Digital Commons Network^™

Research Considerations For Prospective Studies Of Patients With Coma And Disorders Of Consciousness, Lorenzo Tinti, Thomas Lawson, Erika Molteni, Daniel Kondziella, Verena Rass, Tarek Sharshar, Yelena G Bodien, Joseph T Giacino, Stephan A Mayer, Moshgan Amiri, Susanne Muehlschlegel, Chethan P Venkatasubba Rao, Paul M Vespa, David K Menon, Giuseppe Citerio, Raimund Helbok, Molly Mcnett

Faculty, Staff and Students Publications

Disorders of consciousness are neurological conditions characterized by impaired arousal and awareness of self and environment. Behavioural responses are absent or are present but fluctuate. Disorders of consciousness are commonly encountered as a consequence of both acute and chronic brain injuries, yet reliable epidemiological estimates would require inclusive, operational definitions of the concept, as well as wider knowledge dissemination among involved professionals. Whereas several manifestations have been described, including coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state, a comprehensive neurobiological definition for disorders of consciousness is still lacking. The scientific literature is primarily observational, and studies-specific aetiologies lead to …

Editorial: Epilepsy And Alzheimer’S Disease: Shared Pathology, Clinical Presentations, And Targets For Treatment, Beth Leeman-Markowski, Jeannie Chin, Dominique Leitner, Keith Vossel

Faculty, Staff and Students Publications

No abstract provided.

Dimensionality Reduction And Nearest Neighbors For Improving Out-Of-Distribution Detection In Medical Image Segmentation, Mckell Woodland, Nihil Patel, Austin Castelo, Mais Al Taie, Mohamed Eltaher, Joshua P Yung, Tucker J Netherton, Tiffany L Calderone, Jessica I Sanchez, Darrel W Cleere, Ahmed Elsaiey, Nakul Gupta, David Victor, Laura Beretta, Ankit B Patel, Kristy K Brock

Faculty, Staff and Students Publications

Clinically deployed deep learning-based segmentation models are known to fail on data outside of their training distributions. While clinicians review the segmentations, these models tend to perform well in most instances, which could exacerbate automation bias. Therefore, detecting out-of-distribution images at inference is critical to warn the clinicians that the model likely failed. This work applied the Mahalanobis distance (MD) post hoc to the bottleneck features of four Swin UNETR and nnU-net models that segmented the liver on T1-weighted magnetic resonance imaging and computed tomography. By reducing the dimensions of the bottleneck features with either principal component analysis or uniform …

Improving The Performance Of Hirep Lattice Simulations Software By Exploiting The Cpu Hardware Architecture Details And Algorithm Characteristics, Md Rahman

School of Engineering, Computing and Mathematics Theses

In the scientific exploration of Quantum Chromodynamics (QCD)—the theory governing the strong interaction among quarks and gluons—large-scale numerical simulations are per formed using the framework of lattice gauge theories. Lattice Gauge Theory (LGT) simulations involve the formulation of gauge field theories on a space-time lattice. HiRep is a simulation suite designed for running lattice simulations, leveraging high-performance computing platforms. HiRep is designed to be flexible enough to study a wide range of strongly interacting systems, particularly those pertinent to novel physics investigations at CERN’s Large Hadron Collider (LHC). However, improving the execution time of HiRep is a challenging and non-trivial …

Explainable Deep Learning For Medical Imaging Classification, Megan Courtman

School of Engineering, Computing and Mathematics Theses

Machine learning is increasingly being applied to medical imaging tasks. However, the "black box'' nature of techniques such as deep learning has inhibited the interpretability and trustworthiness of these methods, and therefore their clinical utility. In recent years, explainability methods have been developed to allow better interrogation of these approaches.This thesis presents the novel application of explainable deep learning to several medical imaging tasks, to investigate its potential in patient safety and research. It presents the novel application of explainable deep learning to the detection of aneurysm clips in CT brains for MRI safety. It also presents the novel application …

Data Security And User Authentication In Public Cloud Computing Environments, Nelson Vasconcelos Soares Dos Santos

School of Engineering, Computing and Mathematics Theses

Cloud computing has become a prevalent paradigm for organisations and individuals, offering a range of services and resources that enable the efficient management, processing and storage of large quantities of data. However, despite its numerous advantages, cloud computing also presents significant challenges related to data security and user authentication. The distributed nature of cloud environments, coupled with the relinquishment of control over data to cloud service providers, has raised concerns regarding data vulnerability to various types of attacks, such as data breaches, malware injection, and denial of service. Moreover, traditional password and token-based authentication methods have been shown to be …

Pop-Up Books, Magic, And Health, John Kilburn

School of Art, Design and Architecture

No abstract provided.

Welcoming 2024: Supporting Students' Well-Being, Eric A Storch, Rick Yang

Faculty, Staff and Students Publications

No abstract provided.

Evaluating The Implementation Of A Relationship-Centered Communication Training For Connecting With Patients In Virtual Visits, Rachyl Pines, Marie C. Haverfield, Stephanie Wong Chen, Ethan Lee, Cati Brown-Johnson, Merisa Kline, Barbette Weimer-Elder

Faculty Research, Scholarly, and Creative Activity

The use of telehealth, specifically virtual visits, has increased and adoption continues. Providers need effective training for how to communicate with patients to develop a connection during virtual visits. This article describes the implementation and evaluation of a course called Mastering Presence in Virtual Visits. Results show that although providers perceive lack of time, technology issues, and lacking experiential knowledge as barriers to enacting course behaviors, the course was feasible and acceptable. Following the course, providers rated key course behaviors as helpful for practice, and 80.7% of providers were likely to recommend the course to a colleague. The course shifted …

Interest In Over-The-Counter Progestin-Only Pills Among Transgender, Nonbinary, And Gender-Expansive Individuals In The United States, Kate Grindlay, Juno Obedin-Maliver, Sachiko Ragosta, Jen Hastings, Mitchell R. Lunn, Annesa Flentje, Matthew R. Capriotti, Zubin Dastur, Micah E. Lubensky, Heidi Moseson

Faculty Research, Scholarly, and Creative Activity

Background: In July 2023, the US Food and Drug Administration approved the first nonprescription oral contraceptive, a progestin-only pill, in the United States. Transgender, nonbinary, and gender-expansive people assigned female or intersex at birth face substantial contraceptive access barriers and may benefit from over-the-counter oral contraceptive access. However, no previous research has explored their perspectives on this topic. Objective: This study aimed to measure interest in over-the-counter progestin-only pill use among transgender, nonbinary, and gender-expansive individuals assigned female or intersex at birth. Study Design: We conducted an online, cross-sectional survey from May to September 2019 (before the US Food and …

Fuzzy Similarity Analysis Of Effective Training Samples To Improve Machine Learning Estimations Of Water Quality Parameters Using Sentinel-2 Remote Sensing Data, Alireza Taheri Dehkordi, Mohammad Javad Valadan Zoej, Ali Mehran, Mohsen Jafari, Amir Masoud Chegoonian

Faculty Research, Scholarly, and Creative Activity

Continuous monitoring of water quality parameters (WQPs) is crucial due to the global degradation of water quality, primarily caused by climate change and population growth. Typically, machine learning (ML) models are employed to retrieve WQPs, but they require a large amount of training samples to accurately capture the data relationships. Even with sufficient training data, discrepancies still exist between values of predicted and in-situ WQPs. This study proposes a fuzzy similarity analysis (FSA) technique to enhance ML estimates of WQPs by using the prediction errors in effective training samples. The method was successfully applied to retrieve turbidity (Turb) and specific …

Potential Use Of Poultry Farms By Wild Waterfowl In California's Central Valley Varies Across Space, Times Of Day, And Species: Implications For Influenza Transmission Risk, Claire S. Teitelbaum, Michael L. Casazza, Cory T. Overton, Jeffery D. Sullivan, Elliott L. Matchett, Fiona Mcduie, Austen A. Lorenz, Joshua T. Ackerman, Susan E.W. De La Cruz, Diann J. Prosser

Faculty Research, Scholarly, and Creative Activity

Interactions between wildlife and livestock can lead to cross-species disease transmission, which incurs economic costs and threatens wildlife conservation. Wild waterfowl are natural hosts of avian influenza viruses (AIVs), are often abundant near poultry farms, and have been linked to outbreaks of AIVs in poultry. Interspecific and seasonal variation in waterfowl movement and habitat use means that the risk of disease transmission between wild birds and poultry inevitably varies across species, space, and time. Here, we used GPS telemetry data from 10 waterfowl species in and near California's Central Valley, a region where both wild waterfowl and domestic poultry are …

Selective Partitioned Regression For Accurate Kidney Health Monitoring, Alex Whelan, Ragwa Elsayed, Alessandro Bellofiore, David C. Anastasiu

Faculty Research, Scholarly, and Creative Activity

The number of people diagnosed with advanced stages of kidney disease have been rising every year. Early detection and constant monitoring are the only minimally invasive means to prevent severe kidney damage or kidney failure. We propose a cost-effective machine learning-based testing system that can facilitate inexpensive yet accurate kidney health checks. Our proposed framework, which was developed into an iPhone application, uses a camera-based bio-sensor and state-of-the-art classical machine learning and deep learning techniques for predicting the concentration of creatinine in the sample, based on colorimetric change in the test strip. The predicted creatinine concentration is then used to …

Access To Digital Finance: Equity Crowdfunding Across Countries And Platforms, Saul Estrin, Susanna Khavul, Alexander S. Kritikos, Jonas Löher

Faculty Research, Scholarly, and Creative Activity

Financing entrepreneurship spurs innovation and economic growth. Digital financial platforms that crowdfund equity for entrepreneurs have emerged globally, yet they remain poorly understood. We model equity crowdfunding in terms of the relationship between the number of investors and the amount of money raised per pitch. We examine heterogeneity in the average amount raised per pitch that is associated with differences across three countries and seven platforms. Using a novel dataset of successful fundraising on the most prominent platforms in the UK, Germany, and the USA, we find the underlying relationship between the number of investors and the amount of money …

Emergency And Disaster Preparedness For Individuals Who Use Augmentative And Alternative Communication: A Pilot Study On Supported Planning Using A Toolkit, Andrea Barton-Hulsey, Miriam C. Boesch, Yoosun Chung, Tina Caswell, Amy Miller Sonntag, Wendy Quach

Faculty Research, Scholarly, and Creative Activity

Purpose: When emergencies or disasters arise, individuals who use augmenta-tive and alternative communication (AAC) are particularly vulnerable. It is critical that individuals who use AAC are supported to make decisions that impact their own lives and are able to communicate during such a crisis. Preparedness efforts that include a plan around communication needs and supports are necessary for ensuring that individuals who use AAC are able to understand options that ensure personal safety and express their needs during a time of crisis. Method: Qualitative methods were used to identify and describe the experi-ences of two young adults who use AAC …

The Effect Of A Night Shift Nap On Post-Night Shift Performance, Sleepiness, Mood, And First Recovery Sleep: A Randomized Crossover Trial, P. Daniel Patterson, Cassie J. Hilditch, Matthew D. Weaver, David G.L. Roach, Tiffany S. Okerman, Sarah E. Martin, Charity G. Patterson, Leonard S. Weiss

Faculty Research, Scholarly, and Creative Activity

Objectives This study aimed to test the effect of a 30-minute nap versus a 2-hour nap opportunity taken during a simulated night shift on performance, fatigue, sleepiness, mood, and sleep at the end of shift and during post-night shift recovery. Methods We conducted a randomized crossover trial of three nap conditions (30-minute, 2-hour, and no-nap) during 12-hour simulated night shifts. We tested for differences in performance, fatigue, sleepiness, mood, and sleep during in-lab and at-home recovery. Performance was measured with the Brief Psychomotor Vigilance Test (PVT-B). Subjective ratings were assessed with single-item surveys. Results Twenty-eight individuals consented to participate [mean …

Co-Producing Ethics Guidelines Together With People With Learning Disabilities, Mary Bottomley, Jodie Bradley, Lisa Clark, Bryan Collis, Bojana Daw Srdanovic, Victoria Farnsworth, Annie Ferguson, Dan Goodley, Andrew Fox, Nikita K. Hayden, Charlotte Lawthom, Rebecca Lawthom, Claudia Magwood, Robert Mclean, Ian Middleton, Alison Owen, Matty Prothero, Simon Rice, Simon Richards, Katherine Runswick-Cole, Kelly Scargill, Rohit Shankar, Toni Ann Wood

Peninsula Medical School

Background: We are a research team of clinical, academic and advocacy-based researchers with and without learning disabilities, working on the Humanising Healthcare (for people with learning disabilities) project. The project is dedicated to finding and sharing healthcare practices that enhance the lives of people with learning disabilities. As part of our ethics applications to access National Health Service study sites for fieldwork, we worked together to write guiding principles for co-producing research ethics with researchers with learning disabilities. In this paper, we introduce these Participatory Ethics Good Practice Guidelines and reflect on our collaboration. Methods: We reflect on developing the …

Perioperative Oxygenation—What's The Stress?, Joseph Larvin, Mark Edwards, Daniel S. Martin, Martin Feelisch, Michael P.W. Grocott, Andrew F. Cumpstey

Peninsula Medical School

Oxygen is the most used drug in anaesthesia. Despite such widespread use, optimal perioperative oxygen administration remains highly controversial because of concerns about the competing harms of both hyperoxia and hypoxia. Notwithstanding a Cochrane review concluding that routinely administering a fractional inspired oxygen concentration (FiO₂) >0.6 intraoperatively might increase postoperative morbidity and mortality, the World Health Organization (WHO) currently recommends all anaesthetised patients receive 0.8 FiO₂ during and immediately after surgery to reduce surgical site infections. Results from the largest trial available at the time of these two reviews (suggesting long-term survival may be worse with high …

Enhancing Diagnostic Accuracy: A Hybrid Approach To Mitigate Speckle And Rician Noise In Medical Images, Naveenkumar Jayakumar, Saurabh Saoji, Sagar V. Joshi, Hemlata Mane, Roshni Narkhede, Shrikant Jadhav

Faculty Research, Scholarly, and Creative Activity

This research explores the detrimental effects of Rician and speckle noise in medical imaging, particularly within MRI and radiographic modalities. Such noise can significantly obscure critical details, potentially leading to misdiagnoses and inaccurate measurements. Rician noise candidly dangles on the signal strength. Removing this noise affects the origial information in image that makes this noise removal perplexing. On other hand speckle noise is visualised like granular clog in ultrasound imageries. It creates ambiguous details and edges in the images. To address this challenge, the study introduces a novel hybrid method implemented in Java. The method employs a frequency-based decomposition approach …

Protecting The Mental Health Of People Seeking Sanctuary In The Uk's Evolving Legislative Landscape, Rohit Shankar

Peninsula Medical School

No abstract provided.

The Policy And Politics Of Healthcare Corporatisation: The Case Of The English Nhs, Rod Sheaff, Pauline Allen, Mark Exworthy, Russell Mannion

Peninsula Medical School

Rationale: Few accounts of healthcare corporatisation examine the effects of the 2008 financial crisis. New Politics of the Welfare State (NPWS) theories recognise the relevance of crises but give more attention to programmatic than systemic (structural) retrenchment, and little to healthcare corporatisation. Objective: To examine what changes the 2008 financial crisis produced in the pattern of healthcare corporatisation, and the implications for NPWS theories. Methods: Using administrative data from the English NHS during 1995–2019 we formulated a multi-dimensional index of corporatisation, tested its validity, and used it to analyse longitudinally how the financial crisis affected the balance between the responsibilization …

Tiktok As Social Communication Tool To Encourage Participation In Volunteering Projects, Belén Moreno-Albarracín, Tania Blanco-Sánchez

Faculty Research, Scholarly, and Creative Activity

Social media are regarded as tools of communication and social influence. Notwithstanding this, TikTok’s majority audience in 2023 is made up of members of generations Z and Alpha, associated in previous studies with a participatory crisis. Given this contradiction, a research question is proposed: do young people use TikTok to consolidate social values such as solidarity? To answer it, the main objective is to analyse the use of TikTok as an instrument for youth participation in volunteer projects. A mixed methodology is used, based on a content analysis of the 150 videos uploaded to TikTok with the hashtag #voluntariado and …

Editorial: Sex Differences In Cancer Incidence, Mortality, And Survival: Methodological Perspectives, Syed Ahsan Raza, Wilson Luiz Da Costa, Aaron P Thrift

Faculty, Staff and Students Publications

No abstract provided.

Folate Regulation Of Planar Cell Polarity Pathway And F-Actin Through Folate Receptor Alpha, Xiao Han, Xuanye Cao, Robert M Cabrera, Paula Andrea Pimienta Ramirez, Ying Linda Lin, Bogdan J Wlodarczyk, Cuilian Zhang, Richard H Finnell, Yunping Lei

Faculty, Staff and Students Publications

Folate deficiency contribute to neural tube defects (NTDs) which could be rescued by folate supplementation. However, the underlying mechanisms are still not fully understood. Besides, there is considerable controversy concerning the forms of folate used for supplementation. To address this controversy, we prepared culture medium with different forms of folate, Folic acid (FA) and 5-methyltetrahydrofolate(5mTHF), at concentration of 5uM, 500nM, 50nM and folate free, respectively. Mouse embryonic fibroblasts (MEFs) were treated with different folates continuously for three passages and cell proliferation and F-actin was monitored. We determined that compared to 5mTHF, FA showed stronger effects on promoting cell proliferation and …

Traf4-Mediated Nonproteolytic Ubiquitination Of Androgen Receptor Promotes Castration-Resistant Prostate Cancer, Yosi Gilad, Ortal Shimon, Sang Jun Han, David M Lonard, Bert W O'Malley

Faculty, Staff and Students Publications

Steroid receptor coactivators (SRCs) are master regulators of transcription that play key roles in human physiology and pathology. SRCs are particularly important for the regulation of the immune system with major roles in lymphocyte fate determination and function, macrophage activity, regulation of nuclear factor κB (NF-κB) transcriptional activity and other immune system biology. The three members of the p160 SRC family comprise a network of immune-regulatory proteins that can function independently or act in synergy with each other, and compensate for - or moderate - the activity of other SRCs. Recent evidence indicates that the SRCs are key participants in …

Targeting Sars-Cov-2 Nonstructural Protein 3: Function, Structure, Inhibition, And Perspective In Drug Discovery, Xin Li, Yongcheng Song

Faculty, Staff and Students Publications

As a highly contagious human pathogen, severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) has infected billions of people worldwide with more than 6 million deaths. With several effective vaccines and antiviral drugs now available, the SARS-CoV-2 pandemic been brought under control. However, a new pathogenic coronavirus could emerge in the future, given the zoonotic nature of this virus. Natural evolution and drug-induced mutations of SARS-CoV-2 also require continued efforts for new anti-coronavirus drugs. Nonstructural protein (nsp) 3 of CoVs is a large, multifunctional protein, containing a papain-like protease (PLpro) and a macrodomain (Mac1), which are essential for viral replication. Here, we …

Designing A Best Possible Caregiver History To Facilitate Disposition Planning For Older Adults In Emergency Departments, Karen De Sola-Smith, Matthew Growdon, Anita N Chary, Jennifer D Portz, Kenneth Lam

Faculty, Staff and Students Publications

Introduction: Detailed information about caregivers is crucial for planning disposition from emergency departments (EDs), but it is unclear what specific information is useful for ED clinicians and how that information should be presented.

Methods: We used a Design Thinking approach to develop a standardized format-which we call a "Best Possible Caregiver History" (BPCH)-for displaying useful caregiver information to ED clinicians. The key steps of this approach are needfinding, followed by iterative cycles of ideation, rapid prototyping, and testing. For needfinding, we used semi-structured interviews of four ED clinicians on current practices for discovering and documenting caregiver information. For ideation and …

Diagnostic And Prognostic Performance Of The Neutrophil-To-Lymphocyte Ratio In Acute Coronary Syndromes: A Meta-Analysis Of 90 Studies Including 45 990 Patients, Michał Pruc, Jacek Kubica, Maciej Banach, Damian Swieczkowski, Zubaid Rafique, William Frank Peacock, Zbigniew Siudak, Krzysztof Kurek, Prabath Nanayakkara, Łukasz Szarpak

Faculty, Staff and Students Publications

Background: Cardiovascular disease is a leading cause of mortality worldwide and is likely to rise. Acute coronary syndrome (ACS) is consequent on inflammation. As a common and cost-effective inflammatory biomarker, the neutrophil-to-lymphocyte ratio (NLR) may be beneficial in cardiovascular medicine.

Aims: This meta-analysis examines the diagnostic and prognostic performance of the NLR in ACS.

Methods: We systematically searched PubMed Central, Medline, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and Clinicaltrial.gov databases. The search spanned from databases inception to January 10, 2024. The findings were aggregated into normalized mean differences with 95% confidence intervals.

Results: Ninety articles, with 45 990 …

Family Medicine Clerkship Directors' Remediation Of Faculty With Mistreatment Concerns: Results From A Cera Clerkship Directors Survey, William Y Huang, Yuanyuan Zhou, Jonnae Atkinson, Kenneth Barning, Misbah Keen, Joel Purkiss

Faculty, Staff and Students Publications

Introduction: Little is known about how frequently family medicine (FM) clerkship directors remediate faculty with student mistreatment concerns and their comfort level in performing the remediations. In this exploratory study, we investigated factors associated with the number of faculty remediated for student mistreatment concerns by FM clerkship directors and the comfort level of FM clerkship directors in remediating these faculty.

Methods: Data were collected as part of the 2022 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of FM clerkship directors. FM clerkship directors provided responses on how frequently they remediated faculty with mistreatment concerns and their comfort …

Could Workplace-Based Assessments Improve Faculty Teaching Confidence And Competence?, Arindam Sarkar, Kelly L Smith, Brian D Keisler, Kenneth Barning

Faculty, Staff and Students Publications

No abstract provided.