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Implantation Of Left Ventricular Assist Device In The Setting Of Heavily Calcified Left Ventricular Apex Using An Apex Preserving Technique, Ismael A. Salas De Armas, Mehmet H. Akay, Jayeshkumar A. Patel, Chandni Patel, Manish K. Patel, Bindu Akkanti, Biswajit Kar, Igor D. Gregoric 2019 The University of Texas Health Science Center-Houston

Implantation Of Left Ventricular Assist Device In The Setting Of Heavily Calcified Left Ventricular Apex Using An Apex Preserving Technique, Ismael A. Salas De Armas, Mehmet H. Akay, Jayeshkumar A. Patel, Chandni Patel, Manish K. Patel, Bindu Akkanti, Biswajit Kar, Igor D. Gregoric

The VAD Journal

A heavily calcified ventricular apex represents a challenging, rare and unique situation in LVAD implantation. A 44-year-old male was admitted with myocardial infarction. Left heart catheterization was complicated by episodes of ventricular fibrillation. After an acute stabilization with veno-arterial extracorporeal membrane oxygenation (VA-ECMO), an LVAD implantation was approved. Pre-operative work-up had shown a heavily calcified ventricular apex and an intraventricular thrombus, which was confirmed intraoperatively. To retain a viable ventricular geometry, the decision was made to preserve the calcified apex rather than to excise the entire calcified left ventricular aneurysm. Sutures for the inlet cannula were placed around the calcific ...


Industry Spotlight: Medical Devices, Evan D. Poff 2019 Brigham Young University

Industry Spotlight: Medical Devices, Evan D. Poff

Marriott Student Review

Medical devices restore and even redefine health. This Industry Spotlight examines pre-market barriers, medtech business model quirks, current and future developments in the field, and the present-day move to value-based care in the medical device industry.


A “Diagnosis Method" For The Analysis Of Epidemiological Studies. A Reevaluation Of Pan, Et Al. Arch Intern Med 2012, 172:555., Richard D. Feinman, Eugene J. Fine 2019 SUNY Downstate Medical Center

A “Diagnosis Method" For The Analysis Of Epidemiological Studies. A Reevaluation Of Pan, Et Al. Arch Intern Med 2012, 172:555., Richard D. Feinman, Eugene J. Fine

Journal of Evolution and Health

The medical literature has been subject to extensive criticism for a lack of accuracy and reproducibility. A major cause, in our view, is misleading or inappropriate presentation and interpretation of statistical results. Emphasis on percentages or relative values (odds ratios, relative risk, and hazard ratio) always reduces and often obscures information. We suggest a more direct method using the 2 x 2 matrix commonly employed in diagnosis testing. We demonstrate the “diagnosis method,” by evaluating a previously published paper (Pan A, et al.: Arch Intern Med 2012, 172:555-563). on the risk of red meat for disease, focussing on cancer ...


Developing A Real-Time Translator From Neural Signals To Text: An Articulatory Phonetics Approach, Lindy Comstock, Ariel Tankus, Michelle Tran, Nader Pouratian, Itzhak Fried, William Speier 2019 University of California, Los Angeles

Developing A Real-Time Translator From Neural Signals To Text: An Articulatory Phonetics Approach, Lindy Comstock, Ariel Tankus, Michelle Tran, Nader Pouratian, Itzhak Fried, William Speier

Proceedings of the Society for Computation in Linguistics

New developments in brain-computer interfaces (BCI) harness machine learning to decode spoken language from electrocorticographic (ECoG) and local field potential (LFP) signals. Orienting to signals associated with motor movements that produce articulatory features improves phoneme detection quality: individual phonemes share features, but possess a unique feature set; classification by feature set allows for a finer distinction between neural signals. Data indicates vowels are more detectable, consonants have greater detection accuracy, place of articulation informs precision, and manner of articulation affects recall. Findings have implications for the multisensory integration of speech and the role of motor imagery in phonemic neural representations.


Toll-Like Receptor-4 Disruption Suppresses Adipose Tissue Remodeling And Increases Survival In Cancer Cachexia Syndrome, Felipe Henriques, Magno A. Lopes, Felipe O. Franco, Pamela Knobl, Kaltinaitis B. Santos, Luana L. Bueno, Victor A. Correa, Alexander H. Bedard, Adilson L. Guilherme, Alexander Birbrair, Sidney B. Peres, Stephen R. Farmer, Miguel L. Batista Jr. 2018 University of Massachusetts Medical School

Toll-Like Receptor-4 Disruption Suppresses Adipose Tissue Remodeling And Increases Survival In Cancer Cachexia Syndrome, Felipe Henriques, Magno A. Lopes, Felipe O. Franco, Pamela Knobl, Kaltinaitis B. Santos, Luana L. Bueno, Victor A. Correa, Alexander H. Bedard, Adilson L. Guilherme, Alexander Birbrair, Sidney B. Peres, Stephen R. Farmer, Miguel L. Batista Jr.

Open Access Articles

Cancer-induced cachexia, characterized by systemic inflammation, body weight loss, adipose tissue (AT) remodeling and muscle wasting, is a malignant metabolic syndrome with undefined etiology. Here, we show that both genetic ablation and pharmacological inhibition of TLR4 were able to attenuate the main clinical markers of cachexia in mice bearing Lewis lung carcinoma (LLC). AT remodelling was not found in LLC tumor-bearing (TB) TLR4(-/-) mice due to reduced macrophage infiltration and adipocyte atrophy. TLR4(-/-) mice were also resistant to cold-induced browning of subcutaneous AT (scAT). Importantly, pharmacological inhibition of TLR4 (Atorvastatin) reproduced the main protective effect against AT remodeling found in ...


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Titan-Gel.Gif, 2018 Selected Works

Multiple Regression Models To Analyze Length Of Hospitalization Due To Nosocomial Infections In U.S. Hospitals, Ernest M. Oleksy 2018 Cleveland State University

Multiple Regression Models To Analyze Length Of Hospitalization Due To Nosocomial Infections In U.S. Hospitals, Ernest M. Oleksy

The Downtown Review

Nosocomial diseases are a serious concern and detriment to hospitals’ abilities to provide appropriate patient care. Bearing this in mind, an effort must be made to determine whether infection surveillance and control programs have reduced the rates of nosocomial infection at U.S. hospitals. The data that were studied were obtained as part of the Study on the Efficacy of Nosocomial Infection Control (SENIC) and used to develop a model of what variables most contribute to a patient’s length of stay at the Cleveland Clinic (Quade et al, 1980).


Intron-Containing Rna From The Hiv-1 Provirus Activates Type I Interferon And Inflammatory Cytokines, Sean M. McCauley, Kyusik Kim, Anetta Nowosielska, Ann Dauphin, Leonid Yurkovetskiy, William E. Diehl, Jeremy Luban 2018 University of Massachusetts Medical School

Intron-Containing Rna From The Hiv-1 Provirus Activates Type I Interferon And Inflammatory Cytokines, Sean M. Mccauley, Kyusik Kim, Anetta Nowosielska, Ann Dauphin, Leonid Yurkovetskiy, William E. Diehl, Jeremy Luban

Open Access Articles

HIV-1-infected people who take drugs that suppress viremia to undetectable levels are protected from developing AIDS. Nonetheless, HIV-1 establishes proviruses in long-lived CD4(+) memory T cells, and perhaps other cell types, that preclude elimination of the virus even after years of continuous antiviral therapy. Here we show that the HIV-1 provirus activates innate immune signaling in isolated dendritic cells, macrophages, and CD4(+) T cells. Immune activation requires transcription from the HIV-1 provirus and expression of CRM1-dependent, Rev-dependent, RRE-containing, unspliced HIV-1 RNA. If rev is provided in trans, all HIV-1 coding sequences are dispensable for activation except those cis-acting sequences required ...


A Randomized Controlled Trial Of A Modified Cystoscopy Technique, Khalil Hetou 2018 The University of Western Ontario

A Randomized Controlled Trial Of A Modified Cystoscopy Technique, Khalil Hetou

Electronic Thesis and Dissertation Repository

Introduction

Pain, anxiety and embarrassment are well documented feelings in patients undergoing ambulatory diagnostic cystoscopy. In this study, we explored utilizing Peak-end theory in improving pain perception in patients undergoing diagnostic cystoscopy.

Materials and Methods

We conducted a randomized clinical trial at the London Health Sciences Center for patients undergoing an ambulatory diagnostic cystoscopy for the first time. Males and females as well as allocation ratios were 1:1. The control arm received a standard cystoscopy. In the intervention arm the cystoscope was left for additional 2 minutes without further manipulation in the bladder before scope removal. The primary outcome ...


Retrospective Motion Correction In Magnetic Resonance Imaging Of The Brain, Patricia Johnson 2018 The University of Western Ontario

Retrospective Motion Correction In Magnetic Resonance Imaging Of The Brain, Patricia Johnson

Electronic Thesis and Dissertation Repository

Magnetic Resonance Imaging (MRI) is a tremendously useful diagnostic imaging modality that provides outstanding soft tissue contrast. However, subject motion is a significant unsolved problem; motion during image acquisition can cause blurring and distortions in the image, limiting its diagnostic utility. Current techniques for addressing head motion include optical tracking which can be impractical in clinical settings due to challenges associated with camera cross-calibration and marker fixation. Another category of techniques is MRI navigators, which use specially acquired MRI data to track the motion of the head.

This thesis presents two techniques for motion correction in MRI: the first is ...


Ultrasound Use In Resource-Limited Settings: A Systematic Review, Ravindra Gopaul, Gonzalo Bearman, Michael P. Stevens 2018 Virginia Commonwealth University; Penn State Health Milton S. Hershey Medical Center

Ultrasound Use In Resource-Limited Settings: A Systematic Review, Ravindra Gopaul, Gonzalo Bearman, Michael P. Stevens

Journal of Global Radiology

Purpose: Over the past decade, ultrasound (US) machines have become smaller, less expensive, more reliable, durable and user-friendly, making ultrasonography an ideal imaging modality in resource-poor settings. We conducted a literature review to examine the use of ultrasound in resource-limited settings, with emphasis on common applications, barriers to implementation, and impact on clinical decision-making and patient disposition.

Methods and Materials: Literature review. We conducted a PubMed and Cochrane Central search on the clinical use of ultrasound in the developing world. Search terms included ultrasonography, developing countries, resource limited, remote setting, poverty, and low income. Articles from 2000 to 2015 that ...


Investigating The Practical And Clinical Effectiveness Of Applying Current Steering To Deep Brain Stimulation For Parkinsonian Gait Therapy, Daphne Hui 2018 The University of Western Ontario

Investigating The Practical And Clinical Effectiveness Of Applying Current Steering To Deep Brain Stimulation For Parkinsonian Gait Therapy, Daphne Hui

Electronic Thesis and Dissertation Repository

Multiple neural network integration, influence of bradykinesia and rigidity, and bias of upper limb symptom improvement during deep brain stimulation implementation may attribute to the variable responsiveness of Parkinsonian gait therapy. Current steering (CS) addresses variability through fractionating current to fine-tune the stimulation field shape. It was hypothesized that CS would exhibit greater gait improvements and lower the total electrical energy delivered (TEED), which reduces power consumption and battery drainage. Divisions of 70/30 and 50/50 and single-contact stimulation modelled CS and conventions, respectively. Overall ambulation improved with TEED reduction; further, bilateral CS improved step time and length but ...


Real-World Comparative Effectiveness Of Tocilizumab Monotherapy Vs. Tumor Necrosis Factor Inhibitors With Methotrexate In Patients With Rheumatoid Arthritis, Leslie R. Harrold, George W. Reed, Jennie Best, Steve Zlotnick, Joel M. Kremer 2018 University of Massachusetts Medical School

Real-World Comparative Effectiveness Of Tocilizumab Monotherapy Vs. Tumor Necrosis Factor Inhibitors With Methotrexate In Patients With Rheumatoid Arthritis, Leslie R. Harrold, George W. Reed, Jennie Best, Steve Zlotnick, Joel M. Kremer

Open Access Articles

INTRODUCTION: Controlled clinical studies have shown that the efficacy of tocilizumab (TCZ) monotherapy is superior to that of tumor necrosis factor inhibitor (TNFi) monotherapy and comparable to that of TCZ plus methotrexate (MTX) for the treatment of rheumatoid arthritis (RA). This study compared the real-world effectiveness of TCZ monotherapy vs. TNFis plus MTX in US patients with RA.

METHODS: TCZ-naive patients from the Corrona RA registry with prior exposure to > /= 1 TNFi who initiated TCZ monotherapy or TNFi + MTX were included. Outcomes included mean change in Clinical Disease Activity Index (CDAI), achievement of low disease activity (LDA; CDAI < /= 10), achievement of modified American College of Rheumatology (mACR) 20/50 responses, and mean change in modified Health Assessment Questionnaire (mHAQ) at 6 months. Patients initiating TNFi + MTX were grouped by MTX dose ( < /= 10 mg; > 10 to ...


Ectopic High Endothelial Venules In Pancreatic Ductal Adenocarcinoma: A Unique Site For Targeted Delivery, Baharak Bahmani, Mayuko Uehara, Farideh Ordikhani, Xiaofei Li, Liwei Jiang, Naima Banouni, Takaharu Ichimura, Vivek Kasinath, Siawosh K. Eskandari, Nasim Annabi, Jonathan S. Bromberg, Leonard D. Shultz, Dale L. Greiner, Reza Abdi 2018 Harvard Medical School

Ectopic High Endothelial Venules In Pancreatic Ductal Adenocarcinoma: A Unique Site For Targeted Delivery, Baharak Bahmani, Mayuko Uehara, Farideh Ordikhani, Xiaofei Li, Liwei Jiang, Naima Banouni, Takaharu Ichimura, Vivek Kasinath, Siawosh K. Eskandari, Nasim Annabi, Jonathan S. Bromberg, Leonard D. Shultz, Dale L. Greiner, Reza Abdi

Open Access Articles

BACKGROUND: Nanomedicine offers an excellent opportunity to tackle treatment-refractory malignancies by enhancing the delivery of therapeutics to the tumor site. High endothelial venules (HEVs) are found primarily in lymph nodes or formed de novo in peripheral tissues during inflammatory responses. They express peripheral node addressin (PNAd), which is recognized by the monoclonal antibody MECA79.

METHODS: Here, we demonstrated that HEVs form de novo in human pancreatic ductal adenocarcinoma (PDAC). We engineered MECA79 coated nanoparticles (MECA79-NPs) that recognize these ectopic HEVs in PDAC.

FINDINGS: The trafficking of MECA79-NPs following intravenous delivery to human PDAC implanted in a humanized mouse model was ...


In Vivo Tracking Of Tumour Associated Macrophages In Breast Cancer With Magnetic Resonance Imaging, Ashley V. Makela 2018 The University of Western Ontario

In Vivo Tracking Of Tumour Associated Macrophages In Breast Cancer With Magnetic Resonance Imaging, Ashley V. Makela

Electronic Thesis and Dissertation Repository

Introduction: The environment in which a tumour exists and functions is called the tumour microenvironment (TME). In breast cancer, the presence of tumour associated macrophages (TAMs) in the TME is associated with tumour aggressiveness and poor outcomes. Despite evidence for a link between TAM content and outcome, there are few strategies to measure TAMs and no in vivo approach. Iron or fluorine-19 (19F)-based MRI can be used to detect macrophages post intravenous injection of either an iron or perfluorocarbon (PFC) agent. Iron-based MRI is sensitive but difficult to quantify. 19F MRI is specific and signal is proportional ...


Improving Efficiency In Neuroimaging Research Through Application Of Lean Principles, Alexandra Roy, Julia Colpitts, Kara Becker, Judson A. Brewer, Remko van Lutterveld 2018 University of Massachusetts Medical School

Improving Efficiency In Neuroimaging Research Through Application Of Lean Principles, Alexandra Roy, Julia Colpitts, Kara Becker, Judson A. Brewer, Remko Van Lutterveld

Open Access Articles

INTRODUCTION: "Lean" is a set of management principles which focus on increasing value and efficiency by reducing or avoiding waste (e.g., overproduction, defects, inventory, transportation, waiting, motion, over processing). It has been applied to manufacturing, education, and health care, leading to optimized process flow, increased efficiency and increased team empowerment. However, to date, it has not been applied to neuroimaging research.

METHODS: Lean principles, such as Value stream mapping (e.g. a tool with which steps in the workflow can be identified on which to focus improvement efforts), 5S (e.g. an organizational method to boost workplace efficiency and ...


Tibiotalar Arthrodesis: Development Of A Novel Jig And Alignment Guide, Adam Mathew Ropchan 2018 The University of Western Ontario

Tibiotalar Arthrodesis: Development Of A Novel Jig And Alignment Guide, Adam Mathew Ropchan

Electronic Thesis and Dissertation Repository

Tibiotalar arthrodesis is a surgical procedure, used for the treatment of end-stage ankle arthrosis and instability. There are dozens of described procedures in the literature, all with varying rates of success. Two of the most common reasons for reoperation in tibiotalar arthrodesis are nonunion and infection; few studies have established any associations between patient/surgical factors and reoperation for nonunion and infection.

The first part of this thesis focuses on determining the rate of reoperation to the ipsilateral lower limb and if any patient/surgical factors are associated with reoperation for nonunion and infection. The second part of this thesis ...


Targeted Delivery Of Bioactive Molecules For Vascular Intervention And Tissue Engineering, Hannah A. Strobel, Elisabet I. Qendro, Eben Alsberg, Marsha W. Rolle 2018 Worcester Polytechnic Institute

Targeted Delivery Of Bioactive Molecules For Vascular Intervention And Tissue Engineering, Hannah A. Strobel, Elisabet I. Qendro, Eben Alsberg, Marsha W. Rolle

Open Access Articles

Cardiovascular diseases are the leading cause of death in the United States. Treatment often requires surgical interventions to re-open occluded vessels, bypass severe occlusions, or stabilize aneurysms. Despite the short-term success of such interventions, many ultimately fail due to thrombosis or restenosis (following stent placement), or incomplete healing (such as after aneurysm coil placement). Bioactive molecules capable of modulating host tissue responses and preventing these complications have been identified, but systemic delivery is often harmful or ineffective. This review discusses the use of localized bioactive molecule delivery methods to enhance the long-term success of vascular interventions, such as drug-eluting stents ...


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