Medicine and Health Sciences Commons^™

Exploring The State-Of-Receptivity For Mhealth Interventions, Florian Künzler, Varun Mishra, Jan-Niklas Kramer, David Kotz, Elgar Fleisch, Tobias Kowatsch

Dartmouth Scholarship

Recent advancements in sensing techniques for mHealth applications have led to successful development and deployments of several mHealth intervention designs, including Just-In-Time Adaptive Interventions (JITAI). JITAIs show great potential because they aim to provide the right type and amount of support, at the right time. Timing the delivery of a JITAI such as the user is receptive and available to engage with the intervention is crucial for a JITAI to succeed. Although previous research has extensively explored the role of context in users’ responsiveness towards generic phone notiications, it has not been thoroughly explored for actual mHealth interventions. In this …

Association Of Receiving Multiple, Concurrent Fracture-Associated Drugs With Hip Fracture Risk, Rebecca T. Emeny, Chiang-Hua Chang, Jonathan Skinner, James A. O'Malley, Jeremy Smith, Gouri Chakraborti, Clifford J. Rosen, Nancy E. Morden

Dartmouth Scholarship

Importance: Many prescription drugs increase fracture risk, which raises concern for patients receiving 2 or more such drugs concurrently. Logic suggests that risk will increase with each additional drug, but the risk of taking multiple fracture-associated drugs (FADs) is unknown.

Objective: To estimate hip fracture risk associated with concurrent exposure to multiple FADs.

Design, Setting, and Participants: This cohort study used a 20% random sample of Medicare fee-for-service administrative data for age-eligible Medicare beneficiaries from 2004 to 2014. Sex-stratified Cox regression models estimated hip fracture risk associated with current receipt of 1, 2, or 3 or more of 21 FADs …

The Cost Of The Culturati: Studying The Neighborhood Stability Impact Of Cultural District Designations, Prakash Mishra

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

The decision to declare a district for a specific cause is a critical policy decision; making an area an official office park or designated cultural site means it will attract specific types of residents and businesses and require specific amenities. This paper reviews the impact of designating a cultural district as a place-based policy, specifically by developing a measure of neighborhood stability and applying a stress test of neighborhood stability in cultural districts during the Great Recession. The model underpining the neighborhood stability measure is an optimal stopping time model which frames neighborhood rents as a Brownian motion with drift. …

Volume I | Issue Ii | 2019.Pdf, Dujpew Editorial Board

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

No abstract provided.

Masthead 2019, Dujpew Editorial Board

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

No abstract provided.

Letter From The Editor 2019, Dujpew Editorial Board

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

No abstract provided.

Characterization Of A Non-Contact Imaging Scintillator-Based Dosimetry System For Total Skin Electron Therapy., Irwin I. Tendler, Petr Bruza, Michael Jermyn, Xu Cao, Benjamin B. Williams, Lesley A. Jarvis, Brian W. Pogue, David J. Gladstone

Dartmouth Scholarship

Surface dosimetry is required for ensuring effective administration of total skin electron therapy (TSET); however, its use is often reduced due to the time consuming and complex nature of acquisition. A new surface dose imaging technique was characterized in this study and found to provide accurate, rapid and remote measurement of surface doses without the need for post-exposure processing. Disc-shaped plastic scintillators (1 mm thick  ×  15 mm [Formula: see text]) were chosen as optimal-sized samples and designed to attach to a flat-faced phantom for irradiation using electron beams. Scintillator dosimeter response to radiation damage, dose rate, and temperature were …

Use Of Amulet In Behavioral Change For Geriatric Obesity Management, John A. Batsis, Alexandra B. Zagaria, Ryan J. Halter, George G. Boateng, Patrick Proctor, Stephen J. Bartels, David Kotz

Dartmouth Scholarship

Background: Obesity in older adults is a significant public health concern. Weight-loss interventions are known to improve physical function but risk the development of sarcopenia. Mobile health devices have the potential to augment existing interventions and, if designed accordingly, could improve one’s physical activity and strength in routine physical activity interventions.

Methods and results: We present Amulet, a mobile health device that has the capability of engaging patients in physical activity. The purpose of this article is to discuss the development of applications that are tailored to older adults with obesity, with the intention to engage and improve their health. …

Development And Usability Assessment Of A Connected Resistance Exercise Band Application For Strength-Monitoring, John A. Batsis, George G. Boateng, Lillian M. Seo, Curtis L. Petersen, Karen L. Fortuna, Emily V. Wechsler, Ronald J. Peterson, Summer B. Cook, Dawna Pidgeon, Rachel S. Dokko, Ryan J. Halter, David F. Kotz

Dartmouth Scholarship

Resistance exercise bands are a core component of any physical activity strengthening program. Strength training can mitigate the development of sarcopenia, the loss of muscle mass or strength and function with aging. Yet, the adherence of such behavioral exercise strategies in a home-based setting are fraught with issues of monitoring and compliance. Our group developed a Bluetooth-enabled resistance exercise band capable of transmitting data to an open-source platform. In this work, we developed an application to capture this information in real-time, and conducted three usability studies in two mixed-aged groups of participants (n=6 each) and a group of older adults …

Signal Intensity Analysis And Optimization For In Vivo Imaging Of Cherenkov And Excited Luminescence., Ethan P. M. Larochelle, Jennifer R. Shell, Jason R. Gunn, Scott C. Davis, Brian W. Pogue

Dartmouth Scholarship

During external beam radiotherapy (EBRT), in vivo Cherenkov optical emissions can be used as a dosimetry tool or to excite luminescence, termed Cherenkov-excited luminescence (CEL) with microsecond-level time-gated cameras. The goal of this work was to develop a complete theoretical foundation for the detectable signal strength, in order to provide guidance on optimization of the limits of detection and how to optimize near real time imaging. The key parameters affecting photon production, propagation and detection were considered and experimental validation with both tissue phantoms and a murine model are shown. Both the theoretical analysis and experimental data indicate that the …

Technology For Behavioral Change In Rural Older Adults With Obesity, John A. Batsis, John A. Naslund, Alexandra B. Zagaria, David Kotz, Rachel Dokko, Stephen J. Bartels, Elizabeth Carpenter-Song

Dartmouth Scholarship

Background: Mobile health (mHealth) technologies comprise a multidisciplinary treatment strategy providing potential solutions for overcoming challenges of successfully delivering health promotion interventions in rural areas. We evaluated the potential of using technology in a high-risk population.

Methods: We conducted a convergent, parallel mixed-methods study using semi-structured interviews, focus groups, and self-reported questionnaires, using purposive sampling of 29 older adults, 4 community leaders and 7 clinicians in a rural setting. We developed codes informed by thematic analysis and assessed the quantitative data using descriptive statistics.

Results: All groups expressed that mHealth could improve health behaviors. Older adults were optimistic that mHealth …

Calibration And Analysis Of A Multimodal Micro-Ct And Structured Light Imaging System For The Evaluation Of Excised Breast Tissue., David M. Mcclatchy Iii, Elizabeth J. Rizzo, Jeff Meganck, Josh Kempner, Jared Vicory, Wendy A. Wells, Keith D. Paulsen, Brian W. Pogue

Dartmouth Scholarship

A multimodal micro-computed tomography (CT) and multi-spectral structured light imaging (SLI) system is introduced and systematically analyzed to test its feasibility to aid in margin delineation during breast conserving surgery (BCS). Phantom analysis of the micro-CT yielded a signal-to-noise ratio of 34, a contrast of 1.64, and a minimum detectable resolution of 240 ?m for a 1.2?min scan. The SLI system, spanning wavelengths 490?nm to 800?nm and spatial frequencies up to 1.37 , was evaluated with aqueous tissue simulating phantoms having variations in particle size distribution, scatter density, and blood volume fraction. The reduced scattering coefficient, and phase function …

Metaanalysis Of The Relationship Between Violent Video Game Play And Physical Aggression Over Time, Anna T. Prescott, James Sargent, Jay G. Hull

Dartmouth Scholarship

To clarify and quantify the influence of video game violence (VGV) on aggressive behavior, we conducted a metaanalysis of all prospective studies to date that assessed the relation between exposure to VGV and subsequent overt physical aggression. The search strategy identified 24 studies with over 17,000 participants and time lags ranging from 3 months to 4 years. The samples comprised various nationalities and ethnicities with mean ages from 9 to 19 years. For each study we obtained the standardized regression coefficient for the prospective effect of VGV on subsequent aggression, controlling for baseline aggression. VGV was related to aggression using …

Micro-Computed Tomography Enables Rapid Surgical Margin Assessment During Breast Conserving Surgery (Bcs): Correlation Of Whole Bcs Micro-Ct Readings To Final Histopathology., David M. Mcclatchy Iii, Rebecca A. Zuurbier, Wendy A. Wells, Kieth D. Paulsen, Brian W. Pogue

Dartmouth Scholarship

BACKGROUND:

Roughly 23% of breast conserving surgery (BCS) patients undergo a second re-excision procedure due to pathologically positive surgical margins. We investigated the feasibility and potential value of micro-Computed Tomography (micro-CT) as a surgical margin guidance tool during BCS.

METHODS:

A cohort of 32 BCS specimens was prospectively imaged with a pre-clinical micro-CT system upon arrival in the surgical pathology laboratory. Reconstructed micro-CT scans were evaluated retrospectively by an experienced breast radiologist, who provided binary determinations whether lesions extended to the specimen margin. These readings were then compared to the final pathological diagnosis and to 2D specimen radiography readings.

RESULTS: …

Sex-Specific Associations Of Infants’ Gut Microbiome With Arsenic Exposure In A Us Population, Anne G. Hoen, Juliette C. Madan, Zhigang Li, Modupe Coker, Sara N. Lundgren, Hilary G. Morrison, Thomas J. Palys, Brian P. Jackson, Mitchell L. Sogin, Kathryn L. Cottingham, Margaret R. Karagas

Dartmouth Scholarship

Arsenic is a ubiquitous environmental toxicant with antimicrobial properties that can be found in food and drinking water. The influence of arsenic exposure on the composition of the human microbiome in US populations remains unknown, particularly during the vulnerable infant period. We investigated the relationship between arsenic exposure and gut microbiome composition in 204 infants prospectively followed as part of the New Hampshire Birth Cohort Study. Infant urine was analyzed for total arsenic concentration using inductively coupled plasma mass spectrometry. Stool microbiome composition was determined using sequencing of the bacterial 16S rRNA gene. Infant urinary arsenic related to gut microbiome …

Does Pictorial Health Information Improve Health Behaviours And Other Outcomes? A Systematic Review Protocol, Danielle Schubbe, Sarah Cohen, Renata W. Yen, Maria Vd Muijsenbergh, Peter Scalia, Catherine H. Saunders, Marie-Anne Durand

Dartmouth Scholarship

Introduction: Most health information is verbal or written, yet words alone may not be the most effective way to communicate health information. Lower health literacy is prevalent in the US and is linked to limited understanding of one’s medical condition and treatment. Pictures increase comprehension, recall, adherence and attention in health settings. This is called pictorial superiority. No systematic review has examined the impact of pictorial health information among patients and consumers, including those with lower health literacy.

Methods and analysis: This systematic review and meta-analysis will assess the characteristics and effectiveness of pictorial health information on patient and …

Prevalence Rates Of Arthritis Among Us Older Adults With Varying Degrees Of Depression: Findings From The 2011 To 2014 National Health And Nutrition Examination Survey, Jessica L. Brooks, Alexander J. Titus, Courtney A. Polenick, Nicole M. Orzechowski, Manney Carrington Reid, Todd A. Mackenzie, Stephen J. Bartels, John A. Batsis

Dartmouth Scholarship

Arthritis and depressive symptoms often interact and negatively influence one another to worsen mental and physical health outcomes. Better characterization of arthritis rates among older adults with different levels of depressive symptoms is an important step toward informing mental health professionals of the need to detect and respond to arthritis and related mental health complications. The primary objective is to determine arthritis rates among US older adults with varying degrees of depression. Using National Health and Nutrition Examination Survey 2011 to 2014 data (N = 4792), we first identified participants aged ≥50 years. Measures screened for depressive symptoms and …

Metabolic Acidosis After Sodium Thiosulfate Infusion And The Role Of Hydrogen Sulfide, Guenola M. Hunt, Hilary F. Ryder

Dartmouth Scholarship

Sodium thiosulfate (STS), first-line treatment for calcific uremic arteriolopathy, causes a mild asymptomatic acidosis in many patients. However, severe, life-threatening acidosis out of proportion with the expected acid load of STS may occur, potentially due to metabolism of STS to hydrogen sulfide.

Can Novel Technologies Improve Breast Conserving Surgery?, Brian W. Pogue

Dartmouth Scholarship

The practice of breast conserving surgery has been transformative for management of women’s breast cancer, and yet the current practice remains in a situation where approximately one-third of all patients have incomplete surgical resection. This is measured by the finding of clear margins on the surgical specimen, as measured by pathology sampling. This is a very active area of professional debate and research study, and the solutions are not as obvious as one might guess. Still, reviews of the status of the field suggest that technical solutions should be available to help mitigate this issue, and the tools for molecular …

The Workingwell Smartphone App For Individuals With Serious Mental Illnesses: A Proof-Of-Concept, Mixed Methods Feasibility Study (Preprint), Joanne Nicholson, Spenser M. Wright, Alyssa M. Carlisle, Mary Ann Greene Sweeney, Gregory J. Mchugo

Dartmouth Scholarship

Background: The disparities in employment for individuals with serious mental illnesses (SMI) have been well documented, as have the benefits of work. The benefits of mobile technology in providing accessible, in-the-moment support for these individuals has been demonstrated. The WorkingWell mobile app was developed to meet the need for accessible follow-along supports for individuals with SMI in the workplace. Objective: We explore the usability, usage, usefulness and overall feasibility of the WorkingWell mobile app with individuals with SMI receiving community-based services and actively employed. Methods: In this proof-of-concept, mixed methods, two-month feasibility study (N=40), employed individuals with SMI were recruited …

Clinical Effectiveness Of Family Therapeutic Interventions In The Prevention And Treatment Of Perinatal Depression: A Systematic Review And Meta-Analysis, Fallon Cluxton-Keller, Martha L. Bruce

Dartmouth Scholarship

Background:

Family therapy is a potential strategy to increase family support for those suffering from perinatal depression. Family therapeutic interventions for this population typically target depressed women and their adult family members to improve family functioning and reduce depressive symptoms.

Objective:

This systematic review and meta-analysis is a synthesis of the current evidence on the usefulness of family therapy interventions in the prevention and treatment of perinatal depression and impacts on maternal depressive symptoms and family functioning.

Methods:

This study used the Cochrane Collaboration guidelines for systematic reviews and meta-analyses. Six electronic databases were searched for randomized controlled trials and …

Feeding The World With Die Rolls: Potential Applications Of Quantum Computing

Dartmouth Undergraduate Journal of Science

No abstract provided.

The Mouhefanggai And Cavalieri's Principle

Dartmouth Undergraduate Journal of Science

No abstract provided.

Ethical Regulation Of Medical Experiments On Humans, Nick Awertschenko

Dartmouth Undergraduate Journal of Science

No abstract provided.

The Science Behind Memory: Hippocampal Neural Cell Assemblies, Nishi Jain

Dartmouth Undergraduate Journal of Science

No abstract provided.

The Immunity Of The Many: Ethical Considerations Of Vaccinations In Light Of Herd Immunity, Sophia Koval

Dartmouth Undergraduate Journal of Science

No abstract provided.

Frontiers In Dna Synthesis: Click Chemistry

Dartmouth Undergraduate Journal of Science

No abstract provided.

Cilia And Flagella: From Discovery To Disease, Dylan J. Cahill

Dartmouth Undergraduate Journal of Science

No abstract provided.

Letter From The Editor

Dartmouth Undergraduate Journal of Science

No abstract provided.

Workshop On Emerging Technology And Data Analytics For Behavioral Health, David Kotz, Sarah E. Lord, A. James O'Malley, Luke Stark, Lisa Marsch

Dartmouth Scholarship

Wearable and portable digital devices can support self-monitoring for patients with chronic medical conditions, individuals seeking to reduce stress, and people seeking to modify health-related behaviors such as substance use or overeating. The resulting data may be used directly by a consumer, or shared with a clinician for treatment, a caregiver for assistance, or a health coach for support. The data can also be used by researchers to develop and evaluate just-in-time interventions that leverage mobile technology to help individuals manage their symptoms and behavior in real time and as needed. Such wearable systems have huge potential for promoting delivery …