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Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons

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An Automated Method For Identifying Individuals With A Lung Nodule Can Be Feasibly Implemented Across Health Systems, Farhood Farjah, Scott Halgrim, Diana S.M. Buist, Michael K. Gould, Steven B. Zeliadt, Elizabeth T. Loggers, David S. Carrell 2016 University of Washington, Seattle, WA

An Automated Method For Identifying Individuals With A Lung Nodule Can Be Feasibly Implemented Across Health Systems, Farhood Farjah, Scott Halgrim, Diana S.M. Buist, Michael K. Gould, Steven B. Zeliadt, Elizabeth T. Loggers, David S. Carrell

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: The incidence of incidentally detected lung nodules is rapidly rising, but little is known about their management or associated patient outcomes. One barrier to studying lung nodule care is the inability to efficiently and reliably identify the cohort of interest (i.e. cases). Investigators at Kaiser Permanente Southern California (KPSC) recently developed an automated method to identify individuals with an incidentally discovered lung nodule, but the feasibility of implementing this method across other health systems is unknown.

Methods: A random sample of Group Health (GH) members who had a computed tomography in 2012 underwent chart review to determine if ...


Induction Of Dusp9 In Xenografts From Human Breast Cancer Cell Lines Increases Mammary Cancer Stem Cells, Albert Barrios, Meher Parveen, PhD, Easter Thames, Melanie Baker, Shelha Pervin, PhD 2016 Charles R. Drew University of Medicine and Science

Induction Of Dusp9 In Xenografts From Human Breast Cancer Cell Lines Increases Mammary Cancer Stem Cells, Albert Barrios, Meher Parveen, Phd, Easter Thames, Melanie Baker, Shelha Pervin, Phd

Journal of Health Disparities Research and Practice

Breast cancer remains a complex disease that kills 40,000 women every year. Initiation and progression of breast cancer is influenced by heterogeneous groups of cells, including mammary cancer stem cells (MCSCs). Progression of this dreadful disease is driven by many signaling pathways among which MAPK pathway is highly prominent. Since targeting prominent kinases in MAPK pathway has been unsuccessful to control breast cancer, it is important to examine the phosphatases that regulate the activity of these kinases.

Using xenograft model from breast cancer cell lines, our lab has found that during the initial stages of xenograft development (week 1-4 ...


Barriers And Facilitators To Deaf Trauma Survivors’ Help-Seeking Behavior: Lessons For Behavioral Clinical Trials Research: A Master’S Thesis, Melissa L. Anderson 2016 University of Massachusetts Medical School

Barriers And Facilitators To Deaf Trauma Survivors’ Help-Seeking Behavior: Lessons For Behavioral Clinical Trials Research: A Master’S Thesis, Melissa L. Anderson

Melissa L. Anderson

Deaf individuals experience significant obstacles to participating in behavioral health research when careful consideration is not given to accessibility in the design of study methodology. To inform such considerations, we conducted a secondary analysis of a mixed-methods study that explored 16 Deaf trauma survivors’ help-seeking experiences. Our objective was to identify key findings and qualitative themes from consumers' own words that can be applied to the design of behavioral clinical trials methodology. In many ways, the themes that emerged are what we would expect of any research participant, Deaf or hearing – a need for communication access, empathy, respect, strict confidentiality ...


Complexity And Chaos In Surgical Start Times, Dennis J. Baumgardner 2016 Aurora UW Medical Group, Aurora Health Care

Complexity And Chaos In Surgical Start Times, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In discussing an article investigating the causes for delay of first-case operating room start times included in this issue of the Journal of Patient-Centered Research and Reviews, the editor uses elements of complexity science and chaos theory to explain that such stubborn problems rarely stem from one of a few isolated causes. Taking a whole systems approach that utilizes flexibility, cross training, enhanced communication, common sense and perhaps mathematical models is suggested to effect positive change.


The Physiological Responses To Cycling Stress., Moriah Larsen 2016 Northern Arizona University

The Physiological Responses To Cycling Stress., Moriah Larsen

Skyline - The Big Sky Undergraduate Journal

Background: As the intensity of exercise increases, the risk of incidences for exertional heat illness (EHI) continues to climb. The National Athletic Trainers Association (NATA) has set an official position statement; stating a “gold standard” for obtaining core body temperature is via rectal thermometry. It has been reported that other field-expedient methods of obtaining core body temperature (oral, axillary, tympanic, temporal) are invalid or unreliable sources after intense exercise in hot temperature regions. Purpose: To determine if a relationship exists between rectal temperature measurements and tympanic temperature measurements during intensive long bouts of exercise. Design: Controlled Laboratory Study. Setting: Human ...


Using Interviews To Understand Patients’ Post-Operative Pain Management Educational Needs Before And After Elective Total Joint Replacement Surgery, Celeste A. Lemay, Patricia D. Franklin 2016 University of Massachusetts Medical School

Using Interviews To Understand Patients’ Post-Operative Pain Management Educational Needs Before And After Elective Total Joint Replacement Surgery, Celeste A. Lemay, Patricia D. Franklin

Celeste A. Lemay

Objective: To better understand the education needs of patients electing to have TJR in managing their pain in the post-operative period after discharge from the hospital.

Methods: An exploratory, descriptive, qualitative design. Convenience sample of people who reported that they had not received information about pain management prior to TJR surgery were recruited from 9 surgeon practices in 8 states to participate in telephone interviews, utilizing open-ended questions. Questions included: recollection of pre-op class attended and content; experiences with surgical pain after surgery and how it was managed; experiences with pain medicine; experience using non-medicine related pain reduction methods; suggestions ...


Effective Pain Information Pre-Operatively Is Associated With Improved Functional Gain After Total Joint Replacement, Celeste A. Lemay, David Ayers, Patricia D. Franklin 2016 University of Massachusetts Medical School

Effective Pain Information Pre-Operatively Is Associated With Improved Functional Gain After Total Joint Replacement, Celeste A. Lemay, David Ayers, Patricia D. Franklin

Celeste A. Lemay

Objective: We evaluated receipt of pre-operative pain management education in a national prospective cohort on post-operative pain and function.

Methods: Preoperative, 2 week and 6 month postoperative data from a nationally representative cohort of 1404 primary unilateral TJR patients with a date of surgery between May 2011 and December 2014. Data included demographics, comorbid conditions, operative joint pain severity (HOOS/KOOS), musculoskeletal disease burden, physical function (SF36 PCS), and mental health (SF36 MCS). At 2 weeks post-op, patients were asked if they had received information prior to surgery about pain management options and if so, how helpful the information was ...


6-Month Change In Pain And Function By Pre-Operative Pain And Function Among Patients Selected For Total Knee Replacement In The United States, Uyen-Sa D.T. Nguyen, David Ayers, Wenjun Li, Leslie R. Harrold, Patricia D. Franklin 2016 University of Massachusettts Medical School

6-Month Change In Pain And Function By Pre-Operative Pain And Function Among Patients Selected For Total Knee Replacement In The United States, Uyen-Sa D.T. Nguyen, David Ayers, Wenjun Li, Leslie R. Harrold, Patricia D. Franklin

Leslie R. Harrold

Background/Purpose: The increase in total knee replacements (TKRs) between 1979 and 2006 is staggering. Debate is growing regarding the appropriate utilization of TKRs. We examined pain, function, quality of life (QOL), and satisfaction at 6-month post-surgery by pain and function at time of surgery. Methods: Data came from the nationally representative FORCE-TJR cohort of patients from 150 surgeons. Participants had primary, unilateral TKRs due to osteoarthritis between 2011 and 2014. Their knee pain (KOOS), physical functions (SF36), and QOL were measured at pre- and 6 months post-surgery. We classified patients as having high or low pre-operative pain (KOOS Pain ...


Avoiding Overtreatment At The End Of Life: Physician-Patient Communication And Truly Informed Consent, Barbara A. Noah, Neal R. Feigenson 2016 Pace University

Avoiding Overtreatment At The End Of Life: Physician-Patient Communication And Truly Informed Consent, Barbara A. Noah, Neal R. Feigenson

Pace Law Review

This paper’s primary focus will be on considering how best to ensure that patients have the tools to make both informed and authentic choices about their care at the end of life. We will argue that truly informed decision making can help to reduce excessive end-of-life care by any measure. Most importantly for dying patients, better informed decisions can help reduce unnecessary suffering and result in care that aligns with their well-considered values and preferences.

In the first part of this paper, we will explain that, by any of these measures, many dying patients are receiving too much therapy ...


Therapeutic Raavrh10 Mediated Sod1 Silencing In Adult Sod1(G93a) Mice And Nonhuman Primates, Florie Borel, Gwladys Gernoux, Brynn Cardozo, Jake P. Metterville, Gabriela Toro Cabrera, Lina Song, Qin Su, Guang Ping Gao, Mai K. Elmallah, Robert H. Brown Jr., Christian Mueller 2016 University of Massachusetts Medical School

Therapeutic Raavrh10 Mediated Sod1 Silencing In Adult Sod1(G93a) Mice And Nonhuman Primates, Florie Borel, Gwladys Gernoux, Brynn Cardozo, Jake P. Metterville, Gabriela Toro Cabrera, Lina Song, Qin Su, Guang Ping Gao, Mai K. Elmallah, Robert H. Brown Jr., Christian Mueller

Christian Mueller

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease; survival in ALS is typically 3-5 years. No treatment extends patient survival by more than three months. Approximately 20% of familial ALS and 1-3% of sporadic ALS patients carry a mutation in the gene encoding superoxide dismutase 1 (SOD1). In a transgenic ALS mouse model expressing the mutant SOD1(G93A) protein, silencing the SOD1 gene prolongs survival. One study reports a therapeutic effect of silencing the SOD1 gene in systemically treated adult ALS mice; this was achieved with a short hairpin RNA, a silencing molecule that has raised multiple safety concerns ...


Manual Vs. Mechanical Chest Compressions In Out-Of-Hospital Cardiac Arrest, Ellie J. Tansey, Jesse B. Kalhorn, Abigail Hubble 2016 James Madison University

Manual Vs. Mechanical Chest Compressions In Out-Of-Hospital Cardiac Arrest, Ellie J. Tansey, Jesse B. Kalhorn, Abigail Hubble

Physician Assistant Capstones

Objective: The objective was to conduct an analysis of literature that examined whether the use of mechanical vs. manual chest compressions results in outcomes (e.g. quality of CPR, return of spontaneous circulation (ROSC), neurologic outcome, survival) that are significantly increased or decreased in adults that experienced out of hospital cardiac arrest (OHCA). Methods: Systematic searches were conducted through the James Madison University Library. The inclusion criteria included human adults that experienced out of hospital cardiac arrest that were treated by Emergency Medical Services (EMS) with and/or without a mechanical chest compression device. Results: A statistically significant difference was ...


An Automated Syringe Pump System For Improving The Reproducibility Of Dynamic Hyperpolarized Mri Phantoms, Harlee G. Harrison 2016 The University of Texas Graduate School of Biomedical Sciences at Houston

An Automated Syringe Pump System For Improving The Reproducibility Of Dynamic Hyperpolarized Mri Phantoms, Harlee G. Harrison

UT GSBS Dissertations and Theses (Open Access)

AN AUTOMATED SYRINGE PUMP SYSTEM FOR IMPROVING THE REPRODUCIBILITY OF DYNAMIC HYPERPOLARIZED MRI PHANTOMS

Harlee Grace Harrison, B.S.

Advisory Professor: James Bankson, Ph.D.

Magnetic Resonance Imaging (MRI) is a powerful tool in the diagnosis of cancer due to its ability to provide good soft tissue contrast and image resolution without the use of ionizing radiation. The use of hyperpolarized pyruvate as a contrast agent for tumor metabolism during MR scans has the potential to provide information about tumor metabolism in vivo that is not available from traditional imaging measurements or any other method. Hyperpolarization is achieved through dynamic ...


A Comparison Of Imaging Modalities For The Diagnosis Of Osteomyelitis, Brandon J. Smith, MD, Grant S. Buchanan, MD, Franklin D. Shuler, MD, PhD 2016 Marshall University, Joan C. Edwards School of Medicine

A Comparison Of Imaging Modalities For The Diagnosis Of Osteomyelitis, Brandon J. Smith, Md, Grant S. Buchanan, Md, Franklin D. Shuler, Md, Phd

Marshall Journal of Medicine

Osteomyelitis is an increasingly common pathology that often poses a diagnostic challenge to clinicians. Accurate and timely diagnosis is critical to preventing complications that can result in the loss of life or limb. In addition to history, physical exam, and laboratory studies, diagnostic imaging plays an essential role in the diagnostic process. This narrative review article discusses various imaging modalities employed to diagnose osteomyelitis: plain films, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, bone scintigraphy, and positron emission tomography (PET). Articles were obtained from Pubmed and screened for relevance to the topic of diagnostic imaging for osteomyelitis. The authors ...


The Tri-State Experience: Outcome Analysis Of Patients With Triple Negative Breast Cancer Treated At Marshall University, Laurie Matt MD, MPH, Mohammad Mozayen MD, Todd W. Gress MD, Maria Tria Tirona MD 2016 Marshall University

The Tri-State Experience: Outcome Analysis Of Patients With Triple Negative Breast Cancer Treated At Marshall University, Laurie Matt Md, Mph, Mohammad Mozayen Md, Todd W. Gress Md, Maria Tria Tirona Md

Maria Tirona

Breast cancer is the most frequently diagnosed malignancy in women in the United States. It is the second most common malignancy to cause death, with approximately 39,000 women dying of breast cancer in the United States in 2013. Triple negative breast cancer is defined as the absence of estrogen, progesterone and human epidermal growth factor receptor 2 receptors. It has been associated with a higher incidence in African American women, a younger age and a more advanced stage at diagnosis, and an inferior overall survival. To recognize the differences of our West Virginia community population when compared to the ...


Ptsd In The 20th Century American Military: Its Diagnosis, Effects, Treatment, And Management, With A Focus On The Vietnam War, Christy L. Connell 2016 Liberty University

Ptsd In The 20th Century American Military: Its Diagnosis, Effects, Treatment, And Management, With A Focus On The Vietnam War, Christy L. Connell

Bound Away: The Liberty Journal of History

Soldiers have been affected by PTSD for as long as war has existed. The American Military in the twentieth century is no exception. PTSD did not become a diagnosable disease until 1980, and before then it was misdiagnosed as different anxiety disorders and neuroses. Symptoms, treatment options, and long-term affects of PTSD are also discussed. Though other other wars in which America was involved are mentioned, those that receive a more thorough analysis are World War II, the Korean War, and the Vietnam War. Although PTSD is an increasing problem in modern times for those involved in military conflicts, there ...


Developing A Data Repository Of Standard Concussion Assessment Clinical Data For Research Involving College Athletes, Arthur C. Maerlender, Jennifer Mize Nelson, Julie A. Honaker 2016 University of Nebraska-Lincoln

Developing A Data Repository Of Standard Concussion Assessment Clinical Data For Research Involving College Athletes, Arthur C. Maerlender, Jennifer Mize Nelson, Julie A. Honaker

Center for Brain, Biology and Behavior: Papers & Publications

In sports concussion research, obtaining quality data from a sufficient number of participants to reach statistical power has been a particular problem. In addition, the necessary requirements of accessibility, informed consent, and confidentiality must be met. There is need to develop more efficient and controlled methods for collecting data to answer research questions in this realm, but the ability to collect and store these data in an efficient manner at the local level is limited. By virtue of their training, neuropsychologists can play a key role in improving data collection quality. The purpose of this paper is to describe a ...


Antimicrobial Resistance And Neisseria Gonorrhoeae Multiantigen Sequence Typing (Ng-Mast) Genotypes In N. Gonorrhoeae During 2012-2014 In Karachi, Pakistan, Kausar Jabeen, Bhawan Mal P, Khan E, Chandio S, Jacobsson S, Unemo M 2016 Aga Khan University

Antimicrobial Resistance And Neisseria Gonorrhoeae Multiantigen Sequence Typing (Ng-Mast) Genotypes In N. Gonorrhoeae During 2012-2014 In Karachi, Pakistan, Kausar Jabeen, Bhawan Mal P, Khan E, Chandio S, Jacobsson S, Unemo M

Department of Pathology and Laboratory Medicine

Background: Globally, increasing antimicrobial resistance (AMR) in Neisseria gonorrhoea has led to decreased treatment options for gonorrhoea. Continuous monitoring of resistance is crucial to determine evolving resistance trends in Neisseria gonorrhoea and to suggest treatment recommendations. Quality assured gonococcal AMR data from Pakistan are mainly lacking. This study was performed to determine prevalence and trends of gonococcal AMR and molecular epidemiology of local strains during 2012-2014 in Karachi, Pakistan.

Methods: Gonococcal isolates (n = 100) were obtained from urogenital specimens submitted to the Aga Khan University Laboratory, Karachi, Pakistan. Antimicrobial susceptibility was determined using Etest and molecular epidemiology was assessed by ...


Real-World Relevance Of Manual Electrocardiography Qt Interval Measurement, Satish Velagapudi, Zahra Nur Khaled, Bilal Omery, Firas Zahwe, Michael Anigbogu, Sarah Zukkoor, Indrajit Choudhuri 2016 Aurora Health Care

Real-World Relevance Of Manual Electrocardiography Qt Interval Measurement, Satish Velagapudi, Zahra Nur Khaled, Bilal Omery, Firas Zahwe, Michael Anigbogu, Sarah Zukkoor, Indrajit Choudhuri

Indrajit Choudhuri

Background: Electrocardiography (ECG) QT interval (QTI) prolongation independently predicts sudden death. Hospitalized patients are commonly exposed to multiple QT-prolonging drugs, and manual measurement of ECG QTI based on identifying the intersection of isoelectricity with the tangent to the terminal phase T-wave slope (QTTTT) is advocated due to inaccuracies in automated detection algorithms that may imprecisely identify QT duration.

Purpose: We evaluated the performance of QTTTT compared to a standard automated (12SL, GE Healthcare) method (QT-12SL).

Methods: Consecutively obtained ECGs of 250 hospitalized patients were reviewed. The QTI in leads II, aVR, V5 and V6 determined by QT-12SL and QTTTT were ...


Feasibility Of Atrial Delivery And Tracking Of Stem Cells In A Porcine Model, Nina Garlie, Timothy Hacker, Eric G. Schmuck, Jill Koch, Jayant Khitha, Amish Raval, Indrajit Choudhuri 2016 Regenerative Medicine Center, Aurora Research Institute, Aurora Health Care

Feasibility Of Atrial Delivery And Tracking Of Stem Cells In A Porcine Model, Nina Garlie, Timothy Hacker, Eric G. Schmuck, Jill Koch, Jayant Khitha, Amish Raval, Indrajit Choudhuri

Indrajit Choudhuri

Background: Many patients undergoing open heart surgery have sinus node dysfunction and atrial fibrillation, leading to adverse outcomes. Mesenchymal stem cells (MSC) delivered at the time of surgery may have a reparative effect on atrial tissue, thereby improving sinus node function and reducing or preventing atrial fibrillation. Stem cell delivery to the atrium is entirely unstudied. This is a significant gap in medical research, as atrial disease contributes significantly to health care costs. Purpose: The purpose of this pilot study is to establish a technique to deliver MSC to the atria through an open-chest model, to assess the safety of ...


Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan 2016 Aurora Research Institute, Aurora Health Care

Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan

Omar Cheema

Background: Congestive heart failure afflicts 5.7 million people in the United States with annual incidence of 600,000 and mortality of 280,000. Heart failure accounts for greater than 1 million hospitalizations annually and the single largest inpatient Medicare expense. As the U.S. population ages and greater emphasis is placed on population health as a means to bend projected health care expenditures, large health care organizations will need to develop algorithms to identify patients at high risk with heart failure and possibly preempt hospitalizations. Doppler echocardiography is routinely performed in clinical assessment of severe heart failure.

Purpose: We ...


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