Medicine and Health Sciences Commons^™

A Randomized Controlled Trial Of A Modified Cystoscopy Technique, Khalil Hetou

Electronic Thesis and Dissertation Repository

Introduction

Pain, anxiety and embarrassment are well documented feelings in patients undergoing ambulatory diagnostic cystoscopy. In this study, we explored utilizing Peak-end theory in improving pain perception in patients undergoing diagnostic cystoscopy.

Materials and Methods

We conducted a randomized clinical trial at the London Health Sciences Center for patients undergoing an ambulatory diagnostic cystoscopy for the first time. Males and females as well as allocation ratios were 1:1. The control arm received a standard cystoscopy. In the intervention arm the cystoscope was left for additional 2 minutes without further manipulation in the bladder before scope removal. The primary outcome was …

Retrospective Motion Correction In Magnetic Resonance Imaging Of The Brain, Patricia Johnson

Electronic Thesis and Dissertation Repository

Magnetic Resonance Imaging (MRI) is a tremendously useful diagnostic imaging modality that provides outstanding soft tissue contrast. However, subject motion is a significant unsolved problem; motion during image acquisition can cause blurring and distortions in the image, limiting its diagnostic utility. Current techniques for addressing head motion include optical tracking which can be impractical in clinical settings due to challenges associated with camera cross-calibration and marker fixation. Another category of techniques is MRI navigators, which use specially acquired MRI data to track the motion of the head.

This thesis presents two techniques for motion correction in MRI: the first is …

Investigating The Practical And Clinical Effectiveness Of Applying Current Steering To Deep Brain Stimulation For Parkinsonian Gait Therapy, Daphne Hui

Electronic Thesis and Dissertation Repository

Multiple neural network integration, influence of bradykinesia and rigidity, and bias of upper limb symptom improvement during deep brain stimulation implementation may attribute to the variable responsiveness of Parkinsonian gait therapy. Current steering (CS) addresses variability through fractionating current to fine-tune the stimulation field shape. It was hypothesized that CS would exhibit greater gait improvements and lower the total electrical energy delivered (TEED), which reduces power consumption and battery drainage. Divisions of 70/30 and 50/50 and single-contact stimulation modelled CS and conventions, respectively. Overall ambulation improved with TEED reduction; further, bilateral CS improved step time and length but left CS …

Joint Coordination Variability In Anterior Cruciate Ligament Reconstructed Subjects During Stair Ambulation Using A Vector Coding Technique, Bryan R. Simrak

Theses and Dissertations (ETD)

Anterior cruciate ligament (ACL) rupture is a common injury, with an estimated incidence of 120,000 to 200,000 per year in the United States. ACL reconstruction surgery is the standard treatment for this injury to restore knee joint stability and function. While surgical reconstruction has been shown to restore laxity of the knee, current literature lacks consensus on return to normal knee joint kinematics following surgery. Additionally, re-injury is a major risk for those who return to sports activity after reconstruction surgery. Dynamical systems methods for quantifying joint coordination variability have been explored as a method for detecting differences between ACL …

Effective Measures Of Weight Gain Five Years Post-Kidney Transplantation, Tara Calico Cherry

Theses and Dissertations (ETD)

BACKGROUND: Weight gain is commonly observed post-kidney transplantation and is associated with unfavorable health outcomes, such as graft loss, new onset diabetes, and cardiovascular disease. The purpose of this study was to determine the most effective measure for assessing body composition after kidney transplantation.

DESIGN: The study was a descriptive correlational follow-up study from a single kidney transplant site.

SUBJECTS: A total of 45 eligible patients from a 2007-2011 parent study were selected, ages of 37 to 78.

MEASUREMENTS: Body composition was obtained 5–8 years posttransplant via anthropometric measures (waist circumference, body mass index, and dual energy X-ray …

In Vivo Tracking Of Tumour Associated Macrophages In Breast Cancer With Magnetic Resonance Imaging, Ashley V. Makela

Electronic Thesis and Dissertation Repository

Introduction: The environment in which a tumour exists and functions is called the tumour microenvironment (TME). In breast cancer, the presence of tumour associated macrophages (TAMs) in the TME is associated with tumour aggressiveness and poor outcomes. Despite evidence for a link between TAM content and outcome, there are few strategies to measure TAMs and no in vivo approach. Iron or fluorine-19 (¹⁹F)-based MRI can be used to detect macrophages post intravenous injection of either an iron or perfluorocarbon (PFC) agent. Iron-based MRI is sensitive but difficult to quantify. ¹⁹F MRI is specific and signal is proportional …

Tibiotalar Arthrodesis: Development Of A Novel Jig And Alignment Guide, Adam Mathew Ropchan

Electronic Thesis and Dissertation Repository

Tibiotalar arthrodesis is a surgical procedure, used for the treatment of end-stage ankle arthrosis and instability. There are dozens of described procedures in the literature, all with varying rates of success. Two of the most common reasons for reoperation in tibiotalar arthrodesis are nonunion and infection; few studies have established any associations between patient/surgical factors and reoperation for nonunion and infection.

The first part of this thesis focuses on determining the rate of reoperation to the ipsilateral lower limb and if any patient/surgical factors are associated with reoperation for nonunion and infection. The second part of this thesis turns attention …

The Use Of Current Steering During Subthalamic Deep Brain Stimulation To Alleviate Upper Limb Symptoms Of Parkinson's Disease, Shabna Iftikar Mohideen

Electronic Thesis and Dissertation Repository

Subthalamic (STN) deep brain stimulation (DBS) is an established treatment to alleviate the appendicular motor symptoms of Parkinson's Disease (PD). Current steering during DBS allows the unequal fractionation of current between two electrodes on the lead, resulting in a non-spherical electrical field. It is hypothesized that the way the electrical field is shaped will affect a patient’s upper limb symptom alleviation. Seven PD patients who underwent bilateral STN-DBS were tested over four weeks post-operation. 16 current fractionation settings were tested each week at an amplitude that increased weekly. Optimal setting was defined as the setting that provided the best …

7t Magnetic Resonance Spectroscopy Of Non-Lesional Temporal Lobe Epilepsy, John Robert Adams

Electronic Thesis and Dissertation Repository

Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy, and one that is generally amenable to surgical treatment when surgery is necessary. Unfortunately, roughly 25-30% of the patient population have no visible lesions on clinical MRI scans. Without anatomical abnormalities to help guide surgical resection, the success of surgical treatment decreases substantially. However, metabolic abnormalities may exist that could allow for accurate localization of epileptic tissue in this cohort. Magnetic resonance spectroscopy (MRS) is a technique that can detect and measure the concentration of metabolically important molecules within tissue, giving insight into the underlying cellular metabolism.

In …

Continuous Epidural Analgesia For Postoperative Pain Management: A Policy Analysis, Madison Nowell

Doctoral Projects

Postoperative pain management is a necessary component of the care of every surgical patient. Epidural analgesia is a widely used method to provide excellent postoperative pain relief and enhance postoperative recovery (Sawhney, 2012). Epidural analgesia is associated with fewer side effects than alternative pain management techniques; however, when epidural catheters are managed improperly, or pain is inadequately assessed, epidural analgesia fails to provide adequate pain relief (Deni et al., 2016). More than 80% of surgical patients experience moderate to severe postoperative pain, and 28 to 50% of these patients have a pain score greater than 6 out of 10 at …

Direct Quantification Of Deubiquitinating Enzyme Activity In Single Intact Cells, Nora Safabakhsh

LSU Doctoral Dissertations

Challenges in drug efficacy occur during the treatment of most types of cancer due to the heterogeneity of the tumor microenvironment. This has led to the development of personalized medicine. Due to the clinical success of the proteasome inhibitors Bortezomib and Carfilzomib in treatment of multiple myeloma, interest has shifted towards molecularly-targeted chemotherapeutics for ubiquitin-proteasome system (UPS). Deubiquitinating enzymes (DUBs) are an essential part of this pathway which have been found to promote Bortezomib resistance in multiple myeloma patients. Unfortunately, there is a lack of specific, high throughput biochemical assays to characterize DUB activity in patient samples before and after …

The Efficacy Of Equine Assisted Therapy In The Treatment Of Autism Spectrum Disorders, Amy Hofmann

Electronic Theses and Dissertations

This study examines the effects of equine-assisted psychotherapies in children with an autism spectrum disorder. The CARS-2 and Children’s Sleep Habits Questionnaire parent-report questionnaires were used for evaluation, as well open-ended questions. A single researcher contacted and visited many PATH-certified centers in the United States. Facilities that participated were all located in the Mid-Atlantic to Northeast region. There were 16 participants, from 11 different farms, that completed both the initial and follow-up questionnaires which were given 7 weeks apart. A $25 Amazon gift card was used as an incentive to increase participation. Participating facilities also completed a questionnaire.

Overall, results …

Analytical Models Of Neutron Spectral Fluence, Kerma And Absorbed-Dose For Proton Therapy, Suman Shrestha

LSU Master's Theses

Abstract

Purpose: The accurate prediction of stray neutron dose has become increasingly important as it increases the risk of second cancer development after proton therapy. Previously reported analytical models predicted the quantity dose equivalent, which includes physical and biological considerations but does not explicitly take into account material dependence and variation in the radiation quality. The purpose of this study was to investigate the feasibility of an analytical model of absorbed dose to water from stray neutrons in proton therapy.

Methods: To calculate neutron absorbed dose and kerma in water, the authors developed analytical models of neutron spectral fluence and …

Characterization Of Theranostic Peptides For Glioblastoma Multiforme, Aaron Mellesmoen

All NMU Master's Theses

Glioblastoma multiforme (GBM) is a type of primary CNS tumor in which viable treatment options do not exist. Standard of care including tumor resection, chemotherapy, and radiation does little to extend the 5-year survival expectancy past 5.1%. Herein, two small-peptide molecules with inherent antitumor activity, blood-brain barrier permeability, and capability for tumor-specific drug deliverance and intraoperative visualization (termed theranostic) were of focus. Confocal microscopy was employed to characterize in vitro specificity of chlorotoxin, a 4 kDa scorpion venom peptide, and rBSG, the recombinant 25 kDa non-glycosylated extracellular domain of extracellular matrix metalloproteinase inducer (EMMPRIN; Basigin) isoform …

Simvastatin Does Not Sensitize Ibc3 Her2+ Inflammatory Breast Cancer Brain Metastases To Whole Brain Irradiation In An Immunocompromised Mouse Model, Swaminathan Kumar

Dissertations & Theses (Open Access)

Retrospective data analysis suggests that inflammatory breast cancer (IBC) patients who take statins have better locoregional control after radiotherapy than those who do not [23]. Our lab has previously demonstrated that simvastatin radiosensitizes IBC cells in vitro [23], and brain metastases have strong expression of cholesterol-regulation genes compared to lung metastases in vivo [unpublished]. Delaying whole-brain irradiation (WBI) beyond 21 days is insufficient to reduce the incidence of brain metastases (developed by injecting IBC3 cells through the tail vein) in our mouse model because even high rates of cell killing leave substantial cell volume in established metastases [unpublished].

With the …

Evaluation Of Cardiomems Heart Failure Device, Danielle Moe, Msn, Rn

Doctor of Nursing Practice Projects

Background: Heart failure (HF) is a chronic condition where the heart cannot pump enough blood to adequately oxygenate cells. The CardioMEMS HF device is implanted into the pulmonary artery (PA) allowing practitioners to monitor pressures remotely and prescribe interventions. Objectives: The primary purpose of this project was to determine if CardioMEMS is an effective intervention in the reduction of hospital admissions, emergency department (ED), and clinic visits for HF patients. The secondary purpose was to determine if the quality of life (QOL) and exercise tolerance was improved post-implant. Methods: The author conducted a retrospective chart review by accessing previously compiled …

Bayesian Analytical Approaches For Metabolomics : A Novel Method For Molecular Structure-Informed Metabolite Interaction Modeling, A Novel Diagnostic Model For Differentiating Myocardial Infarction Type, And Approaches For Compound Identification Given Mass Spectrometry Data., Patrick J. Trainor

Electronic Theses and Dissertations

Metabolomics, the study of small molecules in biological systems, has enjoyed great success in enabling researchers to examine disease-associated metabolic dysregulation and has been utilized for the discovery biomarkers of disease and phenotypic states. In spite of recent technological advances in the analytical platforms utilized in metabolomics and the proliferation of tools for the analysis of metabolomics data, significant challenges in metabolomics data analyses remain. In this dissertation, we present three of these challenges and Bayesian methodological solutions for each. In the first part we develop a new methodology to serve a basis for making higher order inferences in metabolomics, …

3d-Printed Fluidic Devices And Incorporated Graphite Electrodes For Electrochemical Immunoassay Of Biomarker Proteins, Abdulhameed Alabdulwaheed

Electronic Theses and Dissertations

Biomarkers are measurable indicators of health status or disease state that can be used for diagnosis and may help guide patient treatment strategies. Enzyme-linked immunosorbent assays (ELISA) and other many clinical techniques currently used for measuring biomarker proteins lack sensitivity, demand high analysis cost, are often not well-suited for measuring multiple biomarkers in a single sample, and require long analysis times. Here, we demonstrate simple, low-cost 3D-printed flow-through devices with integrated electrodes modified with gold nanoparticles (AuNPs) for electrochemical immunoassays of S100B, a biomarker protein related to conditions like skin cancer and brain injuries. Flow-through devices are fabricated from photocurable-resin …

Compartmentalization Of Dna-Based Molecular Computing Elements Using Lipid Bilayers, Aurora Fabry-Wood

Biomedical Engineering ETDs

This dissertation will present a progression from the detection of double-stranded DNA using a combination of toehold-mediated strand displacement and DNAzyme reactions in dilute saline solutions, to the generation of separate compartments to allow standardization of DNA computing elements, by protecting from complementary strands. In well-mixed solutions complementary regions cause spurious interactions. Importantly, these compartments also provide protection from nucleases. Along the way we will also explore the use of silica microsphere supported lipid bilayers to run compartmentalized DNA reactions on a fluid surface and the design of a molecule capable of DNA-based transmembrane signal transduction.

Investigating The Pathogenesis Of Staphylococcus Aureus In Periprosthetic Joint Infections, Santiago L. Iglesias

Electronic Thesis and Dissertation Repository

The most challenging complication after total joint replacement is the periprosthetic joint infection (PJI). Staphylococcus aureus is a commensal bacterium and a human pathogen. It is responsible for more than half of the PJI. We demonstrated that synovial fluid has antimicrobial properties against S. aureus and the iron restriction is one of the mechanisms used for the host to prevent bacterial growth, and is even able to increase killing of S. aureus. We have shown a clear role of transferrin as a restrictive factor in synovial fluid that functions by iron starving the bacteria and sensitizing them to killing …

Hybrid Model - Statistical Features And Deep Neural Network For Brain Tumor Classification In Mri Images, Mustafa Rashid Ismael

Dissertations

A brain tumor is the most common disease that affects the central nervous system (CNS), the brain, and spinal cord. It can be diagnosed using the safest and most reliable imaging modality, the Magnetic Resonance Imaging (MRI), by radiologists who may use the assistance of computer-aided diagnosis (CAD) tools. Automated diagnosis is sought because it is essential to overcome the drawbacks of the manual diagnosis, such as time and the stress of viewing MRI images for long hours, and the human error potential. Image analysis and machine learning algorithms are tools that can be used to build an intelligent CAD …

Cognitive And Emotional Correlates Of Improved Gait Distance During The Course Of Physical Therapy Treatment For An Incomplete Spinal Cord Injury, Danielle Miller

Honors Theses

Objective

The focus of spinal cord injury rehabilitation over the past four decades has shifted from medical management to issuses that affect quality of life and community participation (Gómara- Toldrà, Sliwinski, & Dijkers, 2014). However, the care team for spinal cord injury patients still need to collaberate in order to design and implement interventions that result in maximum participation to provide an individual with a spinal cord injury an effective rehabilitation program. In order to create such a rehablitation program, the care team must know how certain psychological and cognitive aspects, such as depression and implict memory, are related to …

Integration Of Complementary And Alternative Medicine Into The Healthcare System In The United States, Nikki Lu

Global Honors Theses

Chronic diseases are a prevalent issue around the world and chronic diseases are hard to prevent due to various systemic factors in the healthcare system. This paper mainly focused on socioeconomic issues and highlighted a few systemic factors in the US healthcare system. These factors have created various health disparities, inequities among socially constructed groups, and financial expenditures in the US healthcare system. Socioeconomic factors significantly impact the health and healthcare among socially constructed groups. Additionally, in this paper there are current approaches in addressing these healthcare factors such as social determinants of health and precision medicine as well as …

Radical Social Ecology As Deep Pragmatism: A Call To The Abolition Of Systemic Dissonance And The Minimization Of Entropic Chaos, Arielle Brender

Student Theses 2015-Present

This paper aims to shed light on the dissonance caused by the superimposition of Dominant Human Systems on Natural Systems. I highlight the synthetic nature of Dominant Human Systems as egoic and linguistic phenomenon manufactured by a mere portion of the human population, which renders them inherently oppressive unto peoples and landscapes whose wisdom were barred from the design process. In pursuing a radical pragmatic approach to mending the simultaneous oppression and destruction of the human being and the earth, I highlight the necessity of minimizing entropic chaos caused by excess energy expenditure, an essential feature of systems that aim …

Precision Gene Therapy For Charcot-Marie-Tooth Disease: From Identifying Genetic Modifiers To Developing Allele-Specific Therapies, Kathryn H. Morelli Ph.D.

Electronic Theses and Dissertations

Charcot-Marie-Tooth Disease (CMT) is a clinically and genetically heterogeneous collection of inherited peripheral neuropathies generally characterized by progressive muscle atrophy, weakness, and loss of sensation in the distal extremities. This inherited disorder, for which there is currently no curative treatment, is the most common inherited disease of the peripheral nervous system, affecting 1:2,500 individuals worldwide.

Clinically, CMT is broadly divided into demyelinating (type 1) and axonal (type 2) forms. Although the clinical presentation can vary greatly in severity and progression within individual patients. Genetically, over 1,000 mutations in over 80 loci in the human genome have been linked to specific …

Assessment Of Risk In Preterm Infants Using Point Process And Machine Learning Approaches, Venkata Naga Sai Apurupa Amperayani

Electrical Engineering Theses

Preemies, infants who are born too soon, have a higher incidence of Life-Threatening Events (LTE’s) such as apnea (cessation of breathing), bradycardia (slowing of heart rate) and hypoxemia (oxygen desaturation) also termed as ABD (Apnea, Bradycardia, and Desaturation) events. Clinicians at Neonatal Intensive Care Units (NICU) are facing the demanding task of assessing the risk of infants based on their physiological signals. The aim of this thesis is to develop a risk stratification algorithm using a machine-learning framework with the features related to pathological fluctuations derived from point process model that will be embedded into the current physiological recording system …

Design Of A Homeopathic Solution For Chronic Cough, Jacob Ziemke

Senior Honors Projects, 2010-2019

Chronic cough is most commonly defined as a cough that persists for more than eight weeks and is estimated to affect more than 30 million people in the United States at any given time. Diseases contributing to the onset of chronic cough include asthma, pulmonary fibrosis, lung cancer, postnasal drip, gastroesophageal reflux disease (GERD), and bronchitis, and may include lifestyle choices such as smoking. For those who seek medical advice, pharmaceuticals and speech therapy are two common methods of combating chronic cough but serve to mask the symptoms rather than treat the problem; frequently, chronic cough is misdiagnosed or cannot …

A Study Of Acoustically Activated Nanodroplets, Songita Choudhury

Theses & Dissertations

Current treatment of acute myocardial infarction (AMI), which is the main pathophysiological event leading to death in the United States, has advanced considerably with the introduction of emergent percutaneous interventions, but there remains an urgent need for novel techniques to rapidly and accurately detect infarcted or ischemic tissue that results from AMI. Ultrasound contrast agents, also known as microbubbles (MB), have become commonplace in echocardiography. However, MBs are purely intravascular tracers and unable to cross endothelial barriers due to size. The limitations of MBs, namely size and short circulation times within the human body, led to the development of phase-change …

Validity And Reliability Of The Ymca Submaximal Cycle Test Using An Electrically Braked Ergometer, Justin Kidd

Senior Honors Projects, 2010-2019

Purpose: To test the effect of using an electrically braked ergometer on the validity and reliability of the YMCA submaximal cycle test.

Methods: 22 male and 13 female subjects ages 19 to 31 completed one maximal treadmill test and four submaximal cycle tests to measure and estimate VO_2max, respectively. The maximal tests involved recording heart rate and VO₂ during graded exercise until volitional fatigue; an actual max was verified when two out of the following criteria: respiratory Exchange Ratio > 1.1, VO₂ plateau (< 150 ml/min increase in VO₂ during final stage), and achievement of 90% age-predicted HR max (or completed …

Failure Of Primary Total Knee Arthroplasty: Establishing A Baseline For Retrieval Analysis Using Well-Functioning Necropsy Specimens, Meredith Perkins

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) is an effective treatment for end-stage osteoarthritis of the knee. While many patients have positive functional and pain outcomes following primary TKA, a subset of patients have suboptimal outcomes, such as unexplained pain or aseptic loosening of the implant components necessitating revision of the index procedure. The understanding of the exact etiology of these suboptimal outcomes of primary TKA is in its infancy. In order to elucidate the etiology of failure in primary TKAs, a baseline for the factors contributing to arthroplasty failure and dissatisfaction must first be established. The purpose of this study …