Medicine and Health Sciences Commons^™

Buccal Bone Changes Following Rapid Maxillary Expansion (Rmf), Long-Term Results, Elena S. Iacob

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to use Cone Beam Computed Tomography (CBCT) images to quantitatively evaluate buccal bone changes of maxillary first premolar (P1), second premolar (P2) and first molar (M1) shortly after Rapid Maxillary Expansion (RME) and at the end of orthodontic treatment, as well as to evaluate the variables that may be associated with the short-term and long-term changes. Forty-seven consecutive patients (25 males and 22 females) with a mean age of 14.5years and who required RME as part of their orthodontic treatment and had pre-RME (T1) and post-RME (T2) CBCT images available were used for the …

Kinematic Demands Of Nucleus Arthroplasty Technology, Elizabeth J. Sander

Theses and Dissertations (ETD)

Recent advancements in biomaterial technologies have fostered growth in alternative surgical procedures to fusion surgery for treatment of early stages of degenerative disc disease. One application of immediate interest is that of nucleus arthroplasty (NA). Novel materials are being developed to better match the nonlinear biomechanical properties of the native tissue. The effects of changing the motion segment unit (MSU) properties via surgery (nucleotomy) or placement of a nucleus arthroplasty material, changes the effort or work required to move the altered spine condition through a prescribed kinematic path relative to the intact spine condition. The closer the loading mechanics of …

A Kinematics-Based Testing Protocol To Study The Mechanics Of The Human Lumbar Spine, Nephi A. Zufelt

Theses and Dissertations (ETD)

The objective of this work was to develop a new kinematics-based testing protocol to quantify the axial and shear force components and rotational moment properties of the human cadaveric lumbar motion segment unit (MSU) in response to specific kinematic inputs. Modern, non-fusion spinal devices claim to treat degenerative disc disease better than traditional fusion surgery. Though there have been many biomechanical studies completed on these devices, there is still a debate over their efficacy. Conventional testing methods provide insight into the rotational properties of the MSU but lack the sensitivity or capacity to quantify lumbar MSU’s mechanical properties including shear …

Use Of Compliant Interbody Force Sensing Grafts To Compare Load Sharing Properties Of Unidirectional And Bidirectional Multilevel Dynamic Translational Anterior Cervical Plates, Jason Roscoe Roberson

Theses and Dissertations (ETD)

INTRODUCTION: Pseudoarthrosis is a relatively rare complication following anterior cervical arthrodesis, and is felt to be related to stress shielding. To address this, dynamic anterior cervical plates have emerged to maintain load sharing as an arthodesis matures. Dynamic plates can translate bidirectionally (allow translation in compressive and tensile loads), or unidirectionally (allow translation in compression, but maintain its position under tensile loads). The objective of this study was to compare the graft load mechanics between three plated conditions during settling using compliant interbody load cells: A static (fixed, non-moving) plate, a unidirectional multi-level translational plate design, and a bidirectional two-level …

Predictors Of Emesis And Time To Goal Intake After Pyloromyotomy: Analysis From A Prospective Trial., Shawn D. St Peter, Kuojen Tsao, Susan W. Sharp, G W. Holcomb Iii, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

Background: Emesis after pyloromyotomy for pyloric stenosis is a common clinical phenomenon and the limiting factor in time to goal feeds. The amount of emesis that can be expected after myotomy is unknown. No data have been published that equip caregivers with the ability to understand which patients are more likely to have emesis and take longer to advance to goal feeds after pyloromyotomy. Therefore, we performed analysis of prospective data obtained from a randomized trial to determine if outcome can be predicted from preoperative or intraoperative variables.

Methods: The dataset was prospectively collected from a randomized trial comparing open …

Methodology Development For Three-Dimensional Mr-Guided Near Infrared Spectroscopy Of Breast Tumors, Colin M. Carpenter, Subhadra Srinivasan, Brian W. Pogue, Keith D. Paulsen

Dartmouth Scholarship

Combined Magnetic Resonance (MR) and Near Infrared Spectroscopy (NIRS) has been proposed as a unique method to quantify hemodynamics, water content, and cellular size and packing density of breast tumors, as these tissue constituents can be quantified with increased resolution and overlaid on the structural features identified by the MR. However, the choices in how to reconstruct and visualize this information can have a dramatic impact on the feasibility of implementing this modality in the clinic. This is especially true in 3 dimensions, as there is often limited optical sampling of the breast tissue, and methods need to accurately reflect …

Cec: Clinical Exchange Corner, Mary Lloyd Moore, Laura Reynolds

CEC Publications

No abstract provided.

Gender Differences In Motivation To Resolve Eating And Body Image Concerns In College Students, Harold L. Merriman, C. Jayne Brahler, Laura Dinan, Lauren Finzer

Physical Therapy Faculty Publications

The objective of this study was to identify similarities and differences between college women and men with respect to their eating and body image concerns, weight fluctuation and level of motivation to resolve these concerns. 101 University of Dayton students participated in this study. Students completed an eating and body concern survey online.

Body image concerns were significantly greater for females compared to males (p=0.007) and significantly greater as motivation level to resolve the concerns increased (p=0.019). Eating concerns followed the same trends but did not reach statistical significance. Weight fluctuation in both genders increased significantly as motivation level increased …

Design And Rationale Of A Randomized Trial Comparing The Blalock-Taussig And Right Ventricle-Pulmonary Artery Shunts In The Norwood Procedure., Richard G. Ohye, J William Gaynor, Nancy S. Ghanayem, Caren S. Goldberg, Peter C. Laussen, Peter C. Frommelt, Jane W. Newburger, Gail D. Pearson, Sarah Tabbutt, Gil Wernovsky, Lisa M. Wruck, Andrew M. Atz, Steve D. Colan, James Jaggers, Brian W. Mccrindle, Ashwin Prakash, Michael D. Puchalski, Lynn A. Sleeper, Mario P. Stylianou, Lynn Mahony, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The initial palliative procedure for patients born with hypoplastic left heart syndrome and related single right ventricle anomalies, the Norwood procedure, remains among the highest risk procedures in congenital heart surgery. The classic Norwood procedure provides pulmonary blood flow with a modified Blalock-Taussig shunt. Improved outcomes have been reported in a few small, nonrandomized studies of a modification of the Norwood procedure that uses a right ventricle-pulmonary artery shunt to provide pulmonary blood flow. Other nonrandomized studies have shown no differences between the two techniques.

METHODS: The Pediatric Heart Network designed a randomized clinical trial to compare outcomes for …

Reflection On 2017 Lilly Conference In Traverse City, Holly Grieves

Academic Leadership Academy

The Lilly Conference in Traverse City offers sessions on enhancing group presentations and team projects, ideas for creation of service-learning opportunities, strategies for engaging millennial students in course content, training in innovative presentation platforms, methods of supplemental instruction and techniques to facilitate critical thinking in the classroom.

The Department of Occupational Therapy is in the midst of making significant curricular revisions as we transition rom a master’s degree program to an entry-level doctoral program. Attendance at the Lilly Conference assisted in the refinement of teaching methods for existing courses and contributed to the development of teaching methods for new course …

Effect Of 3-Electrode Electrical Stimulation On Current Delivery And Healing In Chronic Wounds, Hyejin Suh

Loma Linda University Electronic Theses, Dissertations & Projects

Chronic wounds have been an enormous burden on the healthcare system due to their prevalence and the lack of efficacy of current treatment modalities. Over the years, electrical stimulation (ES) has been widely used in the treatment of wounds. Unfortunately, the effectiveness of this treatment is under scrutiny, since many studies have failed to report successive and/or consistent effects of ES on wound healing. This inconsistency may be due to the uneven current produced by the conventional 2-electrode delivery system (2-channel ES) and the reduced resting blood flow resulting from thermally cool treatment rooms. In this study, a new approach …

Health And Nutritional Need Assessment Of Hispanics In South Carolina, America Chavez-Martinez

All Dissertations

From 1990 to 2000, South Carolina's Hispanic population increased 211%. Now, states such as South Carolina have the fastest growing Hispanic population in the U.S. Hispanics have a high incidence of obesity and related chronic diseases such as diabetes, stroke, hypertension and heart disease, these diseases could be avoided through diet. Meanwhile, nutrition education interventions help to reduce weight and to change behaviors, leading to better health. This study used qualitative and quantitative methods to examine Hispanics health and nutritional needs to develop a cultural compatible nutrition program for this audience. The qualitative methods explored predisposing, enabling and reinforcing factors …

Reliability Generalization Of The Alcohol Use Disorders Identification Test., Chandni Patel

Electronic Theses and Dissertations

The Alcohol Use Disorder Identification Test (AUDIT) is a brief screening instrument for assessing alcohol use problems among adults. This instrument is widely used and continued evaluation of its psychometric performance is needed. Reliability and validity are the primary psychometric characteristics of interest when evaluating psychological instruments. The focus of the present study is on reliability, which reflects the consistency or repeatability of the scores produced by a given instrument. Using meta-analytic methods, results showed that approximately 65% of previously published studies using the AUDIT did not appropriately report reliability estimates. Among the remaining studies, weighted reliability estimate centered on …

Recently Arrested Adolescents Are At High Risk For Sexually Transmitted Diseases, Christopher Salvatore, Steven Belenko, Richard Dembo, Doris Weiland, Matthew Rollie, Alexandra Hanlon, Kristina Childs

Department of Justice Studies Faculty Scholarship and Creative Works

Adolescent offenders may be at high risk for sexually transmitted diseases (STDs). With previous research and interventions focused on incarcerated adolescents, data are needed on STD prevalence and risk factors among newly arrested youth released to the community, a far larger subgroup.Participants were recruited from all arrested youth processed at the Hillsborough County, Florida Juvenile Assessment Center during the last half of 2006 (506 males, 442 females). Participants voluntarily providing urine samples for drug testing as part of standard protocol were also consented to having their specimens split and tested for chlamydia and gonorrhea, using an FDA-approved nucleic acid amplification …

Functional Status, Heart Rate, And Rhythm Abnormalities In 521 Fontan Patients 6 To 18 Years Of Age., Andrew D. Blaufox, Lynn A. Sleeper, David J. Bradley, Roger E. Breitbart, Allan Hordof, Ronald J. Kanter, Elizabeth A. Stephenson, Mario Stylianou, Victoria L. Vetter, J Philip Saul, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Our objective was to determine the relationship between functional outcome and abnormalities of heart rate and rhythm after the Fontan operation.

METHODS: The National Heart, Lung, and Blood Institute Pediatric Heart Network conducted a cross-sectional analysis of patients who had undergone a Fontan procedure at the 7 network centers. Analysis was based on 521 patients with an electrocardiogram (n = 509) and/or bicycle exercise test (n = 404). The Child Health Questionnaire parent report and the oxygen consumption at the anaerobic threshold were used as markers of functional outcome.

RESULTS: Various Fontan procedures had been performed: intracardiac lateral tunnel …

Blood Utilization In Children Managed Non-Operatively For Blunt Solid Organ Injury., Scott J. Keckler, Kuojen Tsao, Susan W. Sharp, G W. Holcomb Iii, Daniel J. Ostlie, Shawn D. St Peter

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Blood product utilization is an important issue in health care, given the frequent shortages in hospitals and the societal burden required to maintain the supply. Therefore, we retrospectively audited our blunt spleen/liver trauma experience to determine the percentage of cross-matched blood that was transfused to see whether more stringent typing criteria should be applied.

METHODS: A retrospective analysis of a recent 7-year experience with nonoperative management in patients with blunt spleen or liver injury was performed. Demographics, packed red blood cells prepared by cross-match, and transfusions were measured. Unmatched, O-type blood given in the trauma bay was excluded. Patients …

Management Of Pediatric Acute Appendicitis In The Computed Tomographic Era., Kuojen Tsao, Shawn D. St Peter, Patricia A. Valusek, Troy L. Spilde, Scott J. Keckler, Abhilash Nair, Daniel J. Ostlie, G W. Holcomb Iii

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND/PURPOSE: The treatment options for complicated appendicitis in children continue to evolve. Optimal management of complicated appendicitis relies on an accurate preoperative diagnosis. We examined the accuracy of our preoperative diagnosis including computed tomography (CT) and the influence on the management of children with perforated and nonperforated appendicitis.

METHODS: Following IRB approval, a 6-year review of all patients that underwent an appendectomy for suspected appendicitis was performed. Treatments included immediate operations and initial nonoperative management (antibiotic therapy +/- percutaneous drainage of abscess). Appendicitis was confirmed by histological examination.

RESULTS: One thousand seventy-eight patients underwent appendectomy for suspected appendicitis. Preoperative CT …

Radiotherapy Optimal Design: An Academic Radiotherapy Treatment Design System, R Acosta, W Brick, A Hanna, Allen Holder, D Lara, G Mcquillen, D Nevin, P Uhlig, B Salter

Mathematical Sciences Technical Reports (MSTR)

Optimally designing radiotherapy and radiosurgery treatments to increase the likelihood of a successful recovery from cancer is an important application of operations research. Researchers have been hindered by the lack of academic software that supports head-to-head comparisons of different techniques, and this article addresses the inherent difficulties of designing and implementing an academic treatment planning system. In particular, this article details the algorithms and the software design of Radiotherapy optimAl Design (RAD).

Clinical Features And Management Of Autoimmune Hepatitis, Edward L. Krawitt

Dartmouth Scholarship

Autoimmune hepatitis (AIH) is a chronic hepatitis of unknown etiology which can progress to cirrhosis. Its clinical manifestations are highly variable and sometimes follow a fluctuating course. Diagnosis is based on characteristic histologic, clinical, biochemical and serological findings. Anti-inflammatory/immunosuppressive treatment frequently induces remission but long-term maintenance therapy is often required. Liver transplantation is generally successful in patients with decompensated cirrhosis unresponsive to or intolerant of medical therapy.

Immediate Provionalization Of Single Threaded Oxidized Implants On Maxillary Premolars Healed Sites: One-Year Study, Kiyotaka Umezu

Loma Linda University Electronic Theses, Dissertations & Projects

Osseointegrated endosseous implants have been widely used and become a predictable treatment option for completely and partially edentulous patients. The viability and predictability of this treatment modality have been supported with the high success rates in numerous studies. Clinical guideline requires a healing period of 3 to 6 months without functional loading to achieve osseointegration with machine surface implants. Therefore, numerous studies on immediately loaded implants have been conducted in an attempt to minimize or eliminate this healing period. The purpose of this study was to evaluate the success rate of the immediately provisionalized oxidized-surface implants in healed sites supporting …

Predicting Long-Term Memory In Adult Brain Injury Patients Using Mr Spectroscopy, Herminia De La Rosa-Trujillo

Loma Linda University Electronic Theses, Dissertations & Projects

Accurate outcome prediction has proven to be somewhat elusive for patients with traumatic brain injury (TBI). The difficulty is due to the sometimes inaccurate methods of prediction currently available. Despite the advances seen in radiological technology, the traditional methods of x-rays, CT scans and MRIs are not always accurately able to predict patient functional outcome. These radiological methods are adequate in determining gross structural anatomical disturbances, however, they unable to detect more diffuse cellular damage believed to be responsible for the functional impairments evidenced in patients sustaining TBI. Magnetic Resonance Spectroscopy (MRS) is an imaging technique which measures brain metabolites …

Single Daily Dosing Ceftriaxone And Metronidazole Vs Standard Triple Antibiotic Regimen For Perforated Appendicitis In Children: A Prospective Randomized Trial., Shawn D. St Peter, Kuojen Tsao, Troy L. Spilde, G W. Holcomb Iii, Susan W. Sharp, J Patrick Murphy, Charles L. Snyder, Ronald J. Sharp, Walter S. Andrews, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Appendicitis is the most common emergency condition in children. Historically, a 3-drug regimen consisting of ampicillin, gentamicin, and clindamycin (AGC) has been used postoperatively for perforated appendicitis. A retrospective review at our institution has found single day dosing of ceftriaxone and metronidazole (CM) to be a more simple and cost-effective antibiotic strategy. Therefore, we performed a prospective, randomized trial to compare efficacy and cost-effectiveness of these 2 regimens.

METHODS: After internal review board approval (IRB no. 04 12-149), children found to have perforated appendicitis at appendectomy were randomized to either once daily dosing of CM (2 total doses per …

Comparison Of Microleakage In Three Sealant Placement Protocols Vs. The Enamel Loc System, Audrey T. Sheu

Loma Linda University Electronic Theses, Dissertations & Projects

PURPOSE: To evaluate sealant microleakage using four different application techniques.

METHODS: The four application techniques evaluated were acid etch only, Adper L-Pop bonding, Optibond bonding, and Enamel Loc One-Step Sealant. Sixty-four extracted third molar teeth were assigned on one of four application techniques (n=16) and Clinpro sealants applied according to the manufacturer's instructions. The teeth were thermocycled for 500 cycles, dyed, and embedded in resin. The samples were then sectioned and evaluated for microleakage on the buccal and lingual surfaces. Statistical methods employed to analyze the data were the Kruskal-Willis rank test and the Mann-Whitney U test.

RESULTS: No significant …

Resource Utilization And Outcomes From Percutaneous Drainage And Interval Appendectomy For Perforated Appendicitis With Abscess., Scott J. Keckler, Kuojen Tsao, Susan W. Sharp, Daniel J. Ostlie, G W. Holcomb Iii, Shawn D. St Peter

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Given the perceived technical demands of laparoscopic appendectomy and the expected postoperative morbidity in patients with a well-defined abscess, initial percutaneous drainage has become an attractive option in this patient population. This strategy allows for a laparoscopic appendectomy to be performed in an elective manner at the convenience of the surgeon. However, the medical burden on the patient and on the quality of patient outcomes has not been described in the literature. Therefore, we audited our experience with initial percutaneous drainage followed by laparoscopic interval appendectomy to evaluate the need for a prospective trial.

METHODS: After institutional review board …

Tendinopathy Discrimination By Use Of Spatial Frequency Parameters In Ultrasound B-Mode Images, Gregory R. Bashford, Nicholas Tomsen, Shruti Arya, Judith M. Burnfield, Kornelia Kulig

Biomedical Imaging and Biosignal Analysis Laboratory

The structural characteristics of a healthy tendon are related to the anisotropic speckle patterns observed in ultrasonic images. This speckle orientation is disrupted upon damage to the tendon structure as observed in patients with tendinopathy. Quantification of the structural appearance of tendon shows promise in creating a tool for diagnosing, prognosing, or measuring changes in tendon organization over time. The current work describes a first step taken towards this goal—classification of Achilles tendon images into tendinopathy and control categories. Eight spatial frequency parameters were extracted from regions of interest on tendon images, filtered and classified using linear discriminant analysis. Resulting …

Discipline, Facial Affect Recognition And Self-Efficacy, Julie Harris

Graduate Theses

The present study explored facial affect recognition, discipline and self-efficacy correlates, predicted using the Social Cognitive Theory framework. A sample of undergraduate students (N—114) from The University of Texas of the Permian Basin, were surveyed on parental style, discipline, self-efficacy, and then tested for facial affect recognition. The results indicated that participants reporting more corporal punishment scored lower on facial affect than those reporting less corporal punishment (p < .05). No significance was found for corporal punishment and self-efficacy (p > .05). The parental style of the father emerged as a significant predictor for the relationship between corporal punishment and facial affect recognition (p < .05). Results appear to support the idea that the social environment parents, especially fathers, create via discipline may hinder ability to interpret emotion. One important implication of this study is that paternal influence may be more vital to emotional detection development than previously considered.

Use Of Monoclonal ∆-9-Tetrahydrocannabinol Antibodies Chemically Bound To A Polystyrene Surface Using Glutaraldehyde For The Purpose Of Extracting ∆-9-Tetrahydrocannabinol And ∆-9-Tetrahydrocannabinol Carboxylic Acid From Postmortem Whole Blood Samples For Analysis By Gas Chromatography Mass Spectrometry, Thomas Sidney Pittman

Dissertations

Quantitations of drugs and their respective metabolites in postmortem blood samples using gas chromatographic instrumentation is a primary analytical practice used to determine if drugs played a role in or were the cause of a victim's death. Postmortem blood samples often prove difficult to work with due to interfering substances formed during the putrefaction process. Attempts to eliminate interfering substances with present day extraction methods can be time-consuming, costly and often ineffective when dealing with drugs that exhibit toxicity or impairment at very low concentrations. This study was conducted using monoclonal antibodies chemically bound to a polystyrene surface to extract …

Current Significance Of Meconium Plug Syndrome., Scott J. Keckler, Shawn D. St Peter, Troy L. Spilde, Kuojen Tsao, Daniel J. Ostlie, G W. Holcomb Iii, Charles L. Snyder

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The significance of meconium plug syndrome is dependent on the underlying diagnosis. The incidence of pathologic finding, particularly Hirschsprung's disease, contributing to the presence of these plugs, has been debated. However, there are little recent data in the literature. Therefore, we reviewed our experience with meconium plugs as a cause of abdominal distension to evaluate the associated conditions and incidence of Hirschsprung's disease.

METHODS: We reviewed the records of newborns with meconium plugs found in the distal colon on contrast enema from 1994 to 2007. Demographics, radiologic findings, histologic findings, operative findings, and clinical courses were reviewed.

RESULTS: During …

Cost Saving By Reloading The Multiband Ligator In Endoscopic Esophageal Variceal Ligation: A Proposal For Developing Countries, Zaigham Abbas, Lubna Rizvi, Umair Syed Ahmed, Khalid Mumtaz, Wasim Jafri

Department of Medicine

Aim: To assess the cost savings of reloading the multiband ligator in endoscopic esophageal variceal ligation (EVL) used on the same patient for subsequent sessions.

Methods: This single centre retrospective descriptive study analysed patients undergoing variceal ligation at a tertiary care centre between 1st January, 2003 and 30th June, 2006. The multiband ligator was reloaded with six hemorrhoidal bands using hemorrhoidal ligator for the second and subsequent sessions. Analysis of cost saving was done for the number of follow-up sessions for the variceal eradication.

Results: A total of 261 patients underwent at least one session of endoscopic esophageal variceal ligation …

Treg Depletion Inhibits Efficacy Of Cancer Immunotherapy: Implications For Clinical Trials., James Curtin, Marianela Candolfi, Tamer Fakhouri, Chunyan Liu, Anderson Alden, Matthew Edwards, Pedro Lowenstein, Maria Castro

Articles

BACKGROUND: Regulatory T lymphocytes (Treg) infiltrate human glioblastoma (GBM); are involved in tumor progression and correlate with tumor grade. Transient elimination of Tregs using CD25 depleting antibodies (PC61) has been found to mediate GBM regression in preclinical models of brain tumors. Clinical trials that combine Treg depletion with tumor vaccination are underway to determine whether transient Treg depletion can enhance anti-tumor immune responses and improve long term survival in cancer patients. FINDINGS: Using a syngeneic intracrabial glioblastoma (GBM) mouse model we show that systemic depletion of Tregs 15 days after tumor implantation using PC61 resulted in a decrease in Tregs …