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Robustness Of A Newly Proposed Risk Schema For Lymphatic Dissemination In Endometrioid Endometrial Cancer, Danielle M. Greer, Jessica J.F. Kram, Callie M. Cox Bauer, Scott A. Kamelle 2017 Aurora University of Wisconsin Medical Group; Center for Urban Population Health

Robustness Of A Newly Proposed Risk Schema For Lymphatic Dissemination In Endometrioid Endometrial Cancer, Danielle M. Greer, Jessica J.F. Kram, Callie M. Cox Bauer, Scott A. Kamelle

Journal of Patient-Centered Research and Reviews

Background: Surgical management for endometrioid endometrial cancer (EEC) includes complete lymph node dissection for all patients at risk of lymphatic dissemination. The standard risk schema, defined by Mayo Clinic, identifies low-risk patients as those with grade 1/2 EEC, myometrial invasion (MI) ≤ 50%, and tumor diameter (TD) ≤ 2 cm. We recently proposed (and published) a risk schema containing modified forms of grade, MI and TD that suggests a significant decrease in false-negative rate and need for lymphadenectomy in low-risk women.

Purpose: Evaluate robustness of our proposed schema for lymphatic dissemination risk stratification in a subsequent EEC patient cohort.

Methods: We ...


Sensitivity Of Current Methods For Diagnosing And Documenting Metabolic Syndrome Within A Large Community-Based Health Care System, Tiffany A. Mullen, Danielle M. Greer, Jennifer T. Fink, Renee E. Walker 2017 Department of Integrative Medicine, Aurora Sinai Medical Center

Sensitivity Of Current Methods For Diagnosing And Documenting Metabolic Syndrome Within A Large Community-Based Health Care System, Tiffany A. Mullen, Danielle M. Greer, Jennifer T. Fink, Renee E. Walker

Journal of Patient-Centered Research and Reviews

Background: Metabolic syndrome (MetS) is a constellation of metabolic conditions, including abdominal obesity, high blood pressure, high triglyceride level, low high-density-lipoprotein level and high fasting blood glucose level, that increase the risk of developing chronic health conditions. Various combinations of diagnostic criteria have been proposed, including those by the National Cholesterol Education Program Adult Treatment Panel III (ATP III), World Health Organization (WHO) and International Diabetes Foundation (IDF), among others. However, inconsistent use of diagnostic criteria and inadequate scientific evidence supporting use of specific criteria are current problems in health care.

Purpose: Quantify the prevalence of MetS diagnosis within the ...


Stard For Abstracts: Essential Items For Reporting Diagnostic Accuracy Studies In Journal Or Conference Abstracts, Jérémie F Cohen, Daniël A Korevaar, Constantine A Gatsonis, Paul P Glasziou, Lotty Hooft, David Moher, Johannes B Reitsma, Henrica Cw de Vet, Patrick M Bossuyt 2017 University of Amsterdam

Stard For Abstracts: Essential Items For Reporting Diagnostic Accuracy Studies In Journal Or Conference Abstracts, Jérémie F Cohen, Daniël A Korevaar, Constantine A Gatsonis, Paul P Glasziou, Lotty Hooft, David Moher, Johannes B Reitsma, Henrica Cw De Vet, Patrick M Bossuyt

Faculty of Health Sciences & Medicine Publications

Many abstracts of diagnostic accuracy studies are currently insufficiently informative. We extended the STARD (Standards for Reporting Diagnostic Accuracy) statement by developing a list of essential items that authors should consider when reporting diagnostic accuracy studies in journal or conference abstracts. After a literature review of published guidance for reporting biomedical studies, we identified 39 items potentially relevant to report in an abstract. We then selected essential items through a two round web based survey among the 85 members of the STARD Group, followed by discussions within an executive committee. Seventy three STARD Group members responded (86%), with 100% completion ...


Words Do Matter: A Systematic Review On How Different Terminology For The Same Condition Influences Management Preferences, Brooke Nickel, Alexandra Barratt, Tessa Copp, Ray Moynihan, Kirsten McCaffery 2017 University of Sydney

Words Do Matter: A Systematic Review On How Different Terminology For The Same Condition Influences Management Preferences, Brooke Nickel, Alexandra Barratt, Tessa Copp, Ray Moynihan, Kirsten Mccaffery

Ray Moynihan

OBJECTIVES: Changing terminology for low-risk, screen-detected conditions has now been recommended by several expert groups in order to prevent overdiagnosis and reduce the associated harms of overtreatment. However, the effect of terminology on patients' preferences for management is not well understood. This review aims to synthesise existing studies on terminology and its impact on management decision making. DESIGN: Systematic review. METHODS: Studies were included that compared two or more terminologies to describe the same condition and measured the effect on treatment or management preferences and/or choices. Studies were identified via database searches from inception to April 2017, and from ...


Words Do Matter: A Systematic Review On How Different Terminology For The Same Condition Influences Management Preferences, Brooke Nickel, Alexandra Barratt, Tessa Copp, Ray Moynihan, Kirsten McCaffery 2017 University of Sydney

Words Do Matter: A Systematic Review On How Different Terminology For The Same Condition Influences Management Preferences, Brooke Nickel, Alexandra Barratt, Tessa Copp, Ray Moynihan, Kirsten Mccaffery

Faculty of Health Sciences & Medicine Publications

OBJECTIVES:

Changing terminology for low-risk, screen-detected conditions has now been recommended by several expert groups in order to prevent overdiagnosis and reduce the associated harms of overtreatment. However, the effect of terminology on patients' preferences for management is not well understood. This review aims to synthesise existing studies on terminology and its impact on management decision making.

DESIGN:

Systematic review.

METHODS:

Studies were included that compared two or more terminologies to describe the same condition and measured the effect on treatment or management preferences and/or choices. Studies were identified via database searches from inception to April 2017, and from ...


Alzheimer’S Disease: Dawn Of A New Era?, Farideh Amirrad, Emira Bousoik, Kiumars Shamloo, Hassan Al-Shiyab, Viet-Hong Nguyen, Hamidreza Montazeri Aliabadi 2017 Chapman University

Alzheimer’S Disease: Dawn Of A New Era?, Farideh Amirrad, Emira Bousoik, Kiumars Shamloo, Hassan Al-Shiyab, Viet-Hong Nguyen, Hamidreza Montazeri Aliabadi

Pharmacy Faculty Articles and Research

Alzheimer’s disease (AD) is an irreversible neurodegenerative disease characterized by a progressive decline in cognition and memory, leading to significant impairment in daily activities and ultimately death. It is the most common cause of dementia, the prevalence of which increases with age; however, age is not the only predisposing factor. The pathology of this cognitive impairing disease is still not completely understood, which has limited the development of valid therapeutic options. Recent years have witnessed a wide range of novel approaches to combat this disease, so that they greatly increased our understanding of the disease and of the unique ...


A State-Wide Initiative To Promote Genetic Testing In An Underserved Population, Meghan L. Underhill, Traci M. Blonquist, Karleen Habin, Debra Lundquist, Kristen Shannon, Kathryn Robinson, Mary-Lou Woodford, Jean Boucher 2017 Dana-Farber Cancer Institute

A State-Wide Initiative To Promote Genetic Testing In An Underserved Population, Meghan L. Underhill, Traci M. Blonquist, Karleen Habin, Debra Lundquist, Kristen Shannon, Kathryn Robinson, Mary-Lou Woodford, Jean Boucher

Open Access Articles

Genetic testing for cancer susceptibility has been widely studied and utilized clinically. Access to genetic services in research and practice is largely limited to well-insured, Caucasian individuals. In 2009, the Cancer Resource Foundation (CRF) implemented the Genetic Information for Treatment Surveillance and Support (GIFTSS) program to cover the out-of-pocket expenses associated with cancer genetic testing, targeting high-risk individuals with limited financial means and limited health insurance coverage. Here, we (i) describe the characteristics of participants in the Massachusetts (MA) GIFTSS program and (ii) evaluate mutations found in this diverse sample. A secondary retrospective data analysis was performed using de-identified demographic ...


Ultrasound-Guided Breast Biopsy In The Resource-Limited Setting: An Initial Experience In Rural Uganda, Christopher R. Stark, Kristen K. DeStigter, Alphonsus Matovu, Picho Alli Shadrack 2017 University of Vermont

Ultrasound-Guided Breast Biopsy In The Resource-Limited Setting: An Initial Experience In Rural Uganda, Christopher R. Stark, Kristen K. Destigter, Alphonsus Matovu, Picho Alli Shadrack

The Journal of Global Radiology

Purpose: To describe the methodology and initial experience behind creation of an ultrasoundguided percutaneous breast core biopsy program in rural Uganda.

Methods and Materials: Imaging the World Africa (ITWA) is the registered non-governmental organization division of Imaging the World (ITW), a not-for-profit organization whose primary aim is the integration of affordable high-quality ultrasound into rural health centers. In 2013, ITWA began the pilot phase of an IRB-approved breast care protocol at a rural health center in Uganda. As part of the protocol’s diagnostic arm, an ultrasound-guided percutaneous breast core biopsy training curriculum was implemented in tandem with creation of ...


Development Of 90th Percentile Norms For Ipsilateral Acoustic Reflex Thresholds: A Feasibility Study, Iris Wertheimer 2017 The Graduate Center, City University of New York

Development Of 90th Percentile Norms For Ipsilateral Acoustic Reflex Thresholds: A Feasibility Study, Iris Wertheimer

All Graduate Works by Year: Dissertations, Theses, and Capstone Projects

The acoustic reflex threshold has been well established in the literature as an involuntary bilateral contraction of the stapedius muscle in response to loud transient sounds. Additionally, the clinical utility of the acoustic reflex threshold has been established as it allows for the differential diagnosis of many different conductive, cochlear and retrocochlear pathologies. Gelfand, Schwander and Silman (1990) have established and validated 90th percentile normative data for use with the contralateral acoustic reflex threshold. Much of the literature on the acoustic reflex threshold has focused on the contralateral acoustic reflex threshold; however, surveys have found that many clinicians are ...


The Acquisition And Analysis Of Electroencephalogram Data For The Classification Of Benign Partial Epilepsy Of Childhood With Centrotemporal Spikes, Jessica A. Scarborough 2017 University of San Francisco

The Acquisition And Analysis Of Electroencephalogram Data For The Classification Of Benign Partial Epilepsy Of Childhood With Centrotemporal Spikes, Jessica A. Scarborough

Master's Theses

In this thesis, I will expand upon each step in the process of acquiring and analyzing electroencephalogram (EEG) for the classification of benign childhood epilepsy with centrotemporal spikes. Despite huge advancements in the field of health informatics—natural language processing, machine learning, predictive modeling—there are significant barriers to the access of clinical data. These barriers include information blocking, privacy policy concerns, and a lack of stakeholder support. We will see that these roadblocks are all responsible for stunting biomedical research in some way, including my own experiences in acquiring the data for the second chapter of this thesis.

This ...


Cancer Diagnosis Using Libs And Machine Learning Tools: Progress And Challenges, Noureddine Melikechi, Rosalba Gaudiuso, Ebo Ewusi-Annan 2017 University of Massachusetts Lowell

Cancer Diagnosis Using Libs And Machine Learning Tools: Progress And Challenges, Noureddine Melikechi, Rosalba Gaudiuso, Ebo Ewusi-Annan

UMass Center for Clinical and Translational Science Research Retreat

Despite numerous research and development efforts that provide important tools to fight cancer, this disease still poses great challenges to diagnosis and treatment, and it remains one of the leading causes of death worldwide. Early diagnosis is crucial to increase the survival rate and quality of life of cancer patients. Thus, developing non-invasive screening methods would represent a key step towards point-of-care large scale screening and prevention of asymptomatic tumors such as Epithelian Ovarian Cancer (EOC) and others. Our group has developed two experimental strategies to pursue early cancer diagnosis through Laser-Induced Breakdown Spectroscopy (LIBS), a versatile atomic spectroscopy technique ...


Procalcitonin Levels; An Alternative Diagnostic Approach For Community Acquired Pneumonia In Acute Care Settings And Determination Of Antibiotic Therapy, Jamie Anne Rhodine 2017 University of Wyoming

Procalcitonin Levels; An Alternative Diagnostic Approach For Community Acquired Pneumonia In Acute Care Settings And Determination Of Antibiotic Therapy, Jamie Anne Rhodine

Honors Theses AY 16/17

Procalcitonin (PCT) levels are an accurate reflection of bacterial replication within the human body. By deciphering between bacterial and viral invasion, antibiotic therapy will be reduced contributing to the reduction of antibiotic resistance. For atypical patients with community acquired pneumonia (CAP), PCT levels will detect when antibiotic therapy is effective and when it is safe to discontinue antibiotics. Hospital stay length will be reduced and patients to nurse ratios will improve. One simple diagnostic PCT test used as an adjunct with traditional diagnostic testing for CAP will help minimize morbidity and mortality rates among patients. Traditionally used with septic patients ...


Quantifying Joint Coordination Variability In Anterior Cruciate Ligament-Reconstructed Individuals During Walking, Kylie Davis 2017 University of Tennessee Health Science Center

Quantifying Joint Coordination Variability In Anterior Cruciate Ligament-Reconstructed Individuals During Walking, Kylie Davis

Theses and Dissertations (ETD)

The knee is the second most common joint to sustain injury. An estimated 200,000 anterior cruciate ligament (ACL) ruptures occur each year in the United States alone, and about 100,000 ACL reconstruction (ACLR) surgeries are performed annually. There is a significant risk of developing osteoarthritis of the knee after incurring an ACL injury, and the incidence of ipsilateral or contralateral injury is six times greater in individuals who have a surgically repaired ACL. Past studies have analyzed kinetic and kinematic characteristics of individual lower extremity joints to reveal differences between subjects with and without ACLR. Despite reports of ...


Value Of Circulating Cell-Free Dna Analysis As A Diagnostic Tool For Breast Cancer: A Meta-Analysis, Ziqiang Lin, James Neiswender, Bin Fang, Xuelei Ma, Jing Zhang, Xiuying Hu 2017 West China Medical School, China

Value Of Circulating Cell-Free Dna Analysis As A Diagnostic Tool For Breast Cancer: A Meta-Analysis, Ziqiang Lin, James Neiswender, Bin Fang, Xuelei Ma, Jing Zhang, Xiuying Hu

Open Access Articles

OBJECTIVES: The aim of this study was to systematically evaluate the diagnostic value of cell free DNA (cfDNA) for breast cancer.

RESULTS: Among 308 candidate articles, 25 with relevant diagnostic screening qualified for final analysis. The mean sensitivity, specificity and area under the curve (AUC) of SROC plots for 24 studies that distinguished breast cancer patients from healthy controls were 0.70, 0.87, and 0.9314, yielding a DOR of 32.31. When analyzed in subgroups, the 14 quantitative studies produced sensitivity, specificity, AUC, and a DOR of 0.78, 0.83, 0.9116, and 24.40. The 10 ...


Keeping Weight Off: Study Protocol Of An Rct To Investigate Brain Changes Associated With Mindfulness-Based Stress Reduction, Carl E. Fulwiler, Julia A. Siegel, Jeroan J. Allison, Milagros C. Rosal, Judson A. Brewer, Jean A. King 2017 University of Massachusetts Medical School

Keeping Weight Off: Study Protocol Of An Rct To Investigate Brain Changes Associated With Mindfulness-Based Stress Reduction, Carl E. Fulwiler, Julia A. Siegel, Jeroan J. Allison, Milagros C. Rosal, Judson A. Brewer, Jean A. King

Jean A. King

INTRODUCTION: Obesity is a growing epidemic fuelled by unhealthy behaviours and associated with significant comorbidities and financial costs. While behavioural interventions produce clinically meaningful weight loss, weight loss maintenance is challenging. This may partially be due to failure to target stress and emotional reactivity. Mindfulness-based stress reduction (MBSR) reduces stress and emotional reactivity and may be a useful tool for behaviour change maintenance. This study seeks to provide a mechanistic understanding for clinical trials of the benefits of MBSR for weight loss maintenance by examining changes in functional connectivity (FC) and the association of these changes with clinical outcomes.

METHODS ...


A Novel Hybrid Imaging System To Aid In Surgical Decision Making, Lawrence Yip, Madeleine Van De Kleut, Ivan Kosik, Astrid Chamson-Reig, Jeffrey JL Carson 2017 Western University

A Novel Hybrid Imaging System To Aid In Surgical Decision Making, Lawrence Yip, Madeleine Van De Kleut, Ivan Kosik, Astrid Chamson-Reig, Jeffrey Jl Carson

Western Research Forum 2018 "Controversy: Challenging The Boundaries in Research"

Background:

Breast cancer accounts for 25% of all cancer cases among women. In breast-conserving surgery, a common treatment, the tumour is excised with a healthy tissue margin. However, detection of the margin can be difficult. Current techniques to guide excision are often insufficient, and re-excision can occur up to 25% of the time.

Methods:

Photoacoustic imaging is a hybrid imaging modality that combines the advantages of optical imaging and ultrasound while using safe non-ionizing light. This project involves the development of a novel imaging system with a new scanner design to overcome common limitations and provide images to aid in ...


Penetrance Estimates For Incidental Genomic Findings In Acmg-59, James A. Diao 2017 Yale University

Penetrance Estimates For Incidental Genomic Findings In Acmg-59, James A. Diao

Yale Day of Data

The dropping costs and rising popularity of next-generation sequencing has introduced the possibility of personalizing medical treatments and screening for genetic diseases. Still, the clinical community’s understanding remains incomplete, with limited consensus on the proper interpretation for many genetic variants. Thus, the standard procedure when returning sequencing results has been to report findings only in genes related to the diagnostic indication, and not incidental findings in other genes. To balance the threat of false positives with the medical benefits of true findings, the American College on Medical Genetics and Genomics (ACMG) recommends an exception: that clinical sequencing laboratories seek ...


Biomarkers Of Sepsis: A Retrospective Approach, Jose M. Roberts 2017 The University of Akron

Biomarkers Of Sepsis: A Retrospective Approach, Jose M. Roberts

Honors Research Projects

Background: Biomarkers are taking the spotlight in becoming the norm for early diagnoses. Sepsis is an inflammatory disease that increases metabolic rate in children. The first biomarker is hyponatremia. Hyponatremia is a frequent electrolyte imbalance in clinical practice, often observed in children with inflammatory disease and infection. Presence of hyponatremia is associated with electrical signaling imbalances, inflammation and renal dysfunction. The clinical value of hyponatremia in pediatric patients is unknown. The C-reactive protein is a second biomarker. Its presence signifies that necrotic cells and inflammation are present.

Objectives: To evaluate the use of biomarkers in children seen in the Emergency ...


Mri-Based Susceptibility Mapping For In-Vivo Iron And Blood Oximetry Measurements, Hannah Erdevig 2017 University of Colorado, Boulder

Mri-Based Susceptibility Mapping For In-Vivo Iron And Blood Oximetry Measurements, Hannah Erdevig

Undergraduate Honors Theses

MRI is increasingly used in mapping tissue susceptibility to identify cerebral microbleeds associated with traumatic brain injury and pathological iron deposits associated with neurodegenerative diseases such as Parkinson's and Alzheimer's disease [1,2]. Accurate measurement is important for determining oxygen and iron content in blood vessels and tissue in the brain, which are in turn used for noninvasive clinical diagnosis and treatment assessments. Magnetic field distortions with a resolution of a few parts per billion can be measured using MRI phase maps. The field distortion map can then be inverted to obtain a quantitative susceptibility map. The primary ...


Associations Between Modifiable Health-Risk Behaviors And Personality Types, Jon C. Schommer, Paul D. Tieger, Anthony W. Olson, Lawrence M. Brown 2017 University of Minnesota

Associations Between Modifiable Health-Risk Behaviors And Personality Types, Jon C. Schommer, Paul D. Tieger, Anthony W. Olson, Lawrence M. Brown

Pharmacy Faculty Articles and Research

Objectives: The first objective for this study was to explore if characteristics of personality type (using the Preferred Communication Style Questionnaire) are associated with the following modifiable health-risk behaviors: smoking, exercise, alcohol consumption, nutrition, sleep, depression-related stress, anxiety-related stress, healthcare professional usage, and self-discipline. The second objective for this study was to explore if characteristics of personality type are associated with (1) the quality of patient-physician relationships, (2) patient-physician communication, and (3) preferred method for receiving information.

Methods: Data were collected from 10,500 adult individuals residing in the United States via an on-line, self-administered survey coordinated by Qualtrics Panels ...


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