Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Quality Management: A Global Case Study In Organ Transplantation, Cassie L. Rodriguez

Master's Projects

Every year the US and European countries face an epidemic of organ failure from a multitude of reasons: cancer, genetic predisposition, exposure to harmful chemicals in home or surrounding areas or through drinking, drugs and smoking. Another problem faced, is the ratio of organ donors to organ recipients. Over 121,000 patients are on the waiting for an organ transplant, and a fraction of those waiting will die because of time. The Hanover Medical school and department of quality management, have created an integrated approach to organ transplant avenues. Quality management is a systematic guide for organ transplantation that allows ...

The Effect Of Hamstring Lengthening On Pelvic Tilt And Lumbar Lordosis, Michael Scott Braman

Theses and Dissertations (ETD)

A direct correlation between hamstring tightness and severity of lower back pain (LBP) has been previously reported. Hamstring contraction creates knee flexion, hip extension and posterior pelvic tilt. Posterior pelvic tilt causes the lumbar spine to flatten (hypolordosis) which places pressure on the anterior structures of the spine, including the intervertebral disc. This increased pressure may predispose individuals to disc degeneration and associated pain. For this reason, hamstring stretching is often prescribed to alleviate LBP, however, the effect of hamstring lengthening on the kinematics of the lumbar spine and pelvis is not well understood. Accurate measurement of lumbar spine movement ...

Zombies, Predatory Wasps And Consciousness, James K. Peterson

Annual Symposium on Biomathematics and Ecology: Education and Research

No abstract provided.

Neural Networks: Using Biomarkers To Inform Diagnosis, Classification Of Disease And Approach To Therapy, Paula Grajdeanu

Annual Symposium on Biomathematics and Ecology: Education and Research

No abstract provided.

Book Reviews, John M. Gleason

RISK: Health, Safety & Environment

Reviews of the books: Mark A. Rothstein, Medical Screening and the Employee Health Cost Crisis (BNA Books 1989). Foreword Edward L. Baker, MD, MPH. 296 pp. Notes, figures, tables, glossary of legal terms, glossary of medical and health care terms, table of cases and index. LC 89-977; ISBN 0-87179-628-7.

Robert Decresce, Mark Lifshitz, Adrianne Mazura, & Joseph Tilson, Drug Testing In The Workplace (ASCP Press and BNA Books 1989). Forewords by Edward Miller, JD and George Lundberg, MD. 278 pp. Notes, figures, tables, table of cases and index. LC 88-39191; ISBN 0-89189-260-5 (ASCP), 0-87179-588-4 (BNA). Both of these books deal with the topic of medical screening of employees. As indicated by the titles, Rothstein's book deals with various types of screening, with a focus on health costs, while DeCresce et al. focus on one ...

The Postfinasteride Syndrome; An Overview, David L. Rowland, Ion G. Motofei, Florian Popa, Vlad D. Constantin, Adriana Vasilache, Ioana Păunică, Cristian Bălălău, Georgeta P. Păunică, Petrisor Banu, Stana Păunică

Journal of Mind and Medical Sciences

As a 5-α reductase inhibitor, Finasteride has proven effective in ameliorating two conditions documented to be androgen dependent, namely male androgenic alopecia and benign prostatic hyperplasia. Therapeutic results are maintained as long as the drug is administered, with treatment cessation generally leading to the return of symptomatology for each condition. In addition, during the therapeutic phase, several adverse effects have been reported, some of which persist long or indefinitely after treatment cessation, known as “post-finasteride syndrome.”

Herein we present and discuss the most common finasteride side effects, along with a psycho-neuroendocrine rationale that could explain the persistence of many adverse ...

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

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

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

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

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 ...

Characterization Of Left-Ventricular Thrombus Formation Using High Frequency Ultrasound, Kelsey A. Bullens, Arvin H. Soepriatna, Pavlos P. Vlachos, Craig J. Goergen

The Summer Undergraduate Research Fellowship (SURF) Symposium

Heart failure is a leading cause of death in the United States, and cardiac thrombus, a common morbidity associated with heart failure, significantly increases a patient’s risk of embolic events. The objective of this project is to characterize left-ventricular (LV) thrombus development using high frequency ultrasound imaging in a murine model. C57BL/6J wild-type mice (n=6) were injected intraperitoneally with iron dextran five times a week for six weeks to increase oxidative stress in the heart. Granulocyte-colony stimulating factor (G-CSF) was subcutaneously injected daily during the second week to initiate stem cell migration and stimulate endothelial cell activation ...

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

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

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

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 ...

Characterization And Personalization Of Botulinum Toxin Type A Therapy For Upper Limb Tremor In Parkinson Disease And Essential Tremor Patients Using Multi-Sensor Kinematic Technology, Olivia Samotus

Electronic Thesis and Dissertation Repository

Tremor commonly affects the upper extremities in essential tremor (ET) and Parkinson disease (PD) patients where many experience functional disability and ultimately seek therapy. As ET and PD tremor features overlap and clinical assessment is challenging due to its highly complex nature, misdiagnosis is common resulting in unsuitable therapies and prognosis. Current treatment options for ET and PD tremor include pharmacotherapy, focal therapy with botulinum toxin type A (BoNT-A) injections, and surgical interventions which provide modest relief of tremor. However, such therapies are commonly associated with significant adverse events and lack long-term efficacy and tolerability. Hence lack of standardized, objective ...

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

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

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 ...