Engineering Commons^™

A Systematic Approach To High Blood Pressure Risk Analysis And Healthcare Cost Reduction In Young Adults [Metodología Sistemática Para El Análisis De Riesgo Y Reducción De Costos De Servicios Médicos De Hipertensión En Adultos Jóvenes], Francisco Rafael Torres Diaz

Theses and Dissertations

The purpose of this research is to utilize publicly available data to estimate the current rate of occurrence of undiagnosed High Blood Pressure (HBP) in young adults (18 to 24 years old) and the out-of-pocket healthcare expenses associated with complications of HBP, to provide feasible alternatives to mitigate the effects on a region's economy. This has been done by building a Risk Factor Simulation Model that utilizes known HBP risk factors’ correlation to HBP, insurance coverage data, and rate of diagnosis to formulate the average Risk Factor Value for a region, which through an Annual Expected Cost Function estimates the …

Exploring The Cause Of Injury Or Death In Grain Entrapment, Engulfment And Extrication, Salah F. Issa

Open Access Dissertations

Grain entrapments and engulfments are one of most common hazards associated with grain storage facilities. Since the 1970’s over 1,880 incidents have been documented in agricultural confined spaces of which 65% of all recorded incidents were grain entrapments and engulfments. There have been several studies conducted on the contributing factors behind these incidents; however, there have been very few attempts to understand the environmental, physiological or psychological factors the victims experience while entrapped, engulfed, or extricated. This includes understanding how secondary injuries are caused by grain or during extrication by first responders. The research effort was divided into three segments. …

Optical Dosimetry Tools And Monte Carlo Based Methods For Applications In Image Guided Optical Therapy In The Brain, Akshay N Prabhu Verleker

Open Access Dissertations

Purpose: The long-term goal of this research is to determine the feasibility of using near infra-red light to stimulate drug release in metastatic lesions within the brain. In this work, we focused on developing the tools needed to quantify and verify photon fluence distribution in biological tissue. To accomplish this task, an optical dosimetry probe and Monte Carlo based simulation code were fabricated, calibrated and developed to predict light transport in heterogeneous tissue phantoms of the skull and brain. Empirical model (EM) of photon transport using CT images as input were devised to provide real-time calculations capable of being translated …

A Study Of Applications Of 3d Animation For Emergency Medicine Pedagogy, Huilong Zheng

Open Access Theses

There is ample precedent for the use of 3D animation in education, though little research on specific applications in the field of medicine. An experiment was carried out to assess the suitability of 3D animation for educational purposes in emergency medicine courses. Two groups of experimental participants were assessed on their ability to respond to three emergency medical situations in simulated test scenarios. Both groups received equivalent information on how to treat the three different medical emergencies. The control group received the information in traditional lecture format. The experimental group instead received the information from a set of 3D animations. …

Modeling Picking On Pharmaceutical Tablets, Shrikant Swaminathan

Open Access Dissertations

Tablets are the most popular solid dosage form in the pharmaceutical industry because they are cheap to manufacture, chemically and mechanically stable and easy to transport and fairly easy to control dosage. Pharmaceutical tableting operations have been around for decades however the process is still not well understood. One of the common problems faced during the production of pharmaceutical tablets by powder compaction is sticking of powder to the punch face, This is known as 'sticking'. A more specialized case of sticking is picking when the powder is pulled away form the compact in the vicinity of debossed features. In …

Three-Dimensional Printing And Nanotechnology For Enhanced Implantable Materials, Karthik Kumar Tappa

Doctoral Dissertations

Orthopedic and oro-maxillofacial implants have revolutionized treatment of bone diseases and fractures. Currently available metallic implants have been in clinical use for more than 40 years and have proved medically efficacious. However, several drawbacks remain, such as excessive stiffness, accumulation of metal ions in surrounding tissue, growth restriction, required removal/revision surgery, inability to carry drugs, and susceptibility to infection. The need for additional revision surgery increases financial costs and prolongs recovery time for patients. These metallic implants are bulk manufactured and often do not meet patient's requirements. A surgeon must machine (cut, weld, trim or drill holes) them in order …

Risk Estimation Toward A Natural History Model For Low Grade Glioma Patients, Anh Thi Hoang Pham

Graduate Theses and Dissertations

Glioma is a common type of primary brain tumor that represents 28% of all brain tumors and 80% of malignant tumors. According to a recent study by the Centers for Disease Control and Prevention (CDC), gliomas account for 53%, 35% and 29% of all brain tumors (68%, 74% and 81% of malignant brain tumors) among children (aged 0-14), teenagers (aged 15-19) and young adults, respectively. Gliomas are often diagnosed through radiological imaging and histopathology. There are two main groups of gliomas following World Health Organization’s classification: Low grade gliomas (LGG), or grade I and II gliomas; and high grade gliomas …

Essays In Physicians Preference Items And Inventory Management Within The Healthcare Supply Chain, Mohammad A. Shbool

Graduate Theses and Dissertations

This work is composed of a number of topics in the healthcare area, which are approached separately with appropriate methodologies. The two topics deal with physician preference items via two different approaches. The first one investigates stock keeping unit (SKU) proliferation in healthcare organizations due to physician preference items (PPI). It captures perspectives of physicians and supply chain professionals about this problem through two surveys. The second topic builds a decision-making framework for the PPI selection process that can be used by healthcare organizations to make more objective decisions. A Multi-criteria decision making technique is implemented to illustrate the framework.

Influence Of The 3d Microenvironment On Glioblastoma Migration And Drug Response, Ruth Marisol Herrera Perez

Open Access Dissertations

Glioblastoma (GBM) is a highly invasive brain cancer characterized by poor prognosis. Despite significant efforts by the basic and clinical research community our understanding of GBM progression and recurrence has been incremental. Improvements in therapeutic response have been dismal, and GBM continues to be the deadliest tumor of the central nervous system, with patient average survival rate of 12 months. Synergistic relationships that the tumor cells establish with the brain microenvironment have been proven fundamental for successful tumor progression and maintenance. Yet, many in vitro GBM studies are performed in formats that fail to recapitulate the most essential component of …

Densified Collagen-Fibril Biomaterials For Bone Tissue Engineering, Lauren E. Watkins

Open Access Theses

Millions of craniofacial bone defects occur annually as a result of trauma, congenital defects, disease, or tooth extraction. When present in the oral cavity, these defects are associated with adverse impacts on speech, mastication, and aesthetics. Thus, there is a clinical need for interventional strategies to restore and preserve alveolar bone mass to improve the success of future treatment options intended to reestablish functionality and aesthetics. Guided bone regeneration using bone grafts and a membrane represent the current standard of care for repairing alveolar bone defects, but face a number of limitations related to resorption time and structural integrity. Improvements …

Understanding Technology Diffusion And Spatial Accessibility In The Home Healthcare Industry, Mehmet Serdar Kilinç

Graduate Theses and Dissertations

Home healthcare is becoming an important alternative to institutionalized care. It not only reduces costs but also increases health outcomes and patient satisfaction. However, the availability and efficiency of home healthcare services need to be improved as the aging population increases in the US. Hence, understanding home healthcare utilization and access are the essential steps to develop strategies ensuring effective and sustainable services to patients.

This research aims to study two main issues in the US home healthcare system: diffusion and long-term impacts of home telehealth and potential spatial accessibility of home healthcare services. Home telehealth is a promising technology …

Nanoformulation For Anticancer Drug Delivery: Enhanced Pharmacokinetics And Circulation, Gaurav Parekh

Doctoral Dissertations

In this study, we have explored the application of the Layer-by-Layer (LbL) assembly technique for improving injectable drug delivery systems of low soluble anticancer drugs (e.g. Camptothecin (CPT), Paclitaxel (PTX) or Doxorubicin (DOX)). For this study, a polyelectrolyte shell encapsulates different types of drug nanocores (e.g. soft core, nanomicelle or solid lipid nanocores).The low soluble drugs tend to crystallize and precipitate in an aqueous medium. This is the reason they cannot be injected and may have low concentrations and low circulation time in the blood. Even though these drugs when present in the cancer microenvironment have high anti-tumor inhibition, the …

Designing A Sustainable And Transferable Inventory Management System For Small Healthcare Facilities, Shree Frazier

Open Access Theses

Managing the costs of supplies within healthcare facilities has been a task that has plagued the health industry for many years. Many facilities are accustomed to using a par system approach. This involves bringing an inventory item to an amount sufficient for daily operation. This method often requires daily inspection by a healthcare worker, which reduces his/her time spent performing value added tasks. Employees at small healthcare facilities have multiple responsibilities, therefore they cannot afford to spend much time on inventory management. A proposed approach is the Kanban method, which allows for strict monitoring of inventory items without the need …

Nanotechnology And Additive Manufacturing Platforms For Clinical Medicine: An Investigation Of 3d Printing Bioactive Constructs And Halloysite Nanotubes For Drug Delivery And Biomaterials, Jeffery A. Weisman

Doctoral Dissertations

Personalized medicine requires the development of new technologies for controlled or targeted drug delivery. Three-dimensional (3D) printing and additive manufacturing techniques can be used to generate customized constructs for bioactive compound delivery. Nanotechnology in the form of nanoparticles, used as a stand-alone construct or for material enhancements, can significantly improve established biomaterials such as PMMA based bone cements or enable new technology to have enhanced capabilities. Combinations of the technologies can be used in such applications as infectious disease treatments, chemotherapeutic targeted drug delivery or targeted delivery of nearly any bioactive compound.

Chemotherapeutic or antibiotic enhanced 3D printing filaments were …

Feasibility Of Pulsed Proton Induced Acoustics For 3d Dosimetry, Fahed M. Alsanea

Open Access Theses

Proton therapy has the potential to deposit its energy in tissue with high conformity to the tumor and significantly reduced integral dose to normal tissue compared to conventional radiation, such as x-rays. As a result, local control can be enhanced while reducing side-effects and secondary cancers. This is due to the way charged Particles deposit their energy or dose, where protons form a Bragg peak and establish a well-defined distal edge as a function of depth (range). To date, the dose delivered to a patient from proton therapy remains uncertain, in particular the positioning of the distal edge of the …

Controlling Protein Release Using Biodegradable Microparticles, Benjamin Patrick Kline

Open Access Theses

Research in the field of protein therapeutics has exploded over the past decade and continues to grow in both academia and in industry. Protein drugs have advantages of being highly specific and highly active making them coveted targets for high profile disease states like cancer and multiple sclerosis. Unfortunately, their many advantages are complemented by their obstacles. Because proteins are highly active and highly specific, the window between efficacy and toxicity is very narrow and drug development can be long and arduous. In addition, protein activity is dependent on its specific folding conformation that is easily disrupted by a variety …

Modeling And Optimization Of Care Transitions, Yuming Mo

Open Access Theses

More than 145 million people live with at least one chronic condition, and almost half of them have multiple conditions. As a result, many managed care and integrated delivery systems have taken a great interest in alleviating the many deficiencies in managing the current care system that spans across various care delivery settings. In addition, many Americans have to rely on some social health insurance plan to cover her care expenses. As a result, these patients often may not been sufficiently cured but have to be transitioned to less expensive but less medically intensive facilities, due to the increasing pressure …

Effects Of Hearing Aid Amplification On Robust Neural Coding Of Speech, Jonathan Daniel Boley

Open Access Dissertations

Hearing aids are able to restore some hearing abilities for people with auditory impairments, but background noise remains a significant problem. Unfortunately, we know very little about how speech is encoded in the auditory system, particularly in impaired systems with prosthetic amplifiers. There is growing evidence that relative timing in the neural signals (known as spatiotemporal coding) is important for speech perception, but there is little research that relates spatiotemporal coding and hearing aid amplification.

This research uses a combination of computational modeling and physiological experiments to characterize how hearing aids affect vowel coding in noise at the level of …

Low Soluble Drug Encapsulation Based On Architecture Of Layer-By-Layer Assembly For Longer Circulation Time And Targeted Therapy, Pravin Pattekari

Doctoral Dissertations

A combined effect of sonication and layer-by-layer assembly (LbL) enhances the solubility of many poorly soluble inorganic and organic materials by forming stable particles with ca. 200 nm size and up to 90 wt% of loading. The entire method is reproducible, easy-to-handle, and flexible for varying surface properties according to the application of the materials. The method develops good colloidal stability of materials in buffers and maintains architecture for future improvement. A top-down approach, with a combined effect of sonication and LbL assembly, ruptures the material and allows adsorption of oppositely charged polyelectrolytes simultaneously. Thus, the approach is applicable for …

The Effect Of Network Transitions On Spontaneous Activity And Sycnhrony In Devloping Neural Networks, Jude P. J. Savarraj

Doctoral Dissertations

Connectivity patterns of developing neural circuits and the effects of its dynamics on network behavior, particularly the emergence of spontaneous activity and synchrony, are not clear. We attempt to quantify anatomical connectivity patterns of rat cortical cultures during different stages of development. By culturing the networks on dishes embedded with micro electrode arrays, we simultaneously record electrical activity from multiple regions of the developing network and monitor its electrical behavior, particularly its tendency to fire spontaneously and to synchronize under certain conditions. We investigate possible correlations between changes in the network connectivity patterns and spontaneous electrical activity and synchrony. Cocultures …

Scheduling In Mohs Micrographic Surgery Clinics, Stephen Vincent Steidle

Open Access Theses

Mohs Micrographic Surgery (MMS) is a surgical method used for the excision of aggressive skin cancers in areas of high cosmetic importance, such as the face and hands. The practice has been gaining popularity worldwide for its low recurrence rates and cosmetic results. Current clinics though are plagued by extreme wait times and an overall poor patient experience. In this paper we look to explore this problem by applying systems engineering principles including optimization and scheduling with the goal of improving the patient experience. Currently, little literature exists exploring the difficulties associated with scheduling for MMS clinic which primarily revolve …

Evaluation Of Autonomous Robotic Milling Methodology For Natural Tooth-Shaped Implants Based On Sko Optimization, Yongki Yoon

Mechanical & Aerospace Engineering Theses & Dissertations

Robotic surgery is one of the most demanding and challenging applications in the field of automatic control. One of the conventional surgeries, the dental implantation, is the standard methodology to place the artificial tooth root composed of titanium material into the upper or lower jawbone. During the dental implant surgery, mechanical removal of the bone material is the most critical procedure because it may affect the patient's safety including damage to the mandibular canal nerve and/or piercing the maxillary sinus. With this problem, even though short term survival rates are greater than 95%, long term success rate of the surgery …

Patient And Nurse Considerations In Home Health Routing With Remote Monitoring Devices, Jessica Spicer

Graduate Theses and Dissertations

We build on the current consistent vehicle routing problem literature by formulating a novel multi- objective mathematical model of the home health scheduling and routing problem that includes the option of assigning some patient visits to remote monitoring devices, with the objectives of mini- mizing total cost, achieving nurse consistency and creating balanced nurse workloads. A heuristic solution approach that approximates the efficient frontier of this multiobjective problem is pre- sented and validated, and the results of using this methodology to solve several realistic instances are included. We also analyze the assignment of patients to devices and present some managerial …

Adaptive Intensity Modulated Radiation Therapy Planning Optimization With Changing Tumor Geometry And Biology Enforcing Both Cumulative And Fraction Size Dose Constraints, Behlul Saka

Graduate Theses and Dissertations

Intensity Modulated Radiation Therapy (IMRT) is a modern technique of delivering radiation treatments to cancer patients. In IMRT technology, intensities must be chosen for the many small unit grids into which the beams are divided to produce a desired distribution of dose at points throughout the body with the goal of maximizing dose delivered to the tumor while sparing healthy tissues from excessive radiation and keeping dose homogeneous across the tumor. Although IMRT plans are optimized as a single overall treatment plan, they are delivered over 30-50 treatment sessions (fractions) and both cumulative and per-fraction dose constraints apply. The extended …

An Empirical Investigation Of Supply Chain Excellence In Healthcare, Brian Keith Smith

Graduate Theses and Dissertations

This research is motivated by opportunities to improve the cost and quality of healthcare delivery through improved supply chain processes. This research assesses the quality of the healthcare supply chain and identifies factors that are driving supply chain excellence among organizations in the healthcare industry. The first objective of this research is to assess the state of quality measurement in the healthcare supply chain. The achievement of this first objective is presented in Chapter 3 of this dissertation in the form of a manuscript accepted for publication in The Quality Management Journal. The second research objective is to develop …

An Analytic Hierarchy Process Approach To Assess Health Service Quality, Yan Li

Theses and Dissertations - UTB/UTPA

While improving quality in health care is currently at the forefront of professional, political, and managerial attention, the key dimensions constituting health-care quality have not been fully understood. Also, few valid approaches have been proposed to the measurement of health-care quality. In this research, the Analytic Hierarchy Process (AHP) approach is applied to study the structure of health-care quality and deducted relative importance weights for each of the quality elements. A statistical quality model is derived to assess medical equipment quality which is an important part constituting the general health-care quality. Finally, the application of the AHP model to assess …

Human Reliability Analysis In The Performance Of Advanced Cardiac Life Support Tasks, Lucia Veronica Rosas

Theses and Dissertations - UTB/UTPA

Error reduction in the performance of medical emergency situations is an area of great concern in today's society. This is specially the case when the situation involves a cardiac arrhythmia. These situations are generally categorized as Advanced Cardiac Life Support (ACLS) events. The American Heart Association provides the proper procedures that practitioners of ACLS should follow to provide care to patients presenting heart arrhythmia problems. These situations occur inside and outside the hospital, outside the hospital being the most critical ones considering the limitation of equipment and availability of qualified care. Errors made by the practitioners of ACLS in this …

Effects Of Diabetes And Aging On Posture And Acceleration Thresholds During Lateral Translations, Samantha Jean Richerson

Doctoral Dissertations

Research objectives. One source of falls in the elderly may be an inability to sufficiently adjust to transient postural perturbations or slips. Identifying useful predictors of fall potential, as well as factors that affect the ability of an individual to detect a movement of the standing support surface may provide insight into postural stability and methods to increase stability in elders. To do this, acceleration thresholds to short, precise, lateral platform translations and the resultant psychophysical responses of adults with early Type 2 diabetes to age-matched controls and young adults were measured.

Methods. Using an innovative SLIP-FALLS platform, …

Modular Machine Learning Methods For Computer-Aided Diagnosis Of Breast Cancer, Mia Kathleen Markey '94

Doctoral Dissertations

The purpose of this study was to improve breast cancer diagnosis by reducing the number of benign biopsies performed. To this end, we investigated modular and ensemble systems of machine learning methods for computer-aided diagnosis (CAD) of breast cancer. A modular system partitions the input space into smaller domains, each of which is handled by a local model. An ensemble system uses multiple models for the same cases and combines the models' predictions.

Five supervised machine learning techniques (LDA, SVM, BP-ANN, CBR, CART) were trained to predict the biopsy outcome from mammographic findings (BIRADS™) and patient age based on a …