Engineering Commons^™

Investigation Of Physiochemical Properties And Biocompatibility Of Amourphos Calcium Polyphosphate Hydrogel Doped With Antibiotics And Injectable Polymeric Dicalcium Phosphate Dihydrate Bone Cement, Yasaman Chehreghanianzabi

Wayne State University Dissertations

Amorphous calcium polyphosphate (ACPP) is an inorganic polymer ceramic. Here we use a simple method of preparing ACPP hydrogel in the presence of excess volume of water. Essentially, water availability to polyphosphate chains accelerates water molecule ingress and microstructural transformation of ACPP hydrogels. Antibiotic delivery capacity of ACPP hydrogel increases by the specific mixing and molding method, where the VCM has higher antibiotic encapsulation efficiency with the small burst release for the compressed discs. In part of this study, we investigate impact of ACPP hydrogel replacement by monomeric calcium phosphate on the quality of final product (dicalcium phosphate dihydrates (DCPD) …

Dynamic Resource Allocation For Coordination Of Inpatient Operations In Hospitals, Najibesadat Sadatijafarkalaei

Wayne State University Dissertations

Healthcare systems face difficult challenges such as increasing complexity of processes, inefficient utilization of resources, high pressure to enhance the quality of care and services, and the need to balance and coordinate the staff workload. Therefore, the need for effective and efficient processes of delivering healthcare services increases. Data-driven approaches, including operations research and predictive modeling, can help overcome these challenges and improve the performance of health systems in terms of quality, cost, patient health outcomes and satisfaction.

Hospitals are a key component of healthcare systems with many scarce resources such as caregivers (nurses, physicians) and expensive facilities/equipment. Most hospital …

Development Of A Novel Cardiac Ischemia-Reperfusion Model In The Axolotl, Jeremy Tolentino Llaniguez

Wayne State University Dissertations

The Center for Disease Control’s National Center for Health Statistics data for mortality from diseases of the heart show the age-adjusted death rate has fallen from almost 600 deaths in the 1950s to just over 190 deaths per 100,000 U.S. residents today. With the recognized limitations of pharmacotherapy of myocardial infarction (MI), cell-based therapies have been undergoing rapid development and clinical testing. However, there is still no consensus about cell types, delivery routes, dosing and treatment schedules and pretreatment conditioning of cells prior to administration. Furthermore, a fundamental question remains unanswered about the reasons for the poor capacity for myocardial …

Proactive Coordination In Healthcare Service Systems Through Near Real-Time Analytics, Seung Yup Lee

Wayne State University Dissertations

The United States (U.S.) healthcare system is the most expensive in the world. To improve the quality and safety of care, health information technology (HIT) is broadly adopted in hospitals. While EHR systems form a critical data backbone for the facility, we need improved 'work-flow' coordination tools and platforms that can enhance real-time situational awareness and facilitate effective management of resources for enhanced and efficient care. Especially, these IT systems are mostly applied for reactive management of care services and are lacking when they come to improving the real-time "operational intelligence" of service networks that promote efficiency and quality of …

Data-Driven Modeling For Decision Support Systems And Treatment Management In Personalized Healthcare, Milad Zafar Nezhad

Wayne State University Dissertations

Massive amount of electronic medical records (EMRs) accumulating from patients and populations motivates clinicians and data scientists to collaborate for the advanced analytics to create knowledge that is essential to address the extensive personalized insights needed for patients, clinicians, providers, scientists, and health policy makers. Learning from large and complicated data is using extensively in marketing and commercial enterprises to generate personalized recommendations. Recently the medical research community focuses to take the benefits of big data analytic approaches and moves to personalized (precision) medicine. So, it is a significant period in healthcare and medicine for transferring to a new paradigm. …

The Impact Of Machine Learning Algorithms On Benchmarking Process In Healthcare Service Delivery, Egbe-Etu Emmanuel Etu

Wayne State University Theses

Currently, organizations have adopted and implemented a variety of innovative quality management philosophies, approaches, and techniques to stay competitive in an ever-changing global economy. Benchmarking is one of such techniques deployed by organizations to stay competitive. The motivation for this research stems from a real-world problem being faced by hospitals in the healthcare industry who have amassed a ton of data and want to embark on benchmarking project to assess the performance of the emergency departments due to challenges faced with poor management of operations which has led to high patient boarding rates, high patient wait-times, poor quality service, low …

Venous Thromboembolism (Vte) Harm Measurement And Risk Assessment In Real-Time Using Electronic Health Records(Ehr), Seyed Mani Marashi

Wayne State University Dissertations

Venous Thromboembolism (VTE) is a deadly disease and is considered as one of the top reasons for avoidable hospital deaths in the United States and around the world. Patients who survive this disease often must face life-long complications such as Post-thrombotic syndrome (PTS), Chronic thromboembolic pulmonary hypertension (CTPH), etc. Therefore, it is important to monitor and reduce the number of VTE instances in hospitals. This study shows how Electronic Health Records (EHRs) can be utilized to achieve this goal.

First, a new near real-time VTE harm measurement model was developed. Not only the developed model can deliver near real-time results, …

Brain Connectivity After Concussion, Armin Iraji

Wayne State University Dissertations

Mild traumatic brain injury (mTBI) accounts for over one million emergency visits in the United States each year. While most mTBI patients have normal findings in clinical neuroimaging, alterations in brain structure and functional connectivity have frequently been reported. In this study, we investigated the large-scale brain structural and functional connectivity using diffusion MRI and resting-state fMRI data. Data from 40 mTBI patients was acquired at the acute stage (within 24 hrs after injury). 35 patients returned for data acquisition at a follow-up (4-6 weeks after injury). Data was also collected from a cohort of 58 healthy subjects, 36 of …

Pet Imaging Of Early Therapeutic Response In Solid Tumors, Stephanie J. Blocker

Wayne State University Dissertations

An important pillar of precision medicine for oncology is the ability to identify patients who respond to treatment early into their therapy. Positron emission tomography (PET) allows physicians and researchers to measure changes in tumor behavior prior to noticeable differences in morphology.

Objective: Determine the utility of multiple tracers for PET in assessing early changes in tumor activity that result from treatment.

Methods: Two tracers for PET were studied. 64Cu-labeled liposomes were used to assess changes in liposome delivery two solid colon tumors early into treatment with bevacizumab (Bev). 18F-FMAU thymidine analog (1-(2'-deoxy-2'-fluoro-beta-D-arabinofuranosyl)thymine), was utilized to detect early response to …

Reusable Medical Equipment Inventory Assessment At A Detroit Medical Center, Tannaz Khaleghi

Wayne State University Theses

In recent years an outstanding growth has been observed in utilizing various medical devices due to growing demand. When both the quantity and quality into account, the price of medical devices becomes a critical factor to maintain cost/profit balances in financial systems. As a result healthcare systems should put more emphasis on how many of the trays they buy and store as their inventory due to high costs. Adequate levels of reusable medical equipment (RME) inventory is crucial for many healthcare systems

due to the RME equipment being expensive. On the other, the RME availability for vital departments such as …

An Analysis Of Plasticity In The Rat Respiratory System Following Cervical Spinal Cord Injury And The Application Of Nanotechnology To Induce Or Enhance Recovery Of Diaphragm Function, Janelle Lorien Walker

Wayne State University Dissertations

Second cervical segment spinal cord hemisection (C2Hx) results in ipsilateral hemidiaphragm paralysis. However, the intact latent crossed phrenic pathway can restore function spontaneously over time or immediately following drug administration.

WGA bound fluorochromes were administered to identify nuclei associated with diaphragm function in both the acute and chronic C2Hx models. WGA is unique in that it undergoes receptor mediated endocytosis and is transsynaptically transported across select physiologically active synapses. Comparison of labeling in the acutely injured to the chronically injured rat provided an anatomical map of spinal and supraspinal injury induced synaptic plasticity. The plasticity occurs over time in the …

Toward Magnetic Resonance Only Treatment Planning: Distortion Mitigation And Image-Guided Radiation Therapy Validation, Ryan Glen Price

Wayne State University Dissertations

While MR-only treatment planning has shown promise, there are still several well-known challenges that are currently limiting widespread clinical implementation.

Firstly, MR images are affected by both patient-induced and system-level geometric distortions that can significantly degrade treatment planning accuracy. . In addition, the availability of comprehensive distortion analysis software is currently limited. Also while many groups have been working toward a synthetic CT solution, further study is needed on the implementation of synCTs as the reference datasets for linac-based image-guided radiation therapy (IGRT) to help determine their robustness in an MR-only workflow.

A 36×43×2 cm3 phantom with 255 known landmarks …

Modeling And Optimization Of Non-Profit Hospital Call Centers With Service Blending, Yanli Zhao

Wayne State University Dissertations

This dissertation focuses on the operations problems in non-profit hospital call centers with inbound and outbound calls service blending.

First, the routing policy for inbound and outbound calls is considered. The objective is to improve the system utilization under constraints of service quality and operators' quantity. A collection of practical staffing assignment methods, separating and mixing staffing policy are evaluated. Erlang C queuing model is used to decide the minimum number of operators required by inbound calls. Theoretical analysis and numerical experiments illustrate that through dynamically assigning the inbound and outbound calls to operators under optimal threshold policy, mixing staffing …

Predictive Analytics For Disease Condition Of Patients In Emergency Department, Azade Tabaie

Wayne State University Theses

Emergency Departments (EDs) in hospitals are experiencing severe crowding and prolonged patient waiting times. The reported crowding in hospitals shows patients in hospital hallways, long waiting times and full occupancy of ED beds. ED crowding has several potential unfavorable effects including patients and staff frustration, lower patient satisfaction and poor health outcomes. The primary motivations behind this study are shortening the patients’ waiting time and improving patient satisfaction and level of care.

The very initial interaction between clinicians and a patient is recorded on nurse triage notes which contain details of the reason for patient’s visit including specific symptoms and …

An Investigation Of The Relationship Between Axonal Injury, Biomarker Expression And Mechanical Response In A Rodent Head Impact Acceleration Model, Yan Li

Wayne State University Dissertations

In the United States 1.4 million people sustain traumatic brain injury (TBI) each year, resulting in 235,000 hospitalizations and 50,000 fatalities annually. Traumatic axonal injury (TAI) is a serious outcome of TBI that accounts for 40-50% of hospitalizations due to head injury and one third of the mortality due to TBI, and it is difficult to diagnose and evaluate. The purpose of this dissertation is to determine mechanical injury predictors for TAI and identify potential biomarkers to evaluate TAI.

In this dissertation, a modified Marmarou impact acceleration injury model was developed to allow the monitoring of velocity of the impactor …

Novel Incorportation Of Biomedical Engineering Algorithms (Bispectral Index Guided Or Anesthetic Concentration Guided) In Real-Time Decision Support To Prevent Intraoperative Awareness Using An Electronic Anesthesia Information Mananagement System, Amy Melanie Shanks

Wayne State University Dissertations

Background: Intraoperative awareness with explicit recall (AWR) is a feared complication of surgery that can lead to significant psychological distress. Several large prospective trials have been completed comparing two methods of monitoring anesthetic depth [minimum alveolar concentration (MAC) or electroencephalography (EEG) monitoring using the bispectral index (BIS)] for the prevention of AWR. However, these trials were conducted in high risk populations, limiting generalizability.

Research Hypothesis: Real-time decision support with Anesthesia Information Management System alerts based on a novel anesthetic concentration algorithm (incorporating the use of intravenous anesthetics) or an EEG-guided algorithm will reduce the known incidence of AWR.

Methods: First, …

Dendrimer Based Nanotherapeutics For Ocular Drug Delivery, Siva Pramodh Kambhampati

Wayne State University Dissertations

PAMAM dendrimers are a class of well-defined, hyperbranched polymeric nanocarriers that are being investigated for ocular drug and gene delivery. Their favorable properties such as small size, multivalency and water solubility can provide significant opportunities for many biologically unstable drugs and allows potentially favorable ocular biodistribution. This work exploits hydroxyl terminated dendrimers (G4-OH) as drug/gene delivery vehicles that can target retinal microglia and pigment epithelium via systemic delivery with improved efficacy at much lower concentrations without any side effects.

Two different drugs Triamcinolone acetonide (TA) and N-Acetyl Cysteine (NAC) conjugated to G4-OH dendrimers showed tailorable sustained release in physiological relevant …

The Role Of Tissue Sound Speed As A Surrogate Marker Of Breast Density, Mark Sak

Wayne State University Dissertations

Breast density is one of the strongest predictors of breast cancer risk as women with the densest breasts have a three- to five-fold increase in risk compared to women with the least dense breasts. Breast density is currently measured by using mammography, the current gold standard for breast imaging. There are many shortcomings to using mammography to measure breast density, including the use of ionizing radiation. Ultrasound tomography (UST) does not use ionizing radiation and can create tomographic breast sound speed images. These sound speed images are useful because breast density is proportional to sound speed. The purpose of this …

Advanced Augmented Reality Telestration Techniques With Applications In Laparoscopic And Robotic Surgery, Stephen Dworzecki

Wayne State University Dissertations

The art of teaching laparoscopic or robotic surgery currently has a primary reliance on an expert surgeon tutoring a student during a live surgery. During these operations, surgeons are viewing the inside of the body through a manipulatable camera. Due to the viewpoint translation and narrow field of view, these techniques have a substantial learning curve in order to gain the mastery necessary to operate safely. In addition to moving and rotating the camera, the surgeon must also manipulate tools inserted into the body. These tools are only visible on camera, and pass through a pivot point on the body …

Optimal Port Placement And Automated Robotic Positioning For Instrumented Laparoscopic Biosensors, Brady King

Wayne State University Dissertations

OPTIMAL SURGICAL PORT PLACEMENT AND AUTOMATED ROBOTIC POSITIONING FOR RAMAN AND OTHER BIOSENSORS

by

BRADY KING

January 2011

Advisors: Dr. Abhilash Pandya, Dr. Darin Ellis, Dr. Le Yi Wang, and Dr. Greg Auner

Major: Computer Engineering

Degree: Doctor of Philosophy

Medical biosensors can provide new information during minimally invasive and robotic surgical procedures. However, these biosensors have significant physical limitations that make it difficult to find optimal port locations and place them in vivo. This dissertation explores the application of robotics and virtual/augmented reality to biosensors to enable their optimal use in vivo.

In the first study, human …

Processing Random Signals In Neuroscience, Electrical Engineering And Operations Research, Kalyan Raman

Wayne State University Dissertations

The topic of this dissertation is the study of noise in electrical engineering, neuroscience, biomedical engineering, and operations research through mathematical models that describe, explain, predict and control dynamic phenomena. Noise is modeled through Brownian Motion and the research problems are mathematically addressed by different versions of a generalized Langevin equation. Our mathematical models utilize stochastic differential equations (SDEs) and stochastic optimal control, both of which were born in the soil of electrical engineering. Central to this dissertation is a brain-physics based model of cerebrospinal fluid (CSF) dynamics, whose structure is fundamentally determined by an electrical circuit analogy. Our general …

Digital Human Models Of People With Disabilities, Ron Hamameh

Wayne State University Theses

The current state-of-the-art in Digital Human Modeling (DHM) allows for full simulation and analysis of any task a person is required to perform at home, at work, in the military, in space, in sports, etc. The problem is that the software is missing a very important population: people with physical disabilities. What modifications and enhancements must be made to existing, commercially available DHM software to include this population?

Raman Spectroscopic Modeling Of T- Lymphocyte Activation And Detection Of Acute Renal Allograft Rejection, Kristian L. Brown

Wayne State University Dissertations

ABSTRACT

RAMAN SPECTROSCOPIC MODELING OF T-LYMPHOCYTE ACTIVATION AND DETECTION OF ACUTE RENAL ALLOGRAFT REJECTION

By

KRISTIAN L. BROWN

2010

Advisor: Gregory Auner, PhD

Major: Biomedical Engineering

Degree: Doctor of Philosophy

Despite the advances made in the area of kidney transplantation, the disparity between the demand and available donated organs remains a dominant and unresolved issue. Given the paucity of available renal allografts the preservation of existing grafts is vital. One factor that has negatively impacted renal allograft survival is acute rejection (AR). Traditionally, kidney transplant centers have used elevations in serum creatinine as a screening tool for detecting AR. However, …

Identification Of Neuroblastoma And Its Prognostic Markers Using Raman Spectroscopy, Rachel Kast

Wayne State University Dissertations

Introduction: Neuroblastoma is the most common cancer of infancy. It is one of several peripheral nervous system tumors, including ganglioneuroma, peripheral nerve sheath tumor, and pheochromocytoma. It is commonly situated on the adrenal gland. It displays similar histology to other small round blue cell tumors, including non-Hodgkin lymphoma, rhabdomyosarcoma, and Ewing sarcoma. One method of judging neuroblastoma aggressiveness uses tumor histology factors, including mitosis-karyorrhexis index, Schwannian stromal development, degree of differentiation, and patient age. Tumor aggressiveness can also be judged based on the amplification of certain genes, including MYCN. Raman spectroscopy is a physics-based method which identifies the biochemical …

Application Of Magnetic Resonance Imaging To Understanding The Pathogenesis Of The X-Linked Leukodystrophy Pelizaeus-Merzbacher Disease, Jeremy Jerome Laukka

Wayne State University Dissertations

Myelin is a multilamellar membrane structure surrounding axons in both the CNS and PNS that facilitates nerve conduction. In the CNS, myelin is synthesized by oligodendrocytes, while in the PNS, myelin is synthesized by Schwann cells. In the CNS, Proteolipid protein 1 (PLP1), an integral membrane protein, is the major protein component of myelin, constituting ~50% of myelin protein. Mutations of the PLP1 gene in man cause a spectrum of neurological disease, ranging from the severe Pelizaeus-Merzbacher disease (PMD), that typically begins during infancy with nystagmus, seizures and hypotonia and evolves into spastic quadriparesis, cognitive impairment and ataxia, to ¡¥pure¡¦ …