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Search Results: 1 - 10 of 208807 matches for " Vicki L. Mahan "
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Clinical Trial Phases  [PDF]
Vicki L. Mahan
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.521175
Developers of drugs, biologicals, and medical devices must ensure product safety, demonstrate medical benefit in people, and mass produce the product. Preclinical development starts before clinical trials and the main goals are to determine safety and effectiveness of the intervention. If preclinical studies show that the therapy is safe and effective, clinical trials are started. Clinical trial phases are steps in the research to determine if an intervention would be beneficial or detrimental to humans and include Phases 0, I, II, III, IV, and V clinical studies. Understanding the basis of clinical trial phases will help researchers plan and implement clinical study protocols and, by doing so, improve the number of therapies coming to market for patients.
Vasoactive-Ventilation-Renal Score Predicts Cardiac Care Unit Length of Stay in Patients Undergoing Re-Entry Sternotomy: A Derivation Study  [PDF]
Vicki L. Mahan, Monika Gupta, Stephen Aronoff, David Bruni, Randy M. Stevens, Achintya Moulick
World Journal of Cardiovascular Surgery (WJCS) , 2018, DOI: 10.4236/wjcs.2018.81002
Abstract: Background: The vasoactive-ventilation-renal (VVR) score includes pulmonary and renal dysfunctions not previously addressed by the vasoactive inotrope score (VIS) and may be a better predictor of cardiac care unit (CCU) length of stay (LOS) in patients undergoing re-entry sternotomy (defined as no earlier than 30 days after previous sternotomy) for congenital heart disease (CHD). Methods: Patients undergoing re-entry sternotomy for CHD from August 1, 2009 to June 30, 2016 were studied retrospectively. A total of 96 patients undergoing 133 re-entry procedures were identified. VVR scores were calculated on CCU admission post-procedure (at 0 hour), 24-hour, and 48-hour after admission to the CCU. The response variable was CCU LOS.? Recursive partition analysis identified variables predicting LOS. Results: 133 re-entry sternotomies in 96 patients made up the samples of the database; 11 samples were removed due to incomplete data or placement on ECMO. Of the initial 25 features, 5 were removed for near zero variance and 3 categorical features were removed for non-information. Covariance analysis did not demonstrate any significant correlation amongst the remaining features. Initial recursive tree regression using ANOVA, cross validation and conditional predictive p-value (cp) = 0.01 produced 3 trees. The tree with lowest cross validation error was selected. The resulting 2 split trees with ventilator days less than 20 days and VVR score at 48 hours greater than 23 identified three CCU LOS groups with mean CCU LOS of 77.6, 55.1, and 9.5 days. Conclusions: Recursive partition analysis identified ventilator days greater than 20 days and the sub-population VVR at 48 hours as predictive of CCU LOS in
Inhaled Carbon Monoxide Provides Cerebral Cytoprotection in Pigs
Vicki L. Mahan, David Zurakowski, Leo E. Otterbein, Frank A. Pigula
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0041982
Abstract: Carbon monoxide (CO) at low concentrations imparts protective effects in numerous preclinical small animal models of brain injury. Evidence of protection in large animal models of cerebral injury, however, has not been tested. Neurologic deficits following open heart surgery are likely related in part to ischemia reperfusion injury that occurs during cardiopulmonary bypass surgery. Using a model of deep hypothermic circulatory arrest (DHCA) in piglets, we evaluated the effects of CO to reduce cerebral injury. DHCA and cardiopulmonary bypass (CPB) induced significant alterations in metabolic demands, including a decrease in the oxygen/glucose index (OGI), an increase in lactate/glucose index (LGI) and a rise in cerebral blood pressure that ultimately resulted in increased cell death in the neocortex and hippocampus that was completely abrogated in piglets preconditioned with a low, safe dose of CO. Moreover CO-treated animals maintained normal, pre-CPB OGI and LGI and corresponding cerebral sinus pressures with no change in systemic hemodynamics or metabolic intermediates. Collectively, our data demonstrate that inhaled CO may be beneficial in preventing cerebral injury resulting from DHCA and offer important therapeutic options in newborns undergoing DHCA for open heart surgery.
Innominate Artery Cannulation Access in Pediatric Patients Undergoing Redo Sternotomy  [PDF]
Lydia Ran, John Schultz, Jeeni Patel, Randy Stevens, Achintya Moulick, Vicki Mahan
World Journal of Cardiovascular Surgery (WJCS) , 2016, DOI: 10.4236/wjcs.2016.69018
Abstract: Redo sternotomy in pediatric patients can be complicated due to the unsuitability of many arterial cannulation sites for the pediatric population. Innominate artery cannulation provides a safe and easily reproducible alternative and prevents many of the disadvantages seen in femoral and axillary artery cannulation. Its use in pediatric cardiac surgery has seen a rise [1]. Herein, we describe the technique for innominate artery cannulation in pediatric patients undergoing redo sternotomy and review our experience with the technique.
Hemodynamic Changes and Clinical Outcomes after the Intra/Extracardiac Fenestrated Fontan Procedure  [PDF]
Naveen Menon, Chihyang Lin, Cesar I. Mesia, Achintya Moulick, Randy Stevens, Vicki Mahan
World Journal of Cardiovascular Surgery (WJCS) , 2018, DOI: 10.4236/wjcs.2018.82004
Abstract: Background: The primary concern of the Fontan procedure has been atrial arrhythmias, but little attention has been given to hemodynamic changes. This study’s purpose was to examine the hemodynamics and arrhythmias of the Intra/extracardiac fenestrated Fontan, and determine any advantages/disadvantages of this newer Fontan procedure. Methods: Patients undergoing the intra/ extracardiac fenestrated Fontan procedure at this institute between December 2009 and June 2017 were included in this retrospective evaluation of preoperative and postoperative hemodynamics during cardiac catheterization. End Diastolic Pressure (EDP), Pulmonary Artery Pressure (PAP), Left Atrial Pressure (LAP), and Transpulmonary Gradient (TPG) were the hemodynamic markers of interest. Occurrence of arrhythmias was also examined preoperatively, less than 2 weeks postoperatively, and greater than 2 weeks postoperatively. Morbidities and mortalities were also evaluated. Results: Fourteen patients underwent the procedure between December 2009 and June 2017. Preoperative data was available in all of these patients. Postoperative data was partially incomplete for atrial arrhythmias and hemodynamic data. EDP rose from 9.29 ± 3.50 mmHg to 10.33 ± 3.12 mmHg. PAP rose from 12.57 ± 2.50 mmHg to 14.27 mmHg. TPG dropped from 5.00 ± 2.29 mmHg to 3.25 ± 1.67 mmHg. LAP rose from 7.57 ±
A Review of Pediatric Cardiovascular Risk Factors and Current Guidelines  [PDF]
Deeksha Sarma, Lawrence M. Benedict, Achintya Moulick, Randy Stevens, Vicki Mahan
World Journal of Cardiovascular Surgery (WJCS) , 2018, DOI: 10.4236/wjcs.2018.84007
Abstract: Dyslipidemia is a highly prevalent condition, and includes a collection of diseases that cause increased levels of plasma triglycerides and/or cholestrol, or decreased levels of HDL-C, with a prototypical disease being familial hypercholesterolemia. Dyslipidemic conditions promote increased atherogenesis through the oxidation of lipids by macrophages, and an increased response to injury by the vascular endothelium. This vascular damage, loss of vascular compliance, and overall hardening of arteries lead to sequellae such as cardiovascular disease, cerebrovascular events, and aneurysm formation. It has been established that certain risk factors predispose individuals to the sequellae of atherosclerosis, including smoking, diabetes, hypertension, and hyperlipidemia. However, studies show that these risk factors can be seen in children as well. This review aims to assess the effect of these risk factors and demonstrate their effects through adolescence into adulthood.
Circadian Oscillations within the Hippocampus Support Memory Formation and Persistence
Kristin L. Eckel-Mahan
Frontiers in Molecular Neuroscience , 2012, DOI: 10.3389/fnmol.2012.00046
Abstract: The ability to sustain memories over long periods of time, sometimes even a lifetime, is one of the most remarkable properties of the brain. Much knowledge has been gained over the past few decades regarding the molecular correlates of memory formation. Once a memory is forged, however, the molecular events that provide permanence are as of yet unclear. Studies in multiple organisms have revealed that circadian rhythmicity is important for the formation, stability, and recall of memories (Gerstner et al., 2009).The neuronal events that provide this link need to be explored further. This article will discuss the findings related to the circadian regulation of memory-dependent processes in the hippocampus. Specifically, the circadian-controlled mitogen-activated protein kinase (MAPK) and cAMP signal transduction pathway plays critical roles in the consolidation of hippocampus-dependent memory. A series of studies have revealed the circadian oscillation of this pathway within the hippocampus, an activity that is absent in memory-deficient, transgenic mice lacking Ca2+-stimulated adenylyl cyclases. Interference with these oscillations proceeding the cellular memory consolidation period impairs the persistence of hippocampus-dependent memory. These data suggest that the persistence of long-term memories may depend upon reactivation of this signal transduction pathway in the hippocampus during the circadian cycle. New data reveals the dependence of hippocampal oscillation in MAPK activity on the suprachiasmatic nucleus, again underscoring the importance of this region in maintaining the circadian physiology of memory. Finally, the downstream ramification of these oscillations in terms of gene expression and epigenetics should be considered, as emerging evidence is pointing strongly to a circadian link between epigenetics and long-term synaptic plasticity.
Review Essay: Perspektive und Balance: Qualitative Forschungsmethoden in der Psychologie Review Essay: Perspective and Balance: Considering Qualitative Research Methods in Psychology Ensayo: Perspectiva y balance: Considerando métodos cualitativos de investigación en psicología
Vicki L. Magee
Forum : Qualitative Social Research , 2002,
Abstract: Der von Mary KOPALA und Lisa A. SUZUKI's herausgegebene Band Using qualitative methods in psychology ist mit 237 Seiten ein Muss für alle, die sich für dieses Thema interessieren. Die Autor(inn)en der insgesamt 17 Kapitel besch ftigen sich mit Fragen wie: Warum spielen quantitative Verfahren eine so dominante Rolle in der Psychologie? Wie ist es um die Reliabilit t von Befunden aus qualitativen Forschungsarbeiten bestellt? Wie k nnen qualitative und quantitative Verfahren kombiniert werden? Welche ethischen Implikationen sind mit einem qualitativen Forschungsansatz verbunden? Was ist notwendig, um qualitative Forschungsarbeiten in renommierten Zeitschriften ver ffentlichen zu k nnen? Beinahe die H lfte der Kapitel geben zudem ausgezeichnete Beispiele qualitativ-psychologischer Untersuchungen. Und trotz einiger (unumg nglicher?) Beschr nkungen schlie t das von KOPALA und SUZUKI's herausgegebene Buch für die psychologische Literatur eine Lücke, was Fragen der Anwendung qualitativer Methoden in der Psychologie angeht. URN: urn:nbn:de:0114-fqs0201234 Mary KOPALA and Lisa A. SUZUKI's edited volume, Using qualitative methods in psychology, offers a great deal in its 237 pages and is a must read for anyone interested in more fully understanding the conversation on this topic. The authors of the book's seventeen chapters address such questions as: why has psychology placed primacy on quantitative methods; how reliable are the results of qualitative research; how can quantitative and qualitative approaches be combined; what ethics guide this approach; and what is needed to get qualitative articles published in reputable journals? Nearly half of the chapters provide excellent examples of qualitative research investigations in psychology. Although the book has some limitations, KOPALA and SUZUKI's book fills a gap in psychological literature regarding the use of qualitative research methods in psychology. URN: urn:nbn:de:0114-fqs0201234 Volumen editado por Mary KOPALA y Lisa A. SUZUKI's, Using qualitative methods in psychology, ofrecen mucho en sus 237 paginas y es algo que debe ser leido por cualquiera interesado en comprender lo que se esta discutiendo actualmente sobre el tema. Los autores de los 17 capitulos del libro ubican cuestiones como: porque la psicologia a dado primacia a los metodos cuantitativos?; cuan confiables son los resultados de las investigaciones cuantitativas?; como pueden combinarse metodos cuantitativos y cualitativos?; que etica guia este enfoque y que se necesita para conseguir la publicacion de investigaciones cualitativas en journals r
Active Galactic Nuclei surveys with goya on the gtc
Vicki L. Sarajedini
Revista mexicana de astronomía y astrofísica , 2007,
Abstract: Active Galactic Nuclei candidates can be identified in deep, multi-wavelength surveys using a variety of techniques. Here we discuss some of these methods, recent results from the Groth Survey Strip AGN survey, and the application of these techniques to the selec- tion of AGN candidates for the GOYA survey with EMIR on the GTC.
Alcoholic pancreatitis: Lessons from the liver
Dahn L Clemens, Katrina J Mahan
World Journal of Gastroenterology , 2010,
Abstract: The association between alcohol consumption and pancreatitis has been recognized for over 100 years. Despite the fact that this association is well recognized, the mechanisms by which alcohol abuse leads to pancreatic tissue damage are not entirely clear. Alcohol abuse is the major factor associated with pancreatitis in the Western world. Interestingly, although most cases of chronic pancreatitis and many cases of acute pancreatitis are associated with alcohol abuse, only a small percentage of individuals who abuse alcohol develop this disease. This situation is reminiscent of the association between alcohol abuse and the incidence of alcoholic liver disease. The liver and the pancreas are developmentally very closely related. Even though these two organs are quite different, they exhibit a number of general structural and functional similarities. Furthermore, the diseases mediated by alcohol abuse in these organs exhibit some striking similarities. The diseases in both organs are characterized by parenchymal cell damage, activation of stellate cells, aberrant wound healing, and fibrosis. Because of the similarities between the liver and the pancreas, and the alcohol-associated diseases of these organs, we may be able to apply much of the knowledge that we have gained regarding the effects of alcohol on the liver to the pancreas.
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