Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Systemic Blood Pressure Trends And Antihypertensive Utilization Following Continuous-Flow Left Ventricular Assist Device Implantation: An Analysis Of The Interagency Registry For Mechanically Assisted Circulatory Support, Adham Elmously, Andreas R. De Biasi, Donald A. Risucci, Berhane Worku, Evelyn M. Horn, Arash Salemi

NYMC Faculty Publications

Background: Elevated systemic blood pressure (SBP) has been linked to complications in Continuous-flow left ventricular assist devices (CF-LVADs), including stroke and pump thrombosis. We queried Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) to describe the response of SBP to CF-LVAD implantation and to delineate contemporary trends in antihypertensive (AH) utilization for patients with these pumps. Methods: We identified all CF-LVAD implantations in patients older than 18 years from 2006-2014, excluding those whose durations were less than 30 days. Pre-implant patient demographics and characteristics were obtained for each record. SBPs [i.e., mean arterial pressures (MAPs)], AH-use data, and vital status …

Maturation Of Human Induced Pluripotent Stem Cell Derived Engineered Cardiac Tissues Using Chief Transfection And Chronic Optical Pacing., Marc M. Dwenger

Electronic Theses and Dissertations

The immaturity of engineered cardiac tissues (ECTs) limits their ability to regenerate damaged myocardium and to serve as in vitro disease models and surrogates for drug toxicity testing. Several chronic biomimetic conditioning protocols, including mechanical stretch, perfusion, and electrical stimulation promote ECT maturation but have significant technical limitations. Non-contacting chronic light stimulation using heterologously expressed light-sensitive ChIEF ion channels, termed optogenetics, may be an advantageous alternative to chronic electrical stimulation. As a proof of principle, we transfected ECTs using an AAV packaged ChIEF and then verified acute optical pacing (OP) by patch clamp. We then chronically OP ECTs for 7 …

Longitudinal Measures Of Deformation Are Associated With A Composite Measure Of Contractility Derived From Pressure-Volume Loop Analysis In Children., Shahryar M. Chowdhury, Ryan J. Butts, Carolyn L. Taylor, Varsha M. Bandisode, Karen S. Chessa, Anthony M. Hlavacek, Arni Nutting, Girish S. Shirali, G Hamilton Baker

Manuscripts, Articles, Book Chapters and Other Papers

Aims: The relationship between echocardiographic measures of left ventricular (LV) systolic function and reference-standard measures have not been assessed in children. The objective of this study was to assess the validity of echocardiographic indices of LV systolic function via direct comparison to a novel composite measure of contractility derived from pressure-volume loop (PVL) analysis.

Methods and results: Children with normal loading conditions undergoing routine left heart catheterization were prospectively enrolled. PVLs were obtained via conductance catheters. A composite invasive composite contractility index (ICCI) was developed using data reduction strategies to combine four measures of contractility derived from PVL analysis. Echocardiograms …

Designing A Mobile Application To Support The Indicated Prevention And Early Intervention Of Childhood Anxiety, Mandar Patwardhan, Ashish Amresh, Ryan Stoll, Kevin A. Gary, Derek B. Hamel, Armando Pina

Ashish Amresh

This paper presents the design of an mHealth application for prevention and early intervention of childhood anxiety. The application is based on REACH, a preventative-early intervention protocol for childhood anxiety. This paper describes the multidisciplinary design process, sharing lessons learned in developing an effective mHealth application. This mHealth application is unique due to participant age, preventive-early intervention focus, and utilization of mobile technology in a situated manner. A design process inspired by user-centered leveraging key informant interviews was used to identify application features, including game based strategies and an animated motivational avatar. Validation was performed through external review and a …

Make Your Garden Grow: Designing A Physical Activity Estimation Improvement Game, Ashish Amresh, Leigh Small

Ashish Amresh

We present a novel game and virtual world based application that is aimed at improving the physical activity estimation skills of parents. It has been well established that lack of proper estimation of preschool children’s activity levels may be one of the main causes for childhood obesity. Childhood obesity has several long term health effects ranging from cardio-vascular disease to type II diabetes and obese preschool children are at risk for later life. We have developed an application that caters to both the parent and the child and uses a virtual garden as a fledgling ecosystem controlled both by the …

Interactive Cause And Effect Comic-Book Storytelling For Improving Nutrition Outcomes In Children, Ashish Amresh, Madhumita Sinha, Rebecca Birr, Rahul Salla

Ashish Amresh

Obesity among children and adolescents is increasingly becoming a major public health problem. Poverty and lower socio-economic status as well as lack of parental awareness regarding a balanced diet and adequate exercise all contribute towards childhood obesity. Unfortunately minority children have been especially vulnerable, among them inner-city Latino children continue to have the highest incidence rates of overweight and obesity; hence targeted intervention for this population group is of paramount importance. Access and affordability of smartphones and mobile internet devices provide an opportunity to create nutrition education interventions that can significantly impact and change attitude and knowledge regarding healthy diet …

Developing A Bilingual, Computer-Tailored, Hpv Vaccination Promotion Intervention Targeting Latino Parents, Angela Chia-Chen Chen, Ashish Amresh

Ashish Amresh

In this paper we present an innovative, computer-tailored application aimed at increasing Latino parents' intention to vaccinate their adolescent children against Human Papilloma Virus (HPV). HPV infection is the most common sexually transmitted infection in the United States. Latinas have the highest age-adjusted incidence rate for HPV-associated cervical cancer compared with their counterparts in other racial/ethnic groups. HPV vaccines offer hope against HPV-associated diseases. Because parental consent is required for children under age 18 to receive t h e HPV vaccination in most U. S. states, parents' attitudes and intention to have their children vaccinated are keys for promoting HPV …

A Complex Systems Framework Approach Towards Multidisciplinary Tumor Boards, Rahul Salla, Robert Pahle, Ashish Amresh

Ashish Amresh

Multidisciplinary tumor boards (MTBs) are universally recommended and have been used in treatment of late stage cancers. Tumor boards have the advantage of including all the stakeholders in the decision making process and improving quality of care, however several studies have pointed to their lack of efficiency and tend to be lackluster while not producing the desired benefits for the participants. In this paper we present the design of a web based immersive framework for collaborative decision making that has the potential to improve several inefficiencies in conducting tumor boards and improve overall clinical outcomes. We present the design of …

The Hospital Antimicrobial Use Process: From Beginning To End, William R. Truong, Jason Yamaki

Pharmacy Faculty Articles and Research

Hospital antimicrobial stewardship (AMS) programs are responsible for ensuring that all antimicrobials are utilized in the most appropriate and safe manner to improve patient outcomes, prevent adverse drug reactions, and prevent the development of antimicrobial resistance. This Perspectives article outlines the hospital antimicrobial use process (AUP), the foundational system that ensures that all antimicrobials are utilized in the most appropriate and safe manner. The AUP consists of the following steps: antimicrobial ordering, order verification, preparation and delivery, administration, monitoring, and discharge prescribing. AMS programs should determine how each step contributes to how an antimicrobial is used appropriately or inappropriately at …

A Multi-Faceted Intervention To Improve Naloxone Co-Prescription Rates Among Primary Care Providers, Jolane S. Conklin

Evidence-Based Practice Project Reports

It is estimated that 91 Americans die every day due to opioid overdoses, with at least half of those overdoses involving an opioid prescription (CDC, 2016d). To address this issue, the U.S. Department of Health and Human Services (USDHHS) has initiated an opioid initiative, and the Centers for Disease Control and Prevention (CDC) has released a clinical guideline, both of which include a focus on increasing use of naloxone. Despite these recommendations, providers often fail to co-prescribe naloxone to patients at increased risk of opioid overdose. The purpose of this evidence-based practice (EBP) project was to evaluate the effect of …

Use Of Urine Antigen Testing For Blastomyces In An Integrated Health System, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Blastomycosis, an endemic fungal infection, mimics many other diseases. We explored the use of Blastomyces urine antigen (BuAg), reportedly the most sensitive noninvasive test, in clinical practice and compared it to other noninvasive tests.

Methods: A total of 836 BuAg tests performed on unique patients (first test only) at one large integrated health system from June 2013 to May 2016 were retrospectively reviewed to examine test characteristics and demographic features. Of these, 100 cases from 2015, a year containing a large local blastomycosis outbreak, were randomly selected for detailed analysis.

Results: Demographics for the BuAg-tested population: mean age 54.9 …

Open Cycle: Forecasting Ovulation For Family Planning, Karen Clark, Mridul Jain, Araya Messa, Vinh Le, Eric C. Larson

SMU Data Science Review

Abstract: Forecasting the length and different phases of a woman’s menstrual cycle, especially ovulation, is an important aspect of family planning. Predicting fertility has many uses in family planning including avoiding pregnancy and assisting couples in becoming pregnant. Past methods have focused on monitoring basal body temperature (BBT), cervical mucus changes, and hormonal levels to determine fertility. While these methods can provide an accurate prediction of ovulation these tests can become expensive, time-consuming, and do not provide prediction until after ovulation has occurred. In this paper, we compare conventional fertility assessment that is based on a rule known as “three-over-six” …

Quantifying Nitric Oxide Production In Platelets Using A Griess Reagent System, Chelsea Shultis

Undergraduate Theses and Capstone Projects

Nitric oxide (NO) is a signaling molecule that regulates many physiological processes in the human body. Common examples of processes that NO is involved in range from immune responses to the regulation of blood pressure. In intact blood vessels, nitric oxide is constitutively released by vascular endothelial cells in order to prevent platelet adhesion and clot formation. Platelets have also been shown to release small amounts of NO as they aggregate on damaged blood vessels. Platelet-derived NO is hypothesized to play an important role in limiting the extent of clot formation. Although platelets produce nitric oxide during aggregation, it is …

Renal Granulomatosis Post Intravesical Bacillus Calmette-Guerin Therapy For Non-Muscle-Invasive Bladder Cancer, Karen Tran-Harding, Rashmi T. Nair, Halemane S. Ganesh

Radiology Faculty Publications

Intravesical Bacillus Calmette–Guerin (BCG) immunotherapy is a proven, effective treatment for intermediate- and high-risk non-muscle-invasive bladder cancer. Minor side effects are common and expected but systemic effects can occur in < 5% of treated patients. We present a rare case of a 49-year-old male that presented with fever and chills after 3 weeks of intravesical BCG therapy post transurethral resection of bladder tumor. New renal lesions were present on contrast-enhanced computed tomography scan which was histologically proven to be necrotizing renal granulomatosis.

The Corticosteroid Compounds Prednisolone And Vamorolone Do Not Alter The Nociception Phenotype And Exacerbate Liver Injury In Sickle Cell Mice., Luis E F Almeida, Jesse M Damsker, Sarah Albani, Nina Afsar, Sayuri Kamimura, Drew Pratt, David E Kleiner, Martha Quezado, Heather Gordish-Dressman, Zenaide M N Quezado

Anesthesiology and Critical Care Medicine Faculty Publications

Clinicians often hesitate prescribing corticosteroids to treat corticosteroid-responsive conditions in sickle cell disease (SCD) patients because their use can be associated with complications (increased hospital readmission, rebound pain, strokes, avascular necrosis, acute chest syndrome). Consequently, SCD patients may receive suboptimal treatment for corticosteroid-responsive conditions. We conducted a preclinical trial of dissociative (vamorolone) and conventional (prednisolone) corticosteroid compounds to evaluate their effects on nociception phenotype, inflammation, and organ dysfunction in SCD mice. Prednisolone and vamorolone had no significant effects on nociception phenotype or anemia in homozygous mice. Conversely, prednisolone and vamorolone significantly decreased white blood cell counts and hepatic inflammation. Interestingly, …

Transcranial Direct Current Stimulation (Tdcs) Improves Performance On Spelling And Word Detection Tasks, J. Kevin Wilson

Psychology ETDs

Deficits in written language involving spelling can have negative effects on a person’s education and occupation. Conventional spelling therapy is a time consuming and cost-prohibitive option, if even available, highlighting the need for improved methods for remediation. One possible way to address this need may be through the use of transcranial direct current stimulation (tDCS). This study sought to examine the effects of tDCS on performance during spelling, word detection, and facial recognition tasks. Active or sham tDCS was randomly assigned to typically functioning adults. The anode electrode was placed over Broca’s area (F7 in the 10/20 EEG system) and …

Paclitaxel Enhances Oncolytic Potential Of Herpes Simplex Virus Type-1 In Cancer Cells, Misagh Naderi

LSU Master's Theses

Taxanes are spindle poisons that bind to and stabilize microtubules resulting in mitotic arrest. Herpes simplex Typ-1 (HSV-1) virions utilize the microtubular network for intracellular transport during both virus entry and virus egress from infected cells. It has been reported previously that taxanes may synergize with oncolytic herpes simplex viruses in the treatment of experimental prostate and breast tumors in mice. Other reports have indicated that taxanes may inhibit viral replication in infected cells. In this study the previously characterized Oncolytic Herpes Simplex Virus type 1 (OSVP), which was constructed in Kousoulas lab was used in conjugation with paclitaxel (taxol) …

Refrigerated Stability Of Diluted Cisatracurium, Rocuronium, And Vecuronium For Skin Testing After Perioperative Anaphylaxis, Kristen Dinsmore, Bethany Campbell, Timothy Archibald, Greg Mosier, Stacy Brown Phd, Alexei Gonzalez-Estrada Md

Appalachian Student Research Forum

Rationale: The purpose of this study is to investigate the stored stability of dilutions of neuromuscular blocking agents (NMBAs), namely cisatracurium, rocuronium, and vecuronium, for skin prick/intradermal testing.

Methods: Concentrations of NMBAs were monitored by liquid chromatography-mass spectrometry (LC-MS/MS) for a period of 14 days. Dilutions of NMBAs were prepared in saline by factors of 10x, 100x, 1,000x, 10,000x, and 100,000x as sensitivity of the assay allowed. Diluted drug products were stored in a laboratory refrigerator until sampling. On sampling days, aliquots of each dilution were removed and compared to a freshly prepared set of reference dilutions.

Results: The results …

Motor Subtypes Of Parkinson’S Disease Can Be Identified By Frequency Component Of Postural Stability, Saba Rezvanian, Thurmon Lockhart, Christopher Frames, Rahul Soangra, Abraham Lieberman

Physical Therapy Faculty Articles and Research

Parkinson’s disease (PD) can be divided into two subtypes based on clinical features—namely tremor dominant (TD) and postural instability and gait difficulty (PIGD). This categorization is important at the early stage of PD, since identifying the subtypes can help to predict the clinical progression of the disease. Accordingly, correctly diagnosing subtypes is critical in initiating appropriate early interventions and tracking the progression of the disease. However, as the disease progresses, it becomes increasingly difficult to further distinguish those attributes that are relevant to the subtypes. In this study, we investigated whether a method using the standing center of pressure (COP) …

Lumbar Decompression Surgery: Does Chronic Steroid Use Increase The Risk Of Postoperative Infectious Complications? – A Study Of The National Surgical Quality Improvement Program (Nsqip) Database, Shane Sobrio, Mikel Thista, Raj Rao, Alex Gu, Chapman Wei, Warren Yu

GW Research Days 2016 - 2020

Intro: It has long been established that corticosteroids have a negative impact on the human immune system’s ability to function at an optimal level. Many past studies have shown that patient’s will have higher rates of infection if they are taking chronic steroids. What has yet to be established is just how much of an increased risk patients on chronic steroids have for infection after undergoing lumbar decompression surgeries, of which there are thousands per year. We hypothesize that patients on chronic steroids will have higher rates of surgical site infections and higher rates of other infections (UTI, pneumonia, etc.) …