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Design Of A Distributed Real-Time E-Health Cyber Ecosystem With Collective Actions: Diagnosis, Dynamic Queueing, And Decision Making, Yanlin Zhou 2018 University of Nebraska - Lincoln

Design Of A Distributed Real-Time E-Health Cyber Ecosystem With Collective Actions: Diagnosis, Dynamic Queueing, And Decision Making, Yanlin Zhou

Theses, Dissertations, and Student Research from Electrical & Computer Engineering

In this thesis, we develop a framework for E-health Cyber Ecosystems, and look into different involved actors. The three interested parties in the ecosystem including patients, doctors, and healthcare providers are discussed in 3 different phases. In Phase 1, machine-learning based modeling and simulation analysis is performed to remotely predict a patient's risk level of having heart diseases in real time. In Phase 2, an online dynamic queueing model is devised to pair doctors with patients having high risk levels (diagnosed in Phase 1) to confirm the risk, and provide help. In Phase 3, a decision making paradigm is ...


High-Resolution Imaging Of Myeloperoxidase Activity Sensors In Human Cerebrovascular Disease, Youssef Z. Wadghiri, Dung Minh. Hoang, Anita M. Leporati, Matthew J. Gounis, Aurora Rodriguez-Rodriguez, Mary L. Mazzanti, John P. Weaver, Ajay K. Wakhloo, Peter Caravan, Alexei A. Bogdanov Jr 2018 New York University School of Medicine

High-Resolution Imaging Of Myeloperoxidase Activity Sensors In Human Cerebrovascular Disease, Youssef Z. Wadghiri, Dung Minh. Hoang, Anita M. Leporati, Matthew J. Gounis, Aurora Rodriguez-Rodriguez, Mary L. Mazzanti, John P. Weaver, Ajay K. Wakhloo, Peter Caravan, Alexei A. Bogdanov Jr

Radiology Publications and Presentations

Progress in clinical development of magnetic resonance imaging (MRI) substrate-sensors of enzymatic activity has been slow partly due to the lack of human efficacy data. We report here a strategy that may serve as a shortcut from bench to bedside. We tested ultra high-resolution 7T MRI (microMRI) of human surgical histology sections in a 3-year IRB approved, HIPAA compliant study of surgically clipped brain aneurysms. microMRI was used for assessing the efficacy of MRI substrate-sensors that detect myeloperoxidase activity in inflammation. The efficacy of Gd-5HT-DOTAGA, a novel myeloperoxidase (MPO) imaging agent synthesized by using a highly stable gadolinium (III) chelate ...


The Synergistic Effects Of Saxagliptin And Metformin On Cd34+ Endothelial Progenitor Cells In Early Type 2 Diabetes Patients: A Randomized Clinical Trial., Fiona J Dore, Cleyton C Domingues, Neeki Ahmadi, Nabanita Kundu, Yana Kropotova, Sara Houston, Carol Rouphael, Aytan Mammadova, Linda Witkin, Anamil Khiyami, Richard L Amdur, Sabyasachi Sen 2018 George Washington University

The Synergistic Effects Of Saxagliptin And Metformin On Cd34+ Endothelial Progenitor Cells In Early Type 2 Diabetes Patients: A Randomized Clinical Trial., Fiona J Dore, Cleyton C Domingues, Neeki Ahmadi, Nabanita Kundu, Yana Kropotova, Sara Houston, Carol Rouphael, Aytan Mammadova, Linda Witkin, Anamil Khiyami, Richard L Amdur, Sabyasachi Sen

Surgery Faculty Publications

AIMS: Type 2 diabetes is associated with endothelial dysfunction leading to cardiovascular disease. CD34+ endothelial Progenitor Cells (EPCs) are responsible for endothelial repair and neo-angiogenesis and can be used as a cardiovascular disease risk biomarker. This study investigated whether the addition of saxagliptin, a DPP-IV inhibitor, to metformin, may reduce cardiovascular disease risk in addition to improving glycemic control in Type 2 diabetes patients.

METHODS: In 12 week, double-blind, randomized placebo-controlled trial, 42 subjects already taking metformin 1-2 grams/day were randomized to placebo or saxagliptin 5 mg. Subjects aged 40-70 years with diabetes for < 10 years, with no known cardiovascular disease, BMI 25-39.9, HbA1C 6-9% were included. We evaluated EPCs number, function, surface markers and gene expression, in addition to arterial stiffness, blood biochemistries, resting energy expenditure, and body composition parameters. A mixed model regression to examine saxagliptin vs placebo, accounting for within-subject autocorrelation, was done with SAS (p < 0.05).

RESULTS: Although there was no ...


Extraction And Analysis Of Vector Flow Imaging Data In A Pediatric Population, Bailey Stinnett 2018 University of Arkansas, Fayetteville

Extraction And Analysis Of Vector Flow Imaging Data In A Pediatric Population, Bailey Stinnett

Biomedical Engineering Undergraduate Honors Theses

Vector flow imaging (VFI) is a new ultrasound technology that provides real time, angle-independent visualization of flow velocities in the heart and great vessels. Thus far, VFI has been used for superficial applications due to the limited penetration depth of available transducer probes; however, this depth in smaller pediatric patients enables adequate aortic views. In this project, VFI was used to study pediatric aortic stenosis (PAS)—a congenital heart defect that results in the narrowing of the aorta and/or aortic valve. The decision to refer PAS patients for surgical or catheter-based intervention is initially based on Doppler ultrasound. VFI ...


In Vitro Aortic Arch Flow Model For Vector Flow Imaging Testing, Jackson Mosley 2018 University of Arkansas, Fayetteville

In Vitro Aortic Arch Flow Model For Vector Flow Imaging Testing, Jackson Mosley

Biomedical Engineering Undergraduate Honors Theses

Pediatric stenosis is the narrowing of the aorta at the aortic valve, above the aortic valve, or below the aortic valve. Typically, this disease’s severity is diagnosed by conventional Doppler ultrasound methods, or echocardiography. Conventional Doppler can sometimes overestimate the pressure gradient over the area of stenosis, diagnosing some cases of PAS to be more severe than they actually are. This causes earlier intervention than is desired in children. A new US modality, Vector Flow Imaging (VFI), is an angle-independent US imaging method that can potentially more accurately quantify peak blood flow velocities and pressure gradients across stenotic sections ...


In-Vitro Simulation Of Acute Ischemic Stroke, Paolo Garcia 2018 University of Arkansas, Fayetteville

In-Vitro Simulation Of Acute Ischemic Stroke, Paolo Garcia

Biomedical Engineering Undergraduate Honors Theses

Acute ischemic stroke (AIS) is a condition that involves the occlusion of a blood vessel within the brain, effectively preventing the passage of oxygen and nutrients. AIS is highly prevalent in the United States, where nearly 795,000 strokes happen per year and 87% of those are ischemic. From a medical standpoint, the obstructing clot can be removed with the use of a stroke retrieval device. However, a need arises for testing the aforementioned devices on a patient’s specific vascular geometries in order to increase the likelihood of a successful procedure. Outlined is a process for developing a physical ...


Maturation Of Human Induced Pluripotent Stem Cell Derived Engineered Cardiac Tissues Using Chief Transfection And Chronic Optical Pacing., Marc M. Dwenger 2018 University of Louisville

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 ...


The Effects Of Heart Medication On The Heart Rates Of Drosophila Melanogaster, Felicia A. Baer 2018 Olivet Nazarene University

The Effects Of Heart Medication On The Heart Rates Of Drosophila Melanogaster, Felicia A. Baer

Honors Program Projects

Background

Current animal models of human cardiac disease may be similar in anatomy and physiology but are often expensive and tedious to work with. The current need is for a model organism that is more efficient to work with in the lab but that still provides an accurate model of human cardiac disease. Drosophila melanogaster (D. mel) is such a candidate. While 74% of the genes coding for protein are conserved between D. mel and human hearts, it is unknown if cardiac medication used in humans, such as atropine and propranolol hydrochloride, similarly affect heart rate. I hypothesized that administration ...


Lifetime Risk Of Atrial Fibrillation According To Optimal, Borderline, Or Elevated Levels Of Risk Factors: Cohort Study Based On Longitudinal Data From The Framingham Heart Study, Laila Staerk, Biqi Wang, Sarah R. Preis, Martin G. Larson, Steven A. Lubitz, Patrick T. Ellinor, David D. McManus, Darae Ko, Lu-Chen Weng, Kathryn L. Lunetta, Lars Frost, Emelia J. Benjamin, Ludovic Trinquart 2018 National Heart, Lung, and Blood Institute

Lifetime Risk Of Atrial Fibrillation According To Optimal, Borderline, Or Elevated Levels Of Risk Factors: Cohort Study Based On Longitudinal Data From The Framingham Heart Study, Laila Staerk, Biqi Wang, Sarah R. Preis, Martin G. Larson, Steven A. Lubitz, Patrick T. Ellinor, David D. Mcmanus, Darae Ko, Lu-Chen Weng, Kathryn L. Lunetta, Lars Frost, Emelia J. Benjamin, Ludovic Trinquart

Open Access Articles

OBJECTIVE: To examine the association between risk factor burdens-categorized as optimal, borderline, or elevated-and the lifetime risk of atrial fibrillation.

DESIGN: Community based cohort study.

SETTING: Longitudinal data from the Framingham Heart Study.

PARTICIPANTS: Individuals free of atrial fibrillation at index ages 55, 65, and 75 years were assessed. Smoking, alcohol consumption, body mass index, blood pressure, diabetes, and history of heart failure or myocardial infarction were assessed as being optimal (that is, all risk factors were optimal), borderline (presence of borderline risk factors and absence of any elevated risk factor), or elevated (presence of at least one elevated risk ...


Problems Experienced In The First Month After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven, Kelly Fuller 2018 University of Alabama at Birmingham School of Nursing

Problems Experienced In The First Month After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven, Kelly Fuller

Journal of Patient-Centered Research and Reviews

Purpose: Heart failure is a global health concern with high morbidity and mortality rates. Individuals with heart failure commonly experience problems that impact daily life. However, little is known regarding which problems are most significant during the immediate posthospitalization period. Thus, the purpose of this study was to identify high-priority problems experienced by individuals the first month after discharge from an acute care facility with a diagnosis of heart failure.

Methods: This descriptive, exploratory study was part of a 12-week randomized controlled pilot study that examined the efficacy of a coping partnership intervention (COPE-HF Partnership) between a trained research nurse ...


Maternal Coxsackievirus B Induced Dysregulation Of Sumoylation Processes As A Potential Cause Of Hypoplastic Left Heart Syndrome, Bailey Kemp, Sarah Severson 2018 University of Minnesota, Morris

Maternal Coxsackievirus B Induced Dysregulation Of Sumoylation Processes As A Potential Cause Of Hypoplastic Left Heart Syndrome, Bailey Kemp, Sarah Severson

Undergraduate Research Symposium 2018

Hypoplastic Left Heart Syndrome (HLHS) is a life-threatening congenital heart defect with unknown etiology. Here we hypothesize that HLHS has etiologic roots in maternal asymptomatic coxsackievirus B infection. Coxsackievirus has been demonstrated to disrupt normal distribution of small ubiquitin-like modifiers (SUMO) in the cell. The vital cardiac transcription factor, Nkx2-5, has been shown to be dependent on SUMOylation for proper function. Specifically, co-localization of SUMO and Nkx2.5 has been identified, as well as decreased SUMOylation associated with Nkx2-5 mutants. As Nxk2-5 is essential for fetal heart development and mutations in the gene for this vital transcription factor have been ...


Anxiety, Depression, And Adverse Clinical Outcomes In Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network Wave Study, Christine Baumgartner, Dongjie Fan, Margaret C. Fang, Daniel E. Singer, Daniel M. Witt, John R. Schmelzer, Marc S. Williams, Jerry H. Gurwitz, Sue Hee Sung, Alan S. Go 2018 University of California, San Francisco

Anxiety, Depression, And Adverse Clinical Outcomes In Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network Wave Study, Christine Baumgartner, Dongjie Fan, Margaret C. Fang, Daniel E. Singer, Daniel M. Witt, John R. Schmelzer, Marc S. Williams, Jerry H. Gurwitz, Sue Hee Sung, Alan S. Go

Open Access Articles

BACKGROUND: Anxiety and depression are associated with worse outcomes in several cardiovascular conditions, but it is unclear whether they affect outcomes in atrial fibrillation (AF). In a large diverse population of adults with AF, we evaluated the association of diagnosed anxiety and/or depression with stroke and bleeding outcomes.

METHODS AND RESULTS: The Cardiovascular Research Network WAVE (Community-Based Control and Persistence of Warfarin Therapy and Associated Rates and Predictors of Adverse Clinical Events in Atrial Fibrillation and Venous Thromboembolism) Study included adults with AF newly starting warfarin between 2004 and 2007 within 5 health delivery systems in the United States ...


Association Between Food Insecurity And Cvd Risk Factors Is Moderated By Intake Of Fruits And Vegetables In Latinos, Andrea Lopez-Cepero, Stephenie C. Lemon, Milagros C. Rosal 2018 University of Massachusetts Medical School

Association Between Food Insecurity And Cvd Risk Factors Is Moderated By Intake Of Fruits And Vegetables In Latinos, Andrea Lopez-Cepero, Stephenie C. Lemon, Milagros C. Rosal

UMass Worcester PRC Presentations

Background: Food insecurity has been consistently associated with CVD risk factors (i.e., obesity, type 2 diabetes, hypertension and hypercholesterolemia). Consumption of fruits and vegetables may reduce CVD risk factors among food insecure Latinos.

Objective: To examine the potential moderating effect of fruit and vegetable intake in the association between food insecurity and CVD risk factors in a sample of Latino men and women in the northeast U.S.

Methods: A representative community sample of Latino individuals was recruited from a community health center in Lawrence, MA. Food insecurity was measured with the 6-item USDA Household Food Security Scale. Fruit ...


Differences In Self-Reported Weekend Catch Up Sleep Between Children And Adolescents With And Without Primary Hypertension, Neena Gupta, Louise Maranda, Rakesh Gupta 2018 University of Massachusetts Medical School

Differences In Self-Reported Weekend Catch Up Sleep Between Children And Adolescents With And Without Primary Hypertension, Neena Gupta, Louise Maranda, Rakesh Gupta

Pediatric Publications and Presentations

Background: The data on the association of sleep duration and blood pressure in the pediatric age group have been mixed and most studies have focused on weekday sleep duration. The purpose of this study was to compare the weekday and weekend sleep patterns between children and adolescents with newly diagnosed primary hypertension and a normotensive control group.

Methods: Children and adolescents from a pediatric nephrology clinic, aged 6-18 years with newly diagnosed primary hypertension were compared to an age and sex matched normotensive control group from a general pediatric clinic. The questions about bed time and getting out of bed ...


Cost-Effectiveness Of Alternative Anticoagulation Strategies For Postoperative Management Of Total Knee Arthroplasty Patients, Savannah R. Smith, Jeffrey Katz, Elena Losina 2018 George Washington University

Cost-Effectiveness Of Alternative Anticoagulation Strategies For Postoperative Management Of Total Knee Arthroplasty Patients, Savannah R. Smith, Jeffrey Katz, Elena Losina

GW Research Days 2016 - Present

Background: Anticoagulation is essential for deep vein thrombosis (DVT) and pulmonary embolism (PE) prevention following total knee arthroplasty (TKA). Some research has suggested that longer duration anticoagulation can substantially reduce the risks of DVT and PE; however, in the absence of definitive recommendations, physicians are left weighing the risks of DVT and PE against those of anticoagulation, including gastrointestinal (GI) and central nervous system (CNS) hemorrhage and increased likelihood of prosthetic joint infection (PJI). We conducted a cost-effectiveness analysis to evaluate the benefits and risks of 14- and 35-day therapy with the most commonly prescribed anticoagulants post-TKA.

Background: Anticoagulation is ...


Acute Hepatic Failure And Oral Amiodarone, Hani Alhamoud, Sivateja Mandava, Talal Alzahrani 2018 George Washington University

Acute Hepatic Failure And Oral Amiodarone, Hani Alhamoud, Sivateja Mandava, Talal Alzahrani

GW Research Days 2016 - Present

Introduction:

Amiodarone is associated with serious complications such as lung toxicity, thyroid dysfunction, and QT-prolongation. Further, hepatic failure from the intravenous (IV) formulation of amiodarone is described in numerous case reports and case series. Although there are reports of elevated liver enzymes from the oral formulation of amiodarone, to our knowledge, none have definitively identified a case of acute hepatic failure from the oral formulation alone. In this case, we report an instance of acute hepatic failure after increasing the oral amiodarone dosage as well as rapid recovery following cessation of the medication.

Case report:

A 61-year-old male with a ...


Association Of Left Atrial Function Index With Atrial Fibrillation And Cardiovascular Disease: The Framingham Offspring Study, Mayank Sardana, Darleen M. Lessard, Bruce A. Barton, Gary F. Mitchell, Aditya Vaze, David D. McManus 2018 University of Massachusetts Medical School

Association Of Left Atrial Function Index With Atrial Fibrillation And Cardiovascular Disease: The Framingham Offspring Study, Mayank Sardana, Darleen M. Lessard, Bruce A. Barton, Gary F. Mitchell, Aditya Vaze, David D. Mcmanus

Quantitative Health Sciences Publications and Presentations

BACKGROUND: Left atrial (LA) size, a marker of atrial structural remodeling, is associated with increased risk for atrial fibrillation (AF) and cardiovascular disease (CVD). LA function may also relate to AF and CVD, irrespective of LA structure. We tested the hypothesis that LA function index (LAFI), an echocardiographic index of LA structure and function, may better characterize adverse LA remodeling and predict incident AF and CVD than existing measures.

METHODS AND RESULTS: In 1786 Framingham Offspring Study eighth examination participants (mean age, 66+/-9 years; 53% women), we related LA diameter and LAFI (derived from the LA emptying fraction, left ...


Prevalence Of Diabetes Mellitus, Hypertension, And Dyslipidemia In Student-Run Screening Clinics For Rural Communities In The Sierra Norte Of Puebla, Mexico, Sean Navin, Daniel M. Tomaszewski 2018 University of Minnesota - Duluth

Prevalence Of Diabetes Mellitus, Hypertension, And Dyslipidemia In Student-Run Screening Clinics For Rural Communities In The Sierra Norte Of Puebla, Mexico, Sean Navin, Daniel M. Tomaszewski

Pharmacy Faculty Articles and Research

Background: The growing prevalence of hypertension (HTN), diabetes mellitus (DM), and in Mexico highlights the need for preventative health care services. Rural communities worldwide lack access to such services. The purpose of this study was to describe the prevalence of HTN, DM, and dyslipidemia in student-run screening clinics in rural communities of the Sierra Norte of Puebla, Mexico to better understand the role the clinics play for the patients served.

Methods: Data were collected from patients from rural, Mexican towns participating in free pharmacy student-run screening clinics. Patients consented to have their de-identified information pooled for re-search. Screenings included blood ...


Device Therapies Among Patients Receiving Primary Prevention Implantable Cardioverter-Defibrillators In The Cardiovascular Research Network, Robert T. Greenlee, Jerry H. Gurwitz, David D. McManus 2018 Marshfield Clinic

Device Therapies Among Patients Receiving Primary Prevention Implantable Cardioverter-Defibrillators In The Cardiovascular Research Network, Robert T. Greenlee, Jerry H. Gurwitz, David D. Mcmanus

Open Access Articles

BACKGROUND: Primary prevention implantable cardioverter-defibrillators (ICDs) reduce mortality in selected patients with left ventricular systolic dysfunction by delivering therapies (antitachycardia pacing or shocks) to terminate potentially lethal arrhythmias; inappropriate therapies also occur. We assessed device therapies among adults receiving primary prevention ICDs in 7 healthcare systems.

METHODS AND RESULTS: We linked medical record data, adjudicated device therapies, and the National Cardiovascular Data Registry ICD Registry. Survival analysis evaluated therapy probability and predictors after ICD implant from 2006 to 2009, with attention to Centers for Medicare and Medicaid Services Coverage With Evidence Development subgroups: left ventricular ejection fraction, 31% to 35 ...


Social Support Predicts Self-Care Confidence In Patients With Heart Failure, Hayley C. Fivecoat, Steven L. Sayers, Barbara Riegel 2018 University of Pennsylvania

Social Support Predicts Self-Care Confidence In Patients With Heart Failure, Hayley C. Fivecoat, Steven L. Sayers, Barbara Riegel

School of Nursing Departmental Papers

Background:

Self-care for patients with heart failure includes engaging in behaviours that maintain medical stability and manage problematic symptoms, as well as the confidence in one’s ability to carry out such behaviours. Given the social context of self-care behaviours in heart failure, there has been increasing interest in social support as a predictor of self-care.

Aim:

The goal of the present study was to examine the role of social support in self-care across time for persons with heart failure.

Methods:

Using data from an observational study of patients with chronic heart failure (n = 280), we examined the role of ...


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