Markov Decision Process Approach To Strategize National Breast Cancer Screening Policy In Data-Limited Settings, Vijeta Deshpande

Masters Theses

Early diagnosis is a promising strategy to reduce premature mortalities and for optimal use of resources. But the absence of mathematical models specific to the data settings in LMIC’s impedes the construction of economic analysis necessary for decision-makers in the development of cancer control programs. This thesis presents a new methodology for parameterizing the natural history model of breast cancer based on data availabilities in low and middle income countries, and formulation of a control optimization problem to find the optimal screening schedule for mammography screening, solved using dynamic programming. As harms and benefits are known to increase with the …

What Do Faculties Specializing In Brain And Neural Sciences Think About, And How Do They Approach, Brain-Friendly Teaching-Learning In Iran?, Sahar Ghanbari, Fariba Haghani, Malahat Akbarfahimi

Journal of Mind and Medical Sciences

Objective: to investigate the perspectives and experiences of the faculties specializing in brain and neural sciences regarding brain-friendly teaching-learning in Iran. Methods: 17 faculties from 5 universities were selected by purposive sampling (2018). In-depth semi-structured interviews with directed content analysis were used. Results: 31 sub-subcategories, 10 subcategories, and 4 categories were formed according to the “General teaching model”. “Mentorship” was a newly added category. Conclusions: A neuro-educational approach that consider the roles of the learner’s brain uniqueness, executive function facilitation, and the valence system are important to learning. Such learning can be facilitated through cognitive load considerations, repetition, deep questioning, …

Statistical Methods For Joint Analysis Of Multiple Phenotypes And Their Applications For Phewas, Xueling Li

Dissertations, Master's Theses and Master's Reports

Genome-wide association studies (GWAS) have successfully detected tens of thousands of robust SNP-trait associations. Earlier researches have primarily focused on association studies of genetic variants and some well-defined functions or phenotypic traits. Emerging evidence suggests that pleiotropy, the phenomenon of one genetic variant affects multiple phenotypes, is widespread, especially in complex human diseases. Therefore, individual phenotype analyses may lose statistical power to identify the underlying genetic mechanism. Contrasting with single phenotype analyses, joint analysis of multiple phenotypes exploits the correlations between phenotypes and aggregates multiple weak marginal effects and is therefore likely to provide new insights into the functional consequences …

Phr: Patient Health Record, Quinn Nelson

Theses/Capstones/Creative Projects

The rapid development of information technology systems has expanded into multiple disciplines and results in systems that are limited by initial design and implementation: the Healthcare Information Technology (HIT) space is no different. The introduction of the Electronic Health Record (EHR) system has changed the way healthcare operates. Initial designs of these systems were focused on serving the needs of insurance companies and healthcare billing departments. Research shows that the design of EHR systems negatively impact provider-patient interactions and the care they receive. This capstone project capitalizes on the collaboration efforts between UNO and UNMC – by joining a research …

Safety, Stephen M. Vantassel, Brenda K. Osthus

Wildlife Damage Management Technical Series

Wildlife damage management (WDM) is an exciting field with many opportunities to provide solutions to the complex issues involved in human-wildlife interactions. In addition, WDM wildlife control operators (WCO) face a variety of threats to their physical well-being. Injuries can result from misused (Figure 1), faulty, or poorly maintained equipment, inexperience, mishandled wildlife, harsh weather, and dangerous situations, such as electrical lines. The goals of this publication are to: * Develop an awareness of safety issues and adopt a mindset of “Safety First”, * Review the major safety threats that WCOs face, * Provide basic information for WCOs to protect …

Validity And Reliability Of The Ymca Submaximal Cycle Test Using An Electrically Braked Ergometer, Justin Kidd

Senior Honors Projects, 2010-2019

Purpose: To test the effect of using an electrically braked ergometer on the validity and reliability of the YMCA submaximal cycle test.

Methods: 22 male and 13 female subjects ages 19 to 31 completed one maximal treadmill test and four submaximal cycle tests to measure and estimate VO_2max, respectively. The maximal tests involved recording heart rate and VO₂ during graded exercise until volitional fatigue; an actual max was verified when two out of the following criteria: respiratory Exchange Ratio > 1.1, VO₂ plateau (< 150 ml/min increase in VO₂ during final stage), and achievement of 90% age-predicted HR max (or completed …

Physical Activity Monitoring Through A Wearable Technological Device, Alissa Underhill

Scholar Week 2016 - present

PURPOSE: To assess the use of a wearable technological device for the increase in attainment of physical activity (PA) with the goal of preventing Type II Diabetes Mellitus (T2DM) through weight loss.

METHODS: Men and women over the age of 40, and at risk for prediabetes, were recruited. The study period was four months in length, with an initial four weeks of baseline PA testing, followed by 12 weeks of lifestyle intervention. Participants averaged 72 days of PA tracking with 46% of participants reaching the maximal number of days (77). RESULTS: Participants (N = 13) were aged …

Target Engagement Imaging Of Parp Inhibitors In Small-Cell Lung Cancer, Brandon Carney, Susanne Kossatz, Benjamin H. Lok, Valentina Schneeberger, Kishore K. Gangangari, Naga Vara Kishore Pillarsetty, Wolfgang A. Weber, Charles M. Rudin, John T. Poirier, Thomas Reiner

Publications and Research

Insufficient chemotherapy response and rapid disease progression remain concerns for smallcell lung cancer (SCLC). Oncologists rely on serial CT scanning to guide treatment decisions, but this cannot assess in vivo target engagement of therapeutic agents. Biomarker assessments in biopsy material do not assess contemporaneous target expression, intratumoral drug exposure, or drug-target engagement. Here, we report the use of PARP1/2-targeted imaging to measure target engagement of PARP inhibitors in vivo. Using a panel of clinical PARP inhibitors, we show that PARP imaging can quantify target engagement of chemically diverse small molecule inhibitors in vitro and in vivo. We measure PARP1/2 inhibition …

Systematic Review And Meta-Analysis: Tuberculosis, Tnfα Inhibitors, And Crohn's Disease, Brent L. Cao

Honors Undergraduate Theses

Inflammation is often a protective reaction against harmful foreign agents. However, in many disease conditions, the mechanisms behind the inflammatory response are poorly understood. Often times, the inflammation causes adverse effects, such as joint pain, abdominal pain, fever, fatigue, and loss of appetite. Thus, many treatments aim to inhibit the inflammatory response in order to control adverse symptoms. Such treatments include TNFα inhibitors. However, a major risk associated with drugs inhibiting tumor necrosis factor alpha (TNFα) is serious infection, including tuberculosis (TB).

Anti-TNFα therapy is used to treat patients with Crohn’s disease, for which the risk of tuberculosis may be …

Impact Of Terminology Mapping On Population Health Cohorts Impact, Barbara A. Berkovich

Dissertations & Theses (Open Access)

Background and Objectives: The population health care delivery model uses phenotype algorithms in the electronic health record (EHR) system to identify patient cohorts targeted for clinical interventions such as laboratory tests, and procedures. The standard terminology used to identify disease cohorts may contribute to significant variation in error rates for patient inclusion or exclusion. The United States requires EHR systems to support two diagnosis terminologies, the International Classification of Disease (ICD) and the Systematized Nomenclature of Medicine (SNOMED). Terminology mapping enables the retrieval of diagnosis data using either terminology. There are no standards of practice by which to evaluate and …

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

The Motor Cortical Representation Of A Muscle Is Not Homogeneous In Brain Connectivity, Jo Armour Smith, Alaa Albishi, Sarine Babikian, Skulpan Asavasopon, Beth E. Fisher, Jason Kutch

Physical Therapy Faculty Articles and Research

Functional connectivity patterns of the motor cortical representational area of single muscles have not been extensively mapped in humans, particularly for the axial musculature. Functional connectivity may provide a neural substrate for adaptation of muscle activity in axial muscles that have both voluntary and postural functions. The purpose of this study was to combine brain stimulation and neuroimaging to both map the cortical representation of the external oblique (EO) in primary motor cortex (M1) and supplementary motor area (SMA), and to establish the resting-state functional connectivity associated with this representation. Motor evoked potentials were elicited from the EO muscle in …

Basic Science To Clinical Research: Segmentation Of Ultrasound And Modelling In Clinical Informatics, Ali K. Hamou

Electronic Thesis and Dissertation Repository

The world of basic science is a world of minutia; it boils down to improving even a fraction of a percent over the baseline standard. It is a domain of peer reviewed fractions of seconds and the world of squeezing every last ounce of efficiency from a processor, a storage medium, or an algorithm. The field of health data is based on extracting knowledge from segments of data that may improve some clinical process or practice guideline to improve the time and quality of care. Clinical informatics and knowledge translation provide this information in order to reveal insights to …

Sms Parent Action Intervention (Span): A Pilot Study To Assess The Feasibility Of Using Text Messaging To Promote Child Health On An American Indian Reservation, Julia M. Malich

Graduate Student Theses, Dissertations, & Professional Papers

Abstract

Purpose: Childhood obesity and its associated health risks are widely recognized as a major public health crisis in the United States (Johnson & Johnson, 2014; Proctor, 2008; Rogers et al, 2013; Vinci et al, 2016) and worldwide (Elías-Boneta, Toro, Garcia, Torres, & Palacios, 2015). Among children in low-income families, American Indian/Alaska Native (AIAN) children have the highest prevalence of obesity (21.1%) compared to other racial/ethnic groups (14.74% overall) (Pan et al, 2015). Parents play an important role in introducing healthy foods and encouraging physical activity in young children (Birch & Ventura, 2009; Lindsay et al., 2006; Natale et al., …

Improved Genome-Scale Multitarget Virtual Screening Via A Novel Collaborative Filtering Approach To Cold-Start Problem, Hansaim Lim, Paul Gray, Lei Xie, Aleksandar Poleksic

Publications and Research

Conventional one-drug-one-gene approach has been of limited success in modern drug discovery. Polypharmacology, which focuses on searching for multi-targeted drugs to perturb disease-causing networks instead of designing selective ligands to target individual proteins, has emerged as a new drug discovery paradigm. Although many methods for single-target virtual screening have been developed to improve the efficiency of drug discovery, few of these algorithms are designed for polypharmacology. Here, we present a novel theoretical framework and a corresponding algorithm for genome-scale multitarget virtual screening based on the one-class collaborative filtering technique. Our method overcomes the sparseness of the protein-chemical interaction data by …

Virus-Host Co-Evolution: Determining The Origin Of Human Cytomegalovirus Us27 And Us28, Jessica A. Scarborough, Juliet Spencer, John Paul

Creative Activity and Research Day - CARD

G protein-coupled receptors (GPCR) are the largest family of cell surface proteins, found in organisms from yeast to humans. Human cytomegalovirus (HCMV) is a widespread pathogen that is particularly skilled at evading immune detection and defense mechanisms, largely due to extensive co-evolution with its host’s immune system. One aspect of this co-evolution involves the acquisition of four virally encoded GPCR homologs: US27, US28, UL33 and UL78. In this research, phylogenetic analysis was used to investigate the origins of the US27 and US28 genes, which are adjacent in the viral genome. The results indicate that both US27 and US28 share the …

The Genomic Cds Sandbox: An Assessment Among Domain Experts., Ayesha Aziz, Kensaku Kawamoto, Karen Eilbeck, Marc S Williams, Robert R Freimuth, Mark A Hoffman, Luke V Rasmussen, Casey L Overby, Brian H Shirts, James M Hoffman, Brandon M Welch

Manuscripts, Articles, Book Chapters and Other Papers

Genomics is a promising tool that is becoming more widely available to improve the care and treatment of individuals. While there is much assertion, genomics will most certainly require the use of clinical decision support (CDS) to be fully realized in the routine clinical setting. The National Human Genome Research Institute (NHGRI) of the National Institutes of Health recently convened an in-person, multi-day meeting on this topic. It was widely recognized that there is a need to promote the innovation and development of resources for genomic CDS such as a CDS sandbox. The purpose of this study was to evaluate …

Characterizing The Performance And Behaviors Of Runners Using Twitter, Qian He, Emmanuel Agu, Diane Strong, Bengisu Tulu, Peder Pedersen

Emmanuel O. Agu

Running is a popular physical activity that improves physical and mental wellbeing. Unfortunately, up-to- date information about runners’ performance and psychological wellbeing is limited. Many questions remain unanswered, such as how far and how fast runners typically run, their preferred running times and frequencies, how long new runners persist before dropping out, and what factors cause runners to quit. Without hard data, establishing patterns of runner behavior and mitigating the challenges they face are difficult. Collecting data manually from large numbers of runners for research studies is costly and time consuming. Emerging Social Networking Services (SNS) and fitness tracking devices …

A New Method For Shear Wave Speed Estimation In Shear Wave Elastography, Aaron J. Engel, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

Visualization of mechanical properties of tissue can aid in noninvasive pathology diagnosis. Shear wave elastography (SWE) measures the elastic properties of soft tissues by estimation of local shear wave propagation speed. In this paper, a new robust method for estimation of shear wave speed is introduced which has the potential for simplifying continuous filtering and real-time elasticity processing. Shear waves were generated by external mechanical excitation and imaged at a high frame rate. Three homogeneous phantoms of varying elastic moduli and one inclusion phantom were imaged. Waves propagating in separate directions were filtered and shear wave speed was estimated by …

A Machine Learning Approach To Post-Market Surveillance Of Medical Devices, Jonathan Bates, Shu-Xia Li, Craig Parzynski, Ronald Coifman, Harlan Krumholz, Joseph Ross

Yale Day of Data

Post-market surveillance is a collection of processes and activities used by product manufacturers and regulators, such as the U.S. Food and Drug Administration (FDA) to monitor the safety and effectiveness of medical devices once they are available for use “on the market”. These activities are designed to generate information to identify poorly performing devices and other safety problems, accurately characterize real-world device performance and clinical outcomes, and facilitate the development of new devices, or new uses for existing devices. Typically, a device is monitored by comparing adverse events in the exposed population to a matched unexposed population. This research considers …

Concussion Awareness And Educational Outreach Through A Website And Mobile Application, Daniel J. Brogan

Neuroscience Summer Fellows

In recent years concussions have become a more apparent problem in youth and adolescent sports. 1 in 5 high school students will sustain a concussion during the season. Due to medical and scientific advances, the diagnosis of concussions is becoming much simpler with key markers that are signs for an injury. Returning to play too soon before an athlete is fully recovered increases the likelihood that serious and irreversible neurological deficits can occur. Symptoms for concussions are necessary to track in order for an athlete to properly report their recovery to a physician. Doctors primarily rely on a patient’s report …

A Geospatial Analysis Of Norovirus Outbreaks In California, And An Investigation Of The Impact Of Environmental Variables, Alexandra Groen

Master's Projects and Capstones

Previous studies and empirical evidence suggest norovirus outbreaks in California exhibit correlation with environmental variables and exhibit spatial spread patterns. Few studies have been done looking at what causes norovirus seasonality in temperate climates and more research is needed on the regional level. This study aims to find what relationships exist with outbreak occurrence and environmental variables in California, as well as any spatial patterns of spread or clustering of outbreaks. Spatial analysis tools were used to find any relationships between California norovirus outbreak data and environmental variables. The results showed a south to north spread of outbreaks in California …

Adapting The Standard Sir Disease Model In Order To Track And Predict The Spreading Of The Ebola Virus Using Twitter Data, Armin Smailhodzic

Masters Theses & Specialist Projects

A method has been developed to track infectious diseases by using data mining of active Twitter accounts and its efficacy was demonstrated during the West African Ebola outbreak of 2014. Using a meme based n-gram semantic usage model to search the Twitter database for indications of illness, flight and death from the spread of Ebola in Africa, principally from Guinea, Sierra Leone and Liberia. Memes of interest relate disease to location and severity and are coupled to the density of Tweets and re-Tweets. The meme spreads through the community of social users in a fashion similar to nonlinear wave propagation- …

Image Enhancement Of Cancerous Tissue In Mammography Images, Richard Thomas Richardson

CCE Theses and Dissertations

This research presents a framework for enhancing and analyzing time-sequenced mammographic images for detection of cancerous tissue, specifically designed to assist radiologists and physicians with the detection of breast cancer. By using computer aided diagnosis (CAD) systems as a tool to help in the detection of breast cancer in computed tomography (CT) mammography images, previous CT mammography images will enhance the interpretation of the next series of images. The first stage of this dissertation applies image subtraction to images from the same patient over time. Image types are defined as temporal subtraction, dual-energy subtraction, and Digital Database for Screening Mammography …

Live Well Springfield – A Community Transformation Movement: Evaluation Of The Live Well Springfield Website, Jesse A. Mushenko

Masters Theses

The Live Well Springfield (LWS) movement is a collaborative effort of partner organizations in Springfield, Massachusetts. The project promotes healthy living by increasing knowledge and awareness of food and physical activity. A key LWS strategy was the creation of a website to function as an information hub. In addition to local event and health information, the website features 16 narratives depicting residents practicing healthy lifestyle choices, designed to encourage community engagement. To date, there has been no evaluation of the website’s reach and effect.

A mixed methods approach, surveys and focus group discussions, was designed to collect data from people …

Coexpression Network Analysis Of Mirna-142 Overexpression In Neuronal Cells, Ishwor Thapa, Howard S. Fox, Dhundy Raj Bastola

Interdisciplinary Informatics Faculty Publications

MicroRNAs are small noncoding RNA molecules, which are differentially expressed in diverse biological processes and are also involved in the regulation of multiple genes. A number of sites in the 3′ untranslated regions (UTRs) of different mRNAs allow complimentary binding for a microRNA, leading to their posttranscriptional regulation. The miRNA-142 is one of the microRNAs overexpressed in neurons that is found to regulate SIRT1 and MAOA genes. Differential analysis of gene expression data, which is focused on identifying up- or downregulated genes, ignores many relationships between genes affected by miRNA-142 overexpression in a cell. Thus, we applied a correlation network …

Enabling Real-Time Ultrasound Imaging Of Soft Tissue Mechanical Properties By Simplification Of The Shear Wave Motion Equation, Aaron J. Engel, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

Ultrasound based shear wave elastography (SWE) is a technique used for non-invasive characterization and imaging of soft tissue mechanical properties. Robust estimation of shear wave propagation speed is essential for imaging of soft tissue mechanical properties. In this study we propose to estimate shear wave speed by inversion of the firstorder wave equation following directional filtering. This approach relies on estimation of first-order derivatives which allows for accurate estimations using smaller smoothing filters than when estimating second-order derivatives. The performance was compared to three current methods used to estimate shear wave propagation speed: direct inversion of the wave equation (DIWE), …

Functional Transcranial Doppler Ultrasound For High Temporal Resolution Measurement Of Lateralization In Visual Memory And Visual Search Cognitive Tasks, B. Hage, M. Alwatban, E. Barney, M. Mills, M. Dodd, E. Truemper, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

Functional transcranial Doppler ultrasound (fTCD) is a noninvasive sensing modality that measures blood flow velocities in cerebral arteries (CBFV) with high temporal resolution. Few studies have examined the relationship of CBFV change during visual search and visual memory cognitive tasks. Here a protocol to compare lateralization between these two similar tasks using fTCD is demonstrated. Thirteen healthy volunteers were shown visual scenes on a computer and performed visual search and visual memory tasks while CBFV in the bilateral middle cerebral arteries was monitored with fTCD. Each subject completed 40 trials, consisting of baseline, calibration, instruction, and task periods. Lateralization was …

Scalable Combinatorial Tools For Health Disparities Research, Michael A. Langston, Robert S. Levine, Barbara J. Kilbourne, Gary L. Rogers Jr., Anne D. Kershenbaum, Suzanne H. Baktash, Steven S. Coughlin, Arnold M. Saxton, Vincent K. Agboto, Darryl B. Hood, Maureen Y. Litchveld, Tonny J. Oyana, Patricia Matthews-Juarez, Paul D. Juarez

Sociology Faculty Research

Despite staggering investments made in unraveling the human genome, current estimates suggest that as much as 90% of the variance in cancer and chronic diseases can be attributed to factors outside an individual’s genetic endowment, particularly to environmental exposures experienced across his or her life course. New analytical approaches are clearly required as investigators turn to complicated systems theory and ecological, place-based and life-history perspectives in order to understand more clearly the relationships between social determinants, environmental exposures and health disparities. While traditional data analysis techniques remain foundational to health disparities research, they are easily overwhelmed by the ever-increasing size …

African Starchy Foods, Gastric Emptying, And Starch Digestion In Malian Stunted Children, Fatimata Cisse

Open Access Dissertations

Starch serves as the main energy source in cereal and tuber-rich diets, and its glycemic response profile has been associated with health-related conditions. Sorghum and millet are known to have relatively low starch digestibility, a potentially desirable property for controlling blood glucose response and providing sustained energy. Gastric emptying rates of traditional sorghum and millet-based African foods of the Sahelian region (couscous, thick and thin porridges made from millet and/or sorghum) were compared to those of non-traditional "modern" foods that are mostly consumed in urban areas using a non-invasive 13C-labelled octanoic acid breath test in healthy volunteers. The obtained results …