Medicine and Health Sciences Commons^™

Evaluation Of The Survival Effect For Various Treatment Modalities Among Stage Ii And Iii Rectal Cancer Patients In California, 1994-2009, Myung Mi Cho

Loma Linda University Electronic Theses, Dissertations & Projects

Background: European trials evaluating the effect of preoperative (PreOP) versus postoperative chemoradiotherapy (PostOP CRT) found no survival benefit. However, the effect of a change from PostOP to PreOP CRT has not been evaluated in a population-based setting. We sought to evaluate multimodal treatment changes and overall survival for perioperative (PeriOP) CRT versus surgery alone and for PreOP versus PostOP CRT from 1994 through 2009 among patients receiving radical surgery for stage II and III rectal cancer (RC).

Patients and Methods: We conducted a nonconcurrent cohort study evaluating demographic predictors of multimodal therapy for stage II and III RC using …

Health Care Informatics Support Of A Simulated Study, Zeinab Salari Far

Theses and Dissertations

The objective of this project is to assess the value of REDCap (Harris, 2009) by conducting a simulated breast cancer clinical trial and demonstration. REDCap is a free, secure, web-based application designed to support data capture for research studies. To assess REDCap's value, we conducted a simulation of a clinical trial study designed to compare the use of two new technologies for breast cancer diagnosis and treatment with current best practice breast cancer diagnosis and treatment. We call the trial, "Real-Time Operating Room BC Diagnostic Treatment (RORBCDT)". The RORBCDT clinical trial is designed to assess the value of a new …

Development Of A Novel Technique For Predicting Tumor Response In Adaptive Radiation Therapy, Rebecca Marie Seibert

Doctoral Dissertations

This dissertation concentrates on the introduction of Predictive Adaptive Radiation Therapy (PART) as a potential method to improve cancer treatment. PART is a novel technique that utilizes volumetric image-guided radiation therapy treatment (IGRT) data to actively predict the tumor response to therapy and estimate clinical outcomes during the course of treatment. To implement PART, a patient database containing IGRT image data for 40 lesions obtained from patients who were imaged and treated with helical tomotherapy was constructed. The data was then modeled using locally weighted regression. This model predicts future tumor volumes and masses and the associated confidence intervals based …

Privacy And Security Issues In Iot Healthcare Applications For The Disabled Users A Survey, Wassnaa Al-Mawee

Masters Theses

Aging of the population resulted in new challenges for the society and healthcare systems. Ambient Assisted Living (AAL) that depends on Internet of Things (IoT) provides assistance to the disabled people and supports their vital daily life activities. Affordability of and accessibility to AAL and the usage of IoT starts revolutionizing healthcare services. This Thesis is a survey of the privacy and security issues in IoT healthcare applications for the disabled users. Introduction includes definitions of privacy and security terms, and discusses their relationship. Then, it presents an overview of the IoT, including its architecture and components. Next, the Thesis …

The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon

Loma Linda University Electronic Theses, Dissertations & Projects

The first study population included 292 unselected consecutive patients from the LLUMC heart failure clinic who were enrolled in the study from January to July 2006 and were followed up through the end of December 2010. The treatment policy at the clinic was to uptitrate dosages of beta-adrenergic blockade (β-blockers), angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) to the most tolerable levels in order to reach target dosages, as recommended by the Heart Failure Society of America (HFSA). Patients were classified into systolic heart failure (ejection fraction (EF) < 40%) or diastolic heart failure (EF≥40%). All dosages of β-blockers, ACEi and ARB were extracted through chart reviews and were used as the main predictors of the patients' survival. Results from analyses showed that reaching target dosages of β-blockers and ACEi/ARB may increase survival when compared to not reaching target among the systolic HF population (HR_{β_biockers}= 0.64, 95% CI 0.26-1.56 and HR_ACEi/ARB=0.50, …

Evaluation Of Polymer Gel Dosimeters For Measurements Of Dose And Let In Proton Beams, Kevin M. Vredevoogd

Dissertations & Theses (Open Access)

This project assessed the effectiveness of polymer gel dosimeters as tools for measuring the dose deposited by and LET of a proton beam. A total of three BANG® dosimeter formulations were evaluated: BANG®-3-Pro-2 BANGkits™ for dose measurement and two BANG®-3 variants, the LET-Baseline and LET-Meter dosimeters, for LET measurement. All dosimeters were read out using an OCT scanner. The basic characteristics of the BANGkits™ were assessed in a series of photon and electron irradiations. The dose-response relationship was found to be sigmoidal with a threshold for response of approximately 15 cGy. The active region of the dosimeter, the volume in …

Design And Optimization Of Four-Dimensional Cone-Beam Computed Tomography In Image-Guided Radiation Therapy, Moiz Ahmad

Dissertations & Theses (Open Access)

The influence of respiratory motion on patient anatomy poses a challenge to accurate radiation therapy, especially in lung cancer treatment. Modern radiation therapy planning uses models of tumor respiratory motion to account for target motion in targeting. The tumor motion model can be verified on a per-treatment session basis with four-dimensional cone-beam computed tomography (4D-CBCT), which acquires an image set of the dynamic target throughout the respiratory cycle during the therapy session. 4D-CBCT is undersampled if the scan time is too short. However, short scan time is desirable in clinical practice to reduce patient setup time. This dissertation presents the …

Complexity And Uncertainty In Human And Ecological Risk Assessment, Matthew Jordan Dellinger

Theses and Dissertations

Multiple interacting stressors in the environment present increasingly complex risks to human health. Too often, however, the data required for traditional risk assessment are either lacking or unavailable at the necessary spatial or temporal scale. In addition, assessment practices and management policies need to move away from single factor approaches in order to accommodate the reality of complex chemical mixtures and environmental stressors. Recent literature suggests that a paradigm shift is under way. This points to a need for the development of new techniques both for rapid data collection and flexible risk assessment strategies that can adapt to make use …

New Applications Of Mass Spectrometry For Drug And Lipid Analysis, Elizabeth Lauren Emerson

Graduate Theses and Dissertations

Mass spectrometry is an important tool used in many different disciplines and settings that include forensics, drug discovery, environmental analysis, and proteomics. Gas chromatography - mass spectrometry (GC-MS) and matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI - TOF MS) are two of the most important instruments used for analysis of compounds. Chapters 1 and 2 of this discussion use GC-MS for the investigation of synthetic cannabinoids in `K2' incense products and the detection of metabolites in urine samples from individuals suspected of consuming these mixtures. Analytical standards were synthesized and used for identification and confirmation of structures. Detection of …

Recycling And Reuse Of Radioactive Materials, Thomas Joseph O'Dou

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Radiochemistry Program at the University of Nevada, Las Vegas (UNLV) has a Radiation Protection Program that was designed to provide students with the ability to safely work with radioactive materials in quantities that are not available in other academic environments. Requirements for continuous training and supervision make this unique program capable of turning out graduates that have an understanding of contamination and dose control techniques that complement their knowledge of the elements that they work with. The Program has also adopted a radionuclide recovery and reuse program that has provided materials from other universities, government agencies, and private companies …

Optimization Of Chiral Separation Of Nadolol By Simulated Moving Bed Technology, Nesma Nehad Hashem

Electronic Thesis and Dissertation Repository

Simulated Moving Bed (SMB) technology has gained increasing attention as one of the most powerful techniques for chromatographic separations due to its cost-effectiveness and efficiency. Application of SMB technology is especially important in the pharmaceutical industry for production of enantiopure drugs, as required under strict FDA regulations, to avoid possible adverse effects of racemic drugs. In this study, the performance of the SMB process in separation of racemic nadolol on a perphenyl carbamoylated beta cyclodextrin (β-CD) stationary phase was investigated. The equilibrium dispersive model coupled with bi-Langmuir adsorption isotherm and lumped kinetic approximation, constitute the mathematical model used to simulate …

The Design And Testing Of A Solar Autoclave With Broad Spectrum Sterilization Capabilities, Sarah S. Trabia

Honors College Theses

Energy is difficult to come by in developing countries and this interferes with the ability of doctors to provide good healthcare to their patients. Without decent sterilization, patients can become infected and diseases can spread throughout hospitals. This study involves designing a solar autoclave for developing countries that is as efficient as electrical autoclaves. The design is intended to not require any electrical input and to be affordable to those who cannot afford advanced medical equipment. Once the solar autoclave is designed, it will be tested to determine if it can sterilize equipment against a variety of different bacteria, including …

The Factors Behind A Successful Implementation Of Electronic Health Records Systems, Anjee Gorkhali

Engineering Management & Systems Engineering Theses & Dissertations

This research explores the role that budget for Information System (IS) and technical expertise of healthcare service provider staff play on the successful leap from a partial to exhaustive implementation of Electronic Health Records (EHR) Systems. Technical expertise in Information Systems might not be easily measurable directly, but there are a number of indicators that could be used as a proxy, such as: Information System (IS) Department Budget, number of IS staff and the extent of technical trainings provided by the IS department to the clinical staff. This research study hypothesizes that quality technical trainings conducted by an IS department …

An Efficient Methodology For Learning Bayesian Networks, Emmanuel Owusu Asante-Asamani

Theses and Dissertations

Statistics from the National Cancer Institute indicate that 1 in 8 women will develop Breast cancer in their lifetime. Researchers have developed numerous statistical models to predict breast cancer risk however physicians are hesitant to use these models because of disparities in the predictions they produce. In an effort to reduce these disparities, we use Bayesian networks to capture the joint distribution of risk factors, and simulate artificial patient populations (clinical avatars) for interrogating the existing risk prediction models. The challenge in this effort has been to produce a Bayesian network whose dependencies agree with literature and are good estimates …

Development And Implementation Of A Remote Audit Tool For High Dose Rate (Hdr) 192ir Brachytherapy Using Optically Stimulated Luminescence Dosimetry, Kevin Casey

Dissertations & Theses (Open Access)

This work aimed to create a mailable and OSLD-based phantom with accuracy suitable for RPC audits of HDR brachytherapy sources at institutions participating in NCI-funded cooperative clinical trials. An 8 × 8 × 10 cm³ prototype with two slots capable of holding nanoDot Al₂O₃:C OSL dosimeters (Landauer, Glenwood, IL) was designed and built. The phantom has a single channel capable of accepting all ¹⁹²Ir HDR brachytherapy sources in current clinical use in the United States. Irradiations were performed with an ¹⁹²Ir HDR source to determine correction factors for linearity with dose, dose rate, …

Development And Implementation Of The Use Of Optically Stimulated Luminescent Detectors In The Radiological Physics Center Anthropomorphic Quality Assurance Phantoms, Jennelle Bergene

Dissertations & Theses (Open Access)

The Radiological Physics Center (RPC) uses both on-site and remote reviews to credential institutions for participation in clinical trials. Anthropomorphic quality assurance (QA) phantoms are one tool the RPC uses to remotely audit institutions, which include thermoluminescent dosimeters (TLDs) and radiochromic film. The RPC desires to switch from TLD as the absolute dosimeter in the phantoms, to optically stimulated luminescent dosimeters (OSLDs), but a problem lies in the angular dependence exhibited by the OSLD. The purpose of this study was to characterize the angular dependence of OSLD and establish a correction factor if necessary, to provide accurate dosimetric measurements as …

Latin Hypercube Sampling And Partial Rank Correlation Coefficient Analysis Applied To An Optimal Control Problem, Boloye Gomero

Masters Theses

Latin Hypercube Sampling/Partial Rank Correlation Coefficient (LHS/PRCC) sensitivity analysis is an efficient tool often employed in uncertainty analysis to explore the entire parameter space of a model. Despite the usefulness of LHS/PRCC sensitivity analysis in studying the sensitivity of a model to the parameter values used in the model, no study has been done that fully integrates Latin Hypercube sampling with optimal control analysis.

In this thesis, we couple the optimal control numerical procedure to the LHS/PRCC procedure and perform a simultaneous examination of the effects of all the LHS parameter on the objective functional value. To test the effectiveness …

Characterization Of Polymeric Phthalocyanine Nanoparticles Using Dynamic Light Scattering Laser, Satish Kumar Murarishetty

All Capstone Projects

The objective of this study is to use DLS (Dynamic Light Scattering) to analyze polymeric copper phthalocyanine nanoparticles (CuPcNPs). CuPcNPs are synthesized in order to facilitate drug penetration of bacterial biofilms for the treatment of chronic wounds. Microorganisms that reside inside the biofilms of chronic wounds are very resistant to any kind of treatment, even to the host’s own immune system. Therefore we have proposed an alternative method to destroy the microorganisms existing within the biofilms. Photodynamic anti-bacterial chemotherapy (PACT) has received much attention for the past decade due to the multi-drug resistant strands. PACT uses photons, a photosensitizer, and …

Nano Encapsulated Drug Delivery For Biofilms, Arunakanth Chavala

All Capstone Projects

Biofilms are now considered ubiquitous in the natural world. Bacterial biofilms have been observed to be extremely heterogeneous, both structurally and with regard to the physiology of the bacterial cells within them. The prevailing conceptual model depicts bacterial biofilms as being made up of microcolonies, which serve as the basic unit of the greater biofilm structure. A major concern with this approach is the frequently observed development of resistance to antimicrobial compounds. A number of elements in the process of biofilm formation have been studied as targets for novel drug delivery technologies. The present study aimed to penetrate biofilm by …

Nanoparticlated Drug Delivery System For Vitreous Humor, Kartheek K. Suragoni

All Capstone Projects

The purpose of this study is to develop a unique nanoparticulated system that has the capability of providing sustained drug delivery into the eyes. In ophthalmic preparations, poor ocular drug delivery of ocular dosage form is due to the production of tears and impermeability through corneal epithelium. The usage of liposomes in ophthalmic disorders shows promising results in ocular drug delivery. Liposomes are bilayered, microscopic vesicles surrounded by the aqueous compartments. Liposomes have the ability to encapsulate both hydrophilic and hydrophobic drugs. This unique property of liposomes helps in delivering the drug at specific site. This invention involves three major …

Identification Of Persistent Long Range Interactions In GA95 And GB95 Through Thermal Unfolding Simulations, Milen Redai Tesfamariam

Chemistry & Biochemistry Theses & Dissertations

For over five decades, different experiments have been performed to research how proteins attain their native three dimensional structures. However, the folding problem continues to be a puzzle in modern science. The design of two proteins that have maximal sequence identity but different folds and functions is one method that is being used to study the relationship between protein structure and amino acid sequence. In particular, mutant proteins of Streptococcus protein G, G_A and G_B, have 95% sequence identity and a 3a helix fold and β4/a fold, respectively. Molecular dynamics simulations of G_A95 …

Analysis Of Dietary Patterns Over Freshman Year Of College, Chelsea Lofland

Statistics

This analysis is an investigation of changes in Cal Poly students’ eating habits over freshman year. The motivation behind this was an interest in college students’ lifestyles; college is the first time most students live on their own and it can be an important maturation period. College is stressful, exciting, liberating, and terrifying all at the same time. This distinctive life experience, along with my desire to handle big and messy data, led me to this research question.

The response variable analyzed was food consumption and the explanatory variables were: sex, race, quarter, food group, stress, exercise, BMI, sleep quality …

Mri-Based Attenuation Correction In Emission Computed Tomography, Harry R. Marshall

Electronic Thesis and Dissertation Repository

The hybridization of magnetic resonance imaging (MRI) with positron emission tomography (PET) or single photon emission computed tomography (SPECT) enables the collection of an assortment of biological data in spatial and temporal register. However, both PET and SPECT are subject to photon attenuation, a process that degrades image quality and precludes quantification. To correct for the effects of attenuation, the spatial distribution of linear attenuation coefficients (μ-coefficients) within and about the patient must be available. Unfortunately, extracting μ-coefficients from MRI is non-trivial. In this thesis, I explore the problem of MRI-based attenuation correction (AC) in emission tomography.

In particular, I …

A Modular Framework For Home Healthcare Monitoring, Blake Puryear

Computer Science and Computer Engineering Undergraduate Honors Theses

Many patients with chronic health problems have multiple ailments but different patients may have different such ailments. Home monitoring systems for individual ailments exist but a patient may have multiple of these, all designed independently. There are no standard architectures so this leads to unmanageable diversity which causes problems for patients in having to learn to use a variety of monitors and for physicians in trying to monitor many patients. The purpose of this project was to design and prototype a next generation modular remote healthcare monitoring system capable of monitoring multiple ailments and extensible to new ailments in order …

Effects Of Hyperthermia On Photochemical Internalization-Mediated Delivery Of Bleomycin, Christina Schlazer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Standard treatment protocols for high-grade gliomas, such as glioblastoma multiforme (GBM), are highly ineffective due to their inability to eradicate infiltrating tumor cells. Improvements in overall survival are likely to be realized only with the development of more effective localized therapies capable of eradicating tumor cells in the surgical resection margin and beyond. Photochemical internalization (PCI) is a localized light-based therapeutic modality that enhances the efficacy of therapeutic macromolecules including chemotherapeutic agents such as bleomycin. A number of studies have shown that this photodynamic therapy (PDT) - based modality may prove effective in the treatment of high-grade gliomas.

Three-dimensional multicell …

Arsenic Contamination In Groundwater In Vietnam: An Overview And Analysis Of The Historical, Cultural, Economic, And Political Parameters In The Success Of Various Mitigation Options, Thuy M. Ly

Pomona Senior Theses

Although arsenic is naturally present in the environment, 99% of human exposure to arsenic is through ingestion. Throughout history, arsenic is known as “the king of poisons”; it is mutagenic, carcinogenic, and teratogenic. Even in smaller concentrations, it accumulates in the body and takes decades before any physical symptoms of arsenic poisoning shows. According to the World Health Organization (WHO), the safe concentration of arsenic in drinking water is 10 µg/L. However, this limit is often times ignored until it is decades too late and people begin showing symptoms of having been poisoned.

This is the current situation for Vietnam, …

Verification Of The Clinical Implementation Of The Respiratory Gated Beam Delivery Technique With Synchrotron-Based Proton Irradiation, Yoshikazu Tsunashima

Dissertations & Theses (Open Access)

The clinical advantage for protons over conventional high-energy x-rays stems from their unique depth-dose distribution, which delivers essentially no dose beyond the end of range. In order to achieve it, accurate localization of the tumor volume relative to the proton beam is necessary. For cases where the tumor moves with respiration, the resultant dose distribution is sensitive to such motion. One way to reduce uncertainty caused by respiratory motion is to use gated beam delivery. The main goal of this dissertation is to evaluate the respiratory gating technique in both passive scattering and scanning delivery mode. Our hypothesis for the …

Border Hispanics’ Physical Activity Improvement In A Chronic Disease Prevention Program, Lu Xu

Theses and Dissertations - UTB/UTPA

In seeking of effective prevention programs to improve physical activities, we want to examine the factors related to physical activities improvement in Alliance for a Healthy Border, a chronic disease prevention program with pre-post-post evaluations through 12 federally qualified community health centers serving primarily Hispanics in communities along the U.S.- Mexico border. Logistic regression was performed to examine the association between physical activity and twenty predictors at baseline. Multinomial regression was used to examine the determinants of physical activities improvement at two time points: program end and post six-months. Socio-demographic, baseline health condition factors, and determination of doing physical activity …

The Efficacy Of An Audio Program And Discussion Guide In Promoting Exclusive Breastfeeding In Cameroon, Africa, Kathryn R. Reinsma

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In the Northwest Region of Cameroon, approximately 90% of women initiate breastfeeding; however, only 34% continue exclusive breastfeeding for the recommended six months (Kakute, et al., 2005; WHO, 2008). Entertainment-education is a mass-media communication strategy of placing educational information into media such as television programs, movies, and radio programs (Siegel & Lotenberg, 2007). This form of behavioral change communication has proven effective in addressing health-related issues in developing countries.

Purpose: The aim was to design an audio program and discussion guide to test the hypothesis that an audio program and discussion guide improves exclusive breastfeeding knowledge, beliefs, benefits, self-efficacy, …

The Role Of Hsp70 In Cancer: A Study Of The Hsp70 / Akt Relationship, John Koren

USF Tampa Graduate Theses and Dissertations

The Hsp70 family of molecular chaperones is essential for

protein folding, re-folding misfolded client proteins, clearance

of aberrant client proteins, and can also inhibit programmed

cell death. There are two major cytosolic members of this

family: the constitutive Hsc70, and the inducible Hsp72. Under

stress conditions the Hsp70 family protects the cell from

protein related damage by the induction of Hsp72. Hsc70 and

Hsp72 are highly homologous with minor differences in

substrate binding. In cancers, Hsp72 is commonly induced and

this induction is thought to aid in cancer cell survival. In these

studies we demonstrate the differential regulation of the …