (TBI) but some data suggests it may not improve outcomes. The objective was to investigate the effect of ICP monitoring among TBI. Methods This retrospective observational cohort study (1/1/2015–6/1/2020) included severe TBI patients. Outcomes [discharge destination, length of stay (LOS)] were compared by ICP monitoring and were stratified by GCS (3 vs. 4–8), α < 0.05. Results Of the123 patients who met inclusion criteria, 47% received ICP monitoring. There were baseline differences in the two groups characteristics, ICP monitored patients were younger (p = 0.02), had a subarachnoid hemorrhage less often (p = 0.04), and a subdural hematoma more often (p = 0.04) than those without ICP monitors. ICP monitored patients had a significantly longer median LOS (12 vs. 3, p < 0.01) than patients without monitoring. There was a trend towards more ICP monitored patients discharged home (...
Background: : Despite limited evidence, aquatic programming has the potential to be an ideal inte... more Background: : Despite limited evidence, aquatic programming has the potential to be an ideal intervention for young children with disabilities because of its unique and dynamic properties. This study explored the impact of an aquatic developmental play program in addressing sensory integration and motor development needs of children with disabilities as well as its impact on parental isolation. Methods: : A case series design was used. Children with disabilities under 3 years of age and their parents participated in a 9-week aquatic developmental play program held in the community. Goals were individualized for each participant and monitored using the Goal Attainment Scaling (GAS) method. The Sensory Profile 2, the Developmental Assessment of Young Children-Second Edition (DAYC-2), and a Parent Support Survey were administered before and after the study. Results: : Seventy-nine percent of the individual goals were met or exceeded expectations among the 11 participants with categorical changes observed on the Sensory Profile 2 and the DAYC-2. Parental satisfaction with services increased and parental feelings of isolation decreased following the aquatic play program. Conclusion: : The results suggest that aquatic programming held in the community may be beneficial not only for the individual needs of children with disabilities but also for the needs of parents.
Supplemental Material, sj-docx-2-jpx-10.1177_23743735211007700 for Online Ratings of Primary Care... more Supplemental Material, sj-docx-2-jpx-10.1177_23743735211007700 for Online Ratings of Primary Care Physicians: Comparison of Gender, Training, and Specialty by Daliah Wachs, Victoria Lorah, Allison Boynton, Amanda Hertzler, Brandon Nichols, Joseph Kraft, Jerry Wang, Ivy Dang, Paul Kalekas and Cheryl Vanier in Journal of Patient Experience
This m anuscript h as been reproduced ffiom the microfilm m aster. UMI films the text directly fr... more This m anuscript h as been reproduced ffiom the microfilm m aster. UMI films the text directly from the original or copy submitted. Thus, som e th esis and dissertation copies are in typewriter face, while others may t>e from any type of computer printer. The q u ality o f th is reproduction Is d ep en d en t upon th e q u ality o f th e copy su b m itte d. Broken or irxiistinct print colored or poor quality illustrations and photographs, print t)leedthrough. substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event th at the author did not serxi UMI a com plete manuscript and there a re missing pages, th ese will be noted. Also, if unauthorized copyright material had to t>e removed, a note will irxiicate the deletion. Oversize m aterials (e.g.. maps, drawings, charts) are reproduced by sectioning th e original, beginning a t th e upper left-hand com er and continuing from left to right in equal sections with small overlaps. Photographs included in the original manuscript have b een reproduced xerographically in this copy. Higher quality 6" x 9" black and white photographic prints are availat)le for any photographs o r illustrations appearing In this copy for an additional charge. Contact UMI dbectly to order.
Supplemental material, sj-pdf-1-ccn-10.1177_2059700220947194 for Interval-censored survival analy... more Supplemental material, sj-pdf-1-ccn-10.1177_2059700220947194 for Interval-censored survival analysis of mild traumatic brain injury with outcome based neuroimaging clinical applications by Cheryl Vanier, Trisha Pandey, Shaunaq Parikh, Alan Rodriguez, Thomas Knoblauch, John Peralta, Amanda Hertzler, Leon Ma, Ruslan Nam, Sami Musallam, Hallie Taylor, Taylor Vickery, Yolanda Zhang, Logan Ranzenberger, Andrew Nguyen, Mike Kapostasy, Alex Asturias, Enrico Fazzini and Travis Snyder in Journal of Concussion
Background: In the most general sense, studies involving global analysis of gene expression aim t... more Background: In the most general sense, studies involving global analysis of gene expression aim to provide a comprehensive catalog of the components involved in the production of recognizable cellular phenotypes. These studies are often limited by the available technologies. One technology, based on microarrays, categorizes gene expression in terms of the abundance of RNA transcripts, and typically employs RNA prepared from whole cells, where cytoplasmic RNA predominates. Results: Using microarrays comprising oligonucleotide probes that represent either proteincoding transcripts or microRNAs (miRNA), we have studied global transcript accumulation patterns for the HepG2 (human hepatoma) cell line. Through subdividing the total pool of RNA transcripts into samples from nuclei, the cytoplasm, and whole cells, we determined the degree of correlation of these patterns across these different subcellular locations. The transcript and miRNA abundance patterns for the three RNA fractions were largely similar, but with some exceptions: nuclear RNA samples were enriched with respect to the cytoplasm in transcripts encoding proteins associated with specific nuclear functions, such as the cell cycle, mitosis, and transcription. The cytoplasmic RNA fraction also was enriched, when compared to the nucleus, in transcripts for proteins related to specific nuclear functions, including the cell cycle, DNA replication, and DNA repair. Some transcripts related to the ubiquitin cycle, and transcripts for various membrane proteins were sorted into either the nuclear or cytoplasmic fractions. Conclusion: Enrichment or compartmentalization of cell cycle and ubiquitin cycle transcripts within the nucleus may be related to the regulation of their expression, by preventing their translation to proteins. In this way, these cellular functions may be tightly controlled by regulating the release of mRNA from the nucleus and thereby the expression of key rate limiting steps in these pathways. Many miRNA precursors were also enriched in the nuclear samples, with significantly fewer being enriched in the cytoplasm. Studies of mRNA localization will help to clarify the roles RNA processing and transport play in the regulation of cellular function.
Epigenetic variation is a potential source of genomic and phenotypic variation among different in... more Epigenetic variation is a potential source of genomic and phenotypic variation among different individuals in a population, and among different varieties within a species. We used a two-tiered approach to identify naturally occurring epigenetic alleles in the flowering plant Arabidopsis: a primary screen for transcript level polymorphisms among three strains (Col, Cvi, Ler), followed by a secondary screen for epigenetic alleles. Here, we describe the identification of stable, meiotically transmissible epigenetic alleles that correspond to one member of a previously uncharacterized non-LTR retroposon family, which we have designated Sadhu. The pericentromeric At2g10410 element is highly expressed in strain Col, but silenced in Ler and 18 other strains surveyed. Transcription of this locus is inversely correlated with cytosine methylation and both the expression and DNA methylation states map in a Mendelian manner to stable cis-acting variation. The silent Ler allele can be converted ...
Background: Patients with diminished GH secretion are candidates for GH therapy (GHT). The GH sti... more Background: Patients with diminished GH secretion are candidates for GH therapy (GHT). The GH stimulation test (GHST) is considered the gold standard for the diagnosis of GH deficiency (GHD), yet the cutoff of 10 ng/mL has not been well validated statistically. Another proposed method to define GHD has been to measure patients’ pituitary volumes (PV), as the size of the gland may correlate with the amount of GH produced. Objective: This study seeks to ascertain whether the GHST or PV is a better predictor of response to GHT, and determine which method can better define true GHD. Patients and Methods: A database at a Pediatric Endocrinology center was queried for patients aged 6-18 yrs who underwent a GHST, MRI, and GHT between 1/2018 - 6/2019. Patients with relevant comorbidities, those with GHST peak ≥ 10.0 ng/mL, and patients that were non-adherent to their GHT were excluded. Clonidine and L-dopa were stimulants for the GHST. MRIs were acquired on a Philips 1.5 or 3.0 T scanner (1...
Background Apprehensions of undocumented immigrants in the Rio Grande Valley sector of the U.S.-M... more Background Apprehensions of undocumented immigrants in the Rio Grande Valley sector of the U.S.-Mexico border have grown to account for nearly half of all apprehensions at the border. The purpose of this study is to report the prevalence, mechanism, and pattern of traumatic injuries sustained by undocumented immigrants who crossed the U.S.-Mexico border at the Rio Grande Valley sector over a span of 5 years and were treated at a local American College of Surgeons verified Level II trauma center. Methods A retrospective chart review was conducted from January 2014 to December 2019. Demographics, comorbidities, injury severity score (ISS), mechanism of injury, anatomical part of the body affected, hospital and ICU length of stay (LOS), and treatment costs were analyzed. Descriptive statistics for demographics, injury location and cause, and temporal trends are reported. The impact of ISS or surgical intervention on hospital LOS was analyzed using an analysis of covariance (ANCOVA). Re...
Declining lecture attendance has been an ongoing concern for educators involved in undergraduate ... more Declining lecture attendance has been an ongoing concern for educators involved in undergraduate medical education. A survey was developed (a) to gain insight into the reasons students skipped class, (b) to identify the type of study materials they were using, and (c) to determine what they thought would motivate them to come to class. The survey was sent to 317 first-year and second-year medical students, and 145 (45%) responded. Only 63% of first-year students and 53% of second-year students attended any lectures that were not mandatory. The attendance was higher for students who aspired to less competitive specialties such as pediatrics and family medicine. The most popular reasons for not coming to class were related to the efficiency of information intake and instructor or class style. The most heavily used resources (> 60%) were materials or recorded lectures provided by the instructor. The second-year students also heavily used outside study materials for Board exams, such...
Trends in Physicians’ Opioid Prescription Patterns Since Implementation of Nevada’s New Controlle... more Trends in Physicians’ Opioid Prescription Patterns Since Implementation of Nevada’s New Controlled Substances Law Spencer Foutz, OMS-II; Email [email protected] Dallin Gillette, OMS-II Cheryl Vanier PhD, Data and Research Analyst Senator Joseph Hardy MD, Associate Dean of Clinical Education Weldon Havins, MD, JD, LLM, FCLM, Associate Dean and Professor of Medical Jurisprudence, Touro University Nevada, Henderson, NV On January 1, 2018, in an attempt to curb Nevada’s opioid epidemic, Assembly Bill 474 (AB474) went into effect. The first bill of its kind, AB474 limits healthcare providers’ ability to prescribe not only opioids, but all controlled substances. Advocates of AB474 state that the bill is key to reducing the number of opioid-related deaths in Nevada. Others state that the mandates in the bill restrict healthcare providers to such a degree that many patients with pain will no longer be treated effectively. This study aims to identify the specific trend of opioid prescribing patterns of Nevada physicians (both allopathic and osteopathic) by specialty and location in response to the implementation of AB474. Using data obtained from the Nevada State Board of Pharmacy, a retrospective analysis of total opioid prescriptions and dosage was performed. De-identified physician data from 2013-2018 was grouped by specialty and county (i.e., pediatricians, Clark county). Special care was taken to preserve physician privacy; as such, all counties other than Clark and Washoe were grouped as “Rural.” The study details changes in Nevada physicians’ prescribing patterns in reaction to the new controlled substance prescribing statutes. Some specialties seem to be inordinately impacted, raising both questions concerning adequate access to pain treating medications and questions regarding previous overprescribing patterns. Further research must be accomplished to elucidate the benefits, or harm, to patients by the unprecedented, restrictive mandates promulgated. Specifically, changes in prevalence of prescription opioids vs. illicit opioid-related deaths, and analysis of the effects of restricting non-opioid controlled substances in addressing Nevada’s opioid epidemic should be investigated. 2020 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2020, VOL. 40, NO. S1, 9 https://doi.org/10.1080/01947648.2020.1715730
The Journal of the American Osteopathic Association, 2020
Abstract Objective To assess the attitudes of academic deans at colleges of osteopathic medicine ... more Abstract Objective To assess the attitudes of academic deans at colleges of osteopathic medicine (COMs) and chairs of COMs’ osteopathic manipulative medicine (OMM) departments toward osteopathic recognition under the single graduate medical education (GME) accreditation system. Methods An 11-item Likert-type survey with additional demographic questions was distributed via email to deans and OMM department chairs at 51 COMs and additional locations in September 2017. Items were formulated to assess survey participants’ understanding and beliefs regarding the value and support of the establishment of osteopathic recognition within the single GME accreditation system. Demographic information gathered was limited to role (ie, dean or OMM department chair). Survey items were ranked on a 5-point Likert-type scale from strongly disagree to strongly agree. Results A total of 39 COMs deans and 24 OMM chairs indicated they understood the intent of osteopathic recognition in a single GME accreditation system, but OMM chairs felt less informed about osteopathic recognition than deans (17% vs 3% disagreeing with the statement, “I have been adequately informed about osteopathic recognition”). There was no difference between deans and chairs regarding their attitudes toward osteopathic recognition in residency training programs, though a minority of deans (n=2) disagreed that osteopathic recognition benefits programs and indicated that they did not recommend it for surgical specialties (n=2) or fellowship programs (n=3). Deans and chairs generally agreed on their overall support of osteopathic recognition, the perceptions of osteopathic medical students toward osteopathic recognition, and the value that osteopathic recognition brings to COMs, with 2 deans dissenting on each item. A moderate correlation was found between information of and attitude toward osteopathic recognition for the deans (r=0.72, n=39), but a much weaker relationship was observed between information and attitude for the chairs (r=0.37, n=24) (difference between the correlations: z=1.89, P=.06). Conclusion Although the deans and OMM chairs agreed that they support, believe in the value of, and find that osteopathic medical students are interested in osteopathic recognition, there is an opportunity for improvement of deans’ and COMs chairs’ understanding of osteopathic recognition.
With the introduction of McMaster University's problem-based, self-directed learning and cognitiv... more With the introduction of McMaster University's problem-based, self-directed learning and cognitive integration in the medical school curriculum, learning in small groups has been gaining popularity with medical schools worldwide. Problem-based learning (PBL) places emphasis on the value of basic medical sciences as the basis of learning medicine using clinical problems. For a successful outcome, a PBL curriculum needs to have a student-centered learning environment, problem-based design and facilitation, and assessment of learning in PBL domains. We describe a PBL program that has been used for undergraduate medical education, including changes made to learning resources and assessment. The changes required input from both faculty educators and students, and success depended on buy-in into the process. One of the changes included implementing the use of standard textbooks, which students use as the primary source of information during self-directed learning. Another change was the use of several reliable, valid, and cost-effective high-stakes written exams from internal and external sources, to promote spaced retrieval of biomedical facts and clinical contexts. By making these and other changes, we have been able to achieve pass rates and board scores which are consistently above the national average for 12 years. We conclude that in order to ensure sustainable successful outcomes, it is important to keep our program dynamic by making improvements in the PBL domains and assessment methods, taking into consideration students' course evaluations of the learning environment.
Abiotic stress, including drought, cold, high temperature and UV radiation, produce common respon... more Abiotic stress, including drought, cold, high temperature and UV radiation, produce common responses in plant tissue, resulting in the overproduction of Reactive Oxygen Species (ROS). ROS molecules damage cell membranes and disrupt plant metabolism. Our previous experiments indicated that naturally chelated/complexed foliar nutritional supplement products reduce the amount of ROS molecules formed under stress conditions. In this study, we investigated the short-term effect of the novel proprietary biostimulant CYT31 on gene expression in plants exposed to drought using Arabidopsis thaliana grown under controlled conditions. Plants were sprayed with biostimulant CYT31 (treated) or water (control). One hour after spraying, plants were exposed to drought conditions for one, two or four hours. Tissue was collected for two-color microarray and cell damage analysis. Tissue damage was evaluated using an electrolyte leakage-detection method. Drought stress up-regulated over 245 genes involved in water deprivation, redox and stress response. The gene response was influenced by the severity of the stress and correlated with tissue damage. The up-regulation of these genes was significantly altered in the tissue treated with biostimulant CYT31, suggesting the activation of several mechanisms leading to the reduction of tissue injury. Gene activation was confirmed by quantitative polymerase chain reaction (qPCR) analysis. This paper describes a proposed model for metabolic pathways activated by biostimulant CYT31 in plants exposed to drought stress.
Elevated atmospheric CO2 ([CO2]) is assumed to increase primary production, particularly in deser... more Elevated atmospheric CO2 ([CO2]) is assumed to increase primary production, particularly in desert systems through stimulatory effects on plant water-use efficiency. We examined the effects of elevated [CO2] at the Nevada Desert FACE (Free-air CO2 Enrichment) Facility (NDFF) in an intact Mojave Desert ecosystem. At the NDFF, ambient and elevated [CO2] levels were 360 and 550 μmol mol-1 [CO2], respectively. CO2 treatments were applied continuously from 1997-2007 in intact plots 25 m in diameter. While other studies focused on soil and root responses to elevated [CO2], our study focused on aboveground production of annuals and perennial plants. In 1997, diameters and heights of all perennial individuals were recorded and mapped. In 2007, diameters and heights were re-measured and aboveground biomass was harvested for every mapped perennial individual. Harvest data were used to construct regressions for twenty perennial species to predict starting biomass based on diameters and heights...
Retroviruses like HIV-1 enter the nucleus of immune cells to infect people, but it has been uncle... more Retroviruses like HIV-1 enter the nucleus of immune cells to infect people, but it has been unclear how a relatively large virus can pass through the nuclear envelope or its small nuclear pores. We found a previously unknown pathway of entry, in which a virus-containing package causes invaginations to form in the nuclear envelope. Our work reveals new drug targets for limiting viral infections.
Metastases are responsible for the vast majority of cancer deaths, yet most therapeutic efforts h... more Metastases are responsible for the vast majority of cancer deaths, yet most therapeutic efforts have focused on targeting and interrupting tumor growth rather than impairing the metastatic process. Traditionally, cancer metastasis is attributed to the dissemination of neoplastic cells from the primary tumor to distant organs through blood and lymphatic circulation. A thorough understanding of the metastatic process is essential to develop new therapeutic strategies that improve cancer survival. Since Paget’s original description of the “Seed and Soil” hypothesis over a hundred years ago, alternative theories and new players have been proposed. In particular, the role of extracellular vesicles (EVs) released by cancer cells and their uptake by neighboring cells or at distinct anatomical sites has been explored. Here, we will outline and discuss these alternative theories and emphasize the horizontal transfer of EV-associated biomolecules as a possibly major event leading to cell tran...
Firearm related mortality in the USA surpassed all other developed countries. This study hypothes... more Firearm related mortality in the USA surpassed all other developed countries. This study hypothesizes that injury patterns, weapon type, and mortality differ between suicide groups as opposed to homicide. The American College of Surgeons National Trauma Database was queried from January 2017 to December 2019. All firearm related injuries were included, and weapon type was abstracted. Differences between homicide and suicide groups by sex, age, race, and injury severity were compared using a Mann–Whitney test for numerical data and Fisher’s exact test for categorical data. The association between weapon type and mortality relative to suicide as opposed to homicide was assessed in Fisher’s exact tests. Significance was defined as p < 0.05. There were 100,031 homicide and 11,714 suicide subjects that met inclusion criteria. Homicides were mostly assault victims (97.6%), male (88%), African–American (62%), had less severe injury (mean (ISS) 12.07) and a median age of 20 years old (IQ...
Objectives Intracranial pressure (ICP) monitoring is recommended for severe traumatic brain injur... more Objectives Intracranial pressure (ICP) monitoring is recommended for severe traumatic brain injuries (TBI) but some data suggests it may not improve outcomes. The objective was to investigate the effect of ICP monitoring among TBI. Methods This retrospective observational cohort study (1/1/2015–6/1/2020) included severe TBI patients. Outcomes [discharge destination, length of stay (LOS)] were compared by ICP monitoring and were stratified by GCS (3 vs. 4–8), α < 0.05. Results Of the123 patients who met inclusion criteria, 47% received ICP monitoring. There were baseline differences in the two groups characteristics, ICP monitored patients were younger (p = 0.02), had a subarachnoid hemorrhage less often (p = 0.04), and a subdural hematoma more often (p = 0.04) than those without ICP monitors. ICP monitored patients had a significantly longer median LOS (12 vs. 3, p < 0.01) than patients without monitoring. There was a trend towards more ICP monitored patients discharged home (...
Background: : Despite limited evidence, aquatic programming has the potential to be an ideal inte... more Background: : Despite limited evidence, aquatic programming has the potential to be an ideal intervention for young children with disabilities because of its unique and dynamic properties. This study explored the impact of an aquatic developmental play program in addressing sensory integration and motor development needs of children with disabilities as well as its impact on parental isolation. Methods: : A case series design was used. Children with disabilities under 3 years of age and their parents participated in a 9-week aquatic developmental play program held in the community. Goals were individualized for each participant and monitored using the Goal Attainment Scaling (GAS) method. The Sensory Profile 2, the Developmental Assessment of Young Children-Second Edition (DAYC-2), and a Parent Support Survey were administered before and after the study. Results: : Seventy-nine percent of the individual goals were met or exceeded expectations among the 11 participants with categorical changes observed on the Sensory Profile 2 and the DAYC-2. Parental satisfaction with services increased and parental feelings of isolation decreased following the aquatic play program. Conclusion: : The results suggest that aquatic programming held in the community may be beneficial not only for the individual needs of children with disabilities but also for the needs of parents.
Supplemental Material, sj-docx-2-jpx-10.1177_23743735211007700 for Online Ratings of Primary Care... more Supplemental Material, sj-docx-2-jpx-10.1177_23743735211007700 for Online Ratings of Primary Care Physicians: Comparison of Gender, Training, and Specialty by Daliah Wachs, Victoria Lorah, Allison Boynton, Amanda Hertzler, Brandon Nichols, Joseph Kraft, Jerry Wang, Ivy Dang, Paul Kalekas and Cheryl Vanier in Journal of Patient Experience
This m anuscript h as been reproduced ffiom the microfilm m aster. UMI films the text directly fr... more This m anuscript h as been reproduced ffiom the microfilm m aster. UMI films the text directly from the original or copy submitted. Thus, som e th esis and dissertation copies are in typewriter face, while others may t>e from any type of computer printer. The q u ality o f th is reproduction Is d ep en d en t upon th e q u ality o f th e copy su b m itte d. Broken or irxiistinct print colored or poor quality illustrations and photographs, print t)leedthrough. substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event th at the author did not serxi UMI a com plete manuscript and there a re missing pages, th ese will be noted. Also, if unauthorized copyright material had to t>e removed, a note will irxiicate the deletion. Oversize m aterials (e.g.. maps, drawings, charts) are reproduced by sectioning th e original, beginning a t th e upper left-hand com er and continuing from left to right in equal sections with small overlaps. Photographs included in the original manuscript have b een reproduced xerographically in this copy. Higher quality 6" x 9" black and white photographic prints are availat)le for any photographs o r illustrations appearing In this copy for an additional charge. Contact UMI dbectly to order.
Supplemental material, sj-pdf-1-ccn-10.1177_2059700220947194 for Interval-censored survival analy... more Supplemental material, sj-pdf-1-ccn-10.1177_2059700220947194 for Interval-censored survival analysis of mild traumatic brain injury with outcome based neuroimaging clinical applications by Cheryl Vanier, Trisha Pandey, Shaunaq Parikh, Alan Rodriguez, Thomas Knoblauch, John Peralta, Amanda Hertzler, Leon Ma, Ruslan Nam, Sami Musallam, Hallie Taylor, Taylor Vickery, Yolanda Zhang, Logan Ranzenberger, Andrew Nguyen, Mike Kapostasy, Alex Asturias, Enrico Fazzini and Travis Snyder in Journal of Concussion
Background: In the most general sense, studies involving global analysis of gene expression aim t... more Background: In the most general sense, studies involving global analysis of gene expression aim to provide a comprehensive catalog of the components involved in the production of recognizable cellular phenotypes. These studies are often limited by the available technologies. One technology, based on microarrays, categorizes gene expression in terms of the abundance of RNA transcripts, and typically employs RNA prepared from whole cells, where cytoplasmic RNA predominates. Results: Using microarrays comprising oligonucleotide probes that represent either proteincoding transcripts or microRNAs (miRNA), we have studied global transcript accumulation patterns for the HepG2 (human hepatoma) cell line. Through subdividing the total pool of RNA transcripts into samples from nuclei, the cytoplasm, and whole cells, we determined the degree of correlation of these patterns across these different subcellular locations. The transcript and miRNA abundance patterns for the three RNA fractions were largely similar, but with some exceptions: nuclear RNA samples were enriched with respect to the cytoplasm in transcripts encoding proteins associated with specific nuclear functions, such as the cell cycle, mitosis, and transcription. The cytoplasmic RNA fraction also was enriched, when compared to the nucleus, in transcripts for proteins related to specific nuclear functions, including the cell cycle, DNA replication, and DNA repair. Some transcripts related to the ubiquitin cycle, and transcripts for various membrane proteins were sorted into either the nuclear or cytoplasmic fractions. Conclusion: Enrichment or compartmentalization of cell cycle and ubiquitin cycle transcripts within the nucleus may be related to the regulation of their expression, by preventing their translation to proteins. In this way, these cellular functions may be tightly controlled by regulating the release of mRNA from the nucleus and thereby the expression of key rate limiting steps in these pathways. Many miRNA precursors were also enriched in the nuclear samples, with significantly fewer being enriched in the cytoplasm. Studies of mRNA localization will help to clarify the roles RNA processing and transport play in the regulation of cellular function.
Epigenetic variation is a potential source of genomic and phenotypic variation among different in... more Epigenetic variation is a potential source of genomic and phenotypic variation among different individuals in a population, and among different varieties within a species. We used a two-tiered approach to identify naturally occurring epigenetic alleles in the flowering plant Arabidopsis: a primary screen for transcript level polymorphisms among three strains (Col, Cvi, Ler), followed by a secondary screen for epigenetic alleles. Here, we describe the identification of stable, meiotically transmissible epigenetic alleles that correspond to one member of a previously uncharacterized non-LTR retroposon family, which we have designated Sadhu. The pericentromeric At2g10410 element is highly expressed in strain Col, but silenced in Ler and 18 other strains surveyed. Transcription of this locus is inversely correlated with cytosine methylation and both the expression and DNA methylation states map in a Mendelian manner to stable cis-acting variation. The silent Ler allele can be converted ...
Background: Patients with diminished GH secretion are candidates for GH therapy (GHT). The GH sti... more Background: Patients with diminished GH secretion are candidates for GH therapy (GHT). The GH stimulation test (GHST) is considered the gold standard for the diagnosis of GH deficiency (GHD), yet the cutoff of 10 ng/mL has not been well validated statistically. Another proposed method to define GHD has been to measure patients’ pituitary volumes (PV), as the size of the gland may correlate with the amount of GH produced. Objective: This study seeks to ascertain whether the GHST or PV is a better predictor of response to GHT, and determine which method can better define true GHD. Patients and Methods: A database at a Pediatric Endocrinology center was queried for patients aged 6-18 yrs who underwent a GHST, MRI, and GHT between 1/2018 - 6/2019. Patients with relevant comorbidities, those with GHST peak ≥ 10.0 ng/mL, and patients that were non-adherent to their GHT were excluded. Clonidine and L-dopa were stimulants for the GHST. MRIs were acquired on a Philips 1.5 or 3.0 T scanner (1...
Background Apprehensions of undocumented immigrants in the Rio Grande Valley sector of the U.S.-M... more Background Apprehensions of undocumented immigrants in the Rio Grande Valley sector of the U.S.-Mexico border have grown to account for nearly half of all apprehensions at the border. The purpose of this study is to report the prevalence, mechanism, and pattern of traumatic injuries sustained by undocumented immigrants who crossed the U.S.-Mexico border at the Rio Grande Valley sector over a span of 5 years and were treated at a local American College of Surgeons verified Level II trauma center. Methods A retrospective chart review was conducted from January 2014 to December 2019. Demographics, comorbidities, injury severity score (ISS), mechanism of injury, anatomical part of the body affected, hospital and ICU length of stay (LOS), and treatment costs were analyzed. Descriptive statistics for demographics, injury location and cause, and temporal trends are reported. The impact of ISS or surgical intervention on hospital LOS was analyzed using an analysis of covariance (ANCOVA). Re...
Declining lecture attendance has been an ongoing concern for educators involved in undergraduate ... more Declining lecture attendance has been an ongoing concern for educators involved in undergraduate medical education. A survey was developed (a) to gain insight into the reasons students skipped class, (b) to identify the type of study materials they were using, and (c) to determine what they thought would motivate them to come to class. The survey was sent to 317 first-year and second-year medical students, and 145 (45%) responded. Only 63% of first-year students and 53% of second-year students attended any lectures that were not mandatory. The attendance was higher for students who aspired to less competitive specialties such as pediatrics and family medicine. The most popular reasons for not coming to class were related to the efficiency of information intake and instructor or class style. The most heavily used resources (> 60%) were materials or recorded lectures provided by the instructor. The second-year students also heavily used outside study materials for Board exams, such...
Trends in Physicians’ Opioid Prescription Patterns Since Implementation of Nevada’s New Controlle... more Trends in Physicians’ Opioid Prescription Patterns Since Implementation of Nevada’s New Controlled Substances Law Spencer Foutz, OMS-II; Email [email protected] Dallin Gillette, OMS-II Cheryl Vanier PhD, Data and Research Analyst Senator Joseph Hardy MD, Associate Dean of Clinical Education Weldon Havins, MD, JD, LLM, FCLM, Associate Dean and Professor of Medical Jurisprudence, Touro University Nevada, Henderson, NV On January 1, 2018, in an attempt to curb Nevada’s opioid epidemic, Assembly Bill 474 (AB474) went into effect. The first bill of its kind, AB474 limits healthcare providers’ ability to prescribe not only opioids, but all controlled substances. Advocates of AB474 state that the bill is key to reducing the number of opioid-related deaths in Nevada. Others state that the mandates in the bill restrict healthcare providers to such a degree that many patients with pain will no longer be treated effectively. This study aims to identify the specific trend of opioid prescribing patterns of Nevada physicians (both allopathic and osteopathic) by specialty and location in response to the implementation of AB474. Using data obtained from the Nevada State Board of Pharmacy, a retrospective analysis of total opioid prescriptions and dosage was performed. De-identified physician data from 2013-2018 was grouped by specialty and county (i.e., pediatricians, Clark county). Special care was taken to preserve physician privacy; as such, all counties other than Clark and Washoe were grouped as “Rural.” The study details changes in Nevada physicians’ prescribing patterns in reaction to the new controlled substance prescribing statutes. Some specialties seem to be inordinately impacted, raising both questions concerning adequate access to pain treating medications and questions regarding previous overprescribing patterns. Further research must be accomplished to elucidate the benefits, or harm, to patients by the unprecedented, restrictive mandates promulgated. Specifically, changes in prevalence of prescription opioids vs. illicit opioid-related deaths, and analysis of the effects of restricting non-opioid controlled substances in addressing Nevada’s opioid epidemic should be investigated. 2020 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2020, VOL. 40, NO. S1, 9 https://doi.org/10.1080/01947648.2020.1715730
The Journal of the American Osteopathic Association, 2020
Abstract Objective To assess the attitudes of academic deans at colleges of osteopathic medicine ... more Abstract Objective To assess the attitudes of academic deans at colleges of osteopathic medicine (COMs) and chairs of COMs’ osteopathic manipulative medicine (OMM) departments toward osteopathic recognition under the single graduate medical education (GME) accreditation system. Methods An 11-item Likert-type survey with additional demographic questions was distributed via email to deans and OMM department chairs at 51 COMs and additional locations in September 2017. Items were formulated to assess survey participants’ understanding and beliefs regarding the value and support of the establishment of osteopathic recognition within the single GME accreditation system. Demographic information gathered was limited to role (ie, dean or OMM department chair). Survey items were ranked on a 5-point Likert-type scale from strongly disagree to strongly agree. Results A total of 39 COMs deans and 24 OMM chairs indicated they understood the intent of osteopathic recognition in a single GME accreditation system, but OMM chairs felt less informed about osteopathic recognition than deans (17% vs 3% disagreeing with the statement, “I have been adequately informed about osteopathic recognition”). There was no difference between deans and chairs regarding their attitudes toward osteopathic recognition in residency training programs, though a minority of deans (n=2) disagreed that osteopathic recognition benefits programs and indicated that they did not recommend it for surgical specialties (n=2) or fellowship programs (n=3). Deans and chairs generally agreed on their overall support of osteopathic recognition, the perceptions of osteopathic medical students toward osteopathic recognition, and the value that osteopathic recognition brings to COMs, with 2 deans dissenting on each item. A moderate correlation was found between information of and attitude toward osteopathic recognition for the deans (r=0.72, n=39), but a much weaker relationship was observed between information and attitude for the chairs (r=0.37, n=24) (difference between the correlations: z=1.89, P=.06). Conclusion Although the deans and OMM chairs agreed that they support, believe in the value of, and find that osteopathic medical students are interested in osteopathic recognition, there is an opportunity for improvement of deans’ and COMs chairs’ understanding of osteopathic recognition.
With the introduction of McMaster University's problem-based, self-directed learning and cognitiv... more With the introduction of McMaster University's problem-based, self-directed learning and cognitive integration in the medical school curriculum, learning in small groups has been gaining popularity with medical schools worldwide. Problem-based learning (PBL) places emphasis on the value of basic medical sciences as the basis of learning medicine using clinical problems. For a successful outcome, a PBL curriculum needs to have a student-centered learning environment, problem-based design and facilitation, and assessment of learning in PBL domains. We describe a PBL program that has been used for undergraduate medical education, including changes made to learning resources and assessment. The changes required input from both faculty educators and students, and success depended on buy-in into the process. One of the changes included implementing the use of standard textbooks, which students use as the primary source of information during self-directed learning. Another change was the use of several reliable, valid, and cost-effective high-stakes written exams from internal and external sources, to promote spaced retrieval of biomedical facts and clinical contexts. By making these and other changes, we have been able to achieve pass rates and board scores which are consistently above the national average for 12 years. We conclude that in order to ensure sustainable successful outcomes, it is important to keep our program dynamic by making improvements in the PBL domains and assessment methods, taking into consideration students' course evaluations of the learning environment.
Abiotic stress, including drought, cold, high temperature and UV radiation, produce common respon... more Abiotic stress, including drought, cold, high temperature and UV radiation, produce common responses in plant tissue, resulting in the overproduction of Reactive Oxygen Species (ROS). ROS molecules damage cell membranes and disrupt plant metabolism. Our previous experiments indicated that naturally chelated/complexed foliar nutritional supplement products reduce the amount of ROS molecules formed under stress conditions. In this study, we investigated the short-term effect of the novel proprietary biostimulant CYT31 on gene expression in plants exposed to drought using Arabidopsis thaliana grown under controlled conditions. Plants were sprayed with biostimulant CYT31 (treated) or water (control). One hour after spraying, plants were exposed to drought conditions for one, two or four hours. Tissue was collected for two-color microarray and cell damage analysis. Tissue damage was evaluated using an electrolyte leakage-detection method. Drought stress up-regulated over 245 genes involved in water deprivation, redox and stress response. The gene response was influenced by the severity of the stress and correlated with tissue damage. The up-regulation of these genes was significantly altered in the tissue treated with biostimulant CYT31, suggesting the activation of several mechanisms leading to the reduction of tissue injury. Gene activation was confirmed by quantitative polymerase chain reaction (qPCR) analysis. This paper describes a proposed model for metabolic pathways activated by biostimulant CYT31 in plants exposed to drought stress.
Elevated atmospheric CO2 ([CO2]) is assumed to increase primary production, particularly in deser... more Elevated atmospheric CO2 ([CO2]) is assumed to increase primary production, particularly in desert systems through stimulatory effects on plant water-use efficiency. We examined the effects of elevated [CO2] at the Nevada Desert FACE (Free-air CO2 Enrichment) Facility (NDFF) in an intact Mojave Desert ecosystem. At the NDFF, ambient and elevated [CO2] levels were 360 and 550 μmol mol-1 [CO2], respectively. CO2 treatments were applied continuously from 1997-2007 in intact plots 25 m in diameter. While other studies focused on soil and root responses to elevated [CO2], our study focused on aboveground production of annuals and perennial plants. In 1997, diameters and heights of all perennial individuals were recorded and mapped. In 2007, diameters and heights were re-measured and aboveground biomass was harvested for every mapped perennial individual. Harvest data were used to construct regressions for twenty perennial species to predict starting biomass based on diameters and heights...
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Papers by Cheryl Vanier