Medicine and Health Sciences Commons^™

A Systematic Approach To High Blood Pressure Risk Analysis And Healthcare Cost Reduction In Young Adults [Metodología Sistemática Para El Análisis De Riesgo Y Reducción De Costos De Servicios Médicos De Hipertensión En Adultos Jóvenes], Francisco Rafael Torres Diaz

Theses and Dissertations

The purpose of this research is to utilize publicly available data to estimate the current rate of occurrence of undiagnosed High Blood Pressure (HBP) in young adults (18 to 24 years old) and the out-of-pocket healthcare expenses associated with complications of HBP, to provide feasible alternatives to mitigate the effects on a region's economy. This has been done by building a Risk Factor Simulation Model that utilizes known HBP risk factors’ correlation to HBP, insurance coverage data, and rate of diagnosis to formulate the average Risk Factor Value for a region, which through an Annual Expected Cost Function estimates the …

Use Of A Telerehabilitation Delivery System For Fall Risk Screening, Robert W. Nithman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem: The Centers for Disease Control and Prevention indicates that falls are the “leading cause of injury death and the most common cause of nonfatal injuries and hospital admission for trauma among people ages 65 and older.”1 Falls can have significant economic consequences to the individual and payer sources. To address these consequences, telerehabilitation was hypothesized to be a suitable supplement for fall screening efforts. Several sources concluded that support for synchronous telerehab was underdeveloped in the literature. Purpose: The purpose of this study was to explore the acceptability, feasibility, reliability, and validity of telehealth-delivered fall screening among community-dwelling older …

Sensitivity Of Diffuse Reflectance Spectroscopy To Dose- And Depth-Dependent Changes In Tumor Oxygenation After Radiation Therapy, Daria Semeniak

Graduate Theses and Dissertations

Along with chemotherapy, immunotherapy, and surgery, radiotherapy is one of the most common treatments used against cancer. Around 50% of all cancer patients undergo radiation therapy. While for some patients radiotherapy works efficiently and lead to a complete cancer disappearance, for others treatment outcome may be less favorable due to radioresistance processes happening within a tumor on the molecular level. Radioresistance remains a big challenge for modern oncology. The ability to identify radioresistance at the early stage of radiotherapy would help physicians to improve therapy efficiency. At the current moment, despite the rapid progress in cancer understanding and diagnostic modalities, …

Exploring The Cause Of Injury Or Death In Grain Entrapment, Engulfment And Extrication, Salah F. Issa

Open Access Dissertations

Grain entrapments and engulfments are one of most common hazards associated with grain storage facilities. Since the 1970’s over 1,880 incidents have been documented in agricultural confined spaces of which 65% of all recorded incidents were grain entrapments and engulfments. There have been several studies conducted on the contributing factors behind these incidents; however, there have been very few attempts to understand the environmental, physiological or psychological factors the victims experience while entrapped, engulfed, or extricated. This includes understanding how secondary injuries are caused by grain or during extrication by first responders. The research effort was divided into three segments. …

Relationship Between Ocular Sensory Dominance And Stereopsis, Raheela Saeed Ali

Student Theses, Dissertations and Capstones

Purpose: It is unknown whether individuals with two balanced eyes show quicker response and lower threshold in fine stereoscopic detection. Previous methods to measure ocular dominance were primarily qualitative, which do not quantify the degree of dominance and show limitation in identifying the dominant eye. In this study, we aimed at quantifying the difference of ocular strength between the two eyes with ocular dominance index (ODI) and studying the association of ocular balance between the two eyes with stereoscopic detection. Methods: Stereoscopic threshold was measured in thirty-three subjects. Stereopsis was measured with random dot stimuli. The minimal detectable disparity (Dmin) …

Optical Dosimetry Tools And Monte Carlo Based Methods For Applications In Image Guided Optical Therapy In The Brain, Akshay N Prabhu Verleker

Open Access Dissertations

Purpose: The long-term goal of this research is to determine the feasibility of using near infra-red light to stimulate drug release in metastatic lesions within the brain. In this work, we focused on developing the tools needed to quantify and verify photon fluence distribution in biological tissue. To accomplish this task, an optical dosimetry probe and Monte Carlo based simulation code were fabricated, calibrated and developed to predict light transport in heterogeneous tissue phantoms of the skull and brain. Empirical model (EM) of photon transport using CT images as input were devised to provide real-time calculations capable of being translated …

The Effects Of Scarring On Face Recognition, Kevin J. Chan

Open Access Theses

The focus of this research is the effects of scarring on face recognition. Face recognition is a common biometric modality implemented for access control operations such as customs and borders. The recent report from the Special Group on Issues Affecting Facial Recognition and Best Practices for their Mitigation highlighted scarring as one of the emerging challenges. The significance of this problem extends to the ISO/IEC and national agencies are researching to enhance their intelligence capabilities. Data was collected on face images with and without scars, using theatrical special effects to simulate scarring on the face and also from subjects that …

A Study Of Applications Of 3d Animation For Emergency Medicine Pedagogy, Huilong Zheng

Open Access Theses

There is ample precedent for the use of 3D animation in education, though little research on specific applications in the field of medicine. An experiment was carried out to assess the suitability of 3D animation for educational purposes in emergency medicine courses. Two groups of experimental participants were assessed on their ability to respond to three emergency medical situations in simulated test scenarios. Both groups received equivalent information on how to treat the three different medical emergencies. The control group received the information in traditional lecture format. The experimental group instead received the information from a set of 3D animations. …

Modeling Picking On Pharmaceutical Tablets, Shrikant Swaminathan

Open Access Dissertations

Tablets are the most popular solid dosage form in the pharmaceutical industry because they are cheap to manufacture, chemically and mechanically stable and easy to transport and fairly easy to control dosage. Pharmaceutical tableting operations have been around for decades however the process is still not well understood. One of the common problems faced during the production of pharmaceutical tablets by powder compaction is sticking of powder to the punch face, This is known as 'sticking'. A more specialized case of sticking is picking when the powder is pulled away form the compact in the vicinity of debossed features. In …

Investigation Of Cnt-Induced Escherichia Coli Lysis And Protein Release, Abdollah Mosleh

Graduate Theses and Dissertations

This research investigated the use of carbon nanotubes (CNTs) as a treatment to increase the permeability of a bacterial cell wall. Recombinant Escherichia coli BL21 (DE3) containing a plasmid that expressed Green Fluorescent Protein (GFP) and -lactamase were exposed to CNTs under various levels of agitation for different times. Fluorescence assay for GFP, optical absorbance for -lactamase activity, and Transmission Electron Microscopy (TEM) were used to determine the amount of released protein, and visually examine the permeability enhancement of the cells, respectively. It was found that more -lactamase was present in the culture fluid after treatment with CNTs in a …

Risk Estimation Toward A Natural History Model For Low Grade Glioma Patients, Anh Thi Hoang Pham

Graduate Theses and Dissertations

Glioma is a common type of primary brain tumor that represents 28% of all brain tumors and 80% of malignant tumors. According to a recent study by the Centers for Disease Control and Prevention (CDC), gliomas account for 53%, 35% and 29% of all brain tumors (68%, 74% and 81% of malignant brain tumors) among children (aged 0-14), teenagers (aged 15-19) and young adults, respectively. Gliomas are often diagnosed through radiological imaging and histopathology. There are two main groups of gliomas following World Health Organization’s classification: Low grade gliomas (LGG), or grade I and II gliomas; and high grade gliomas …

Essays In Physicians Preference Items And Inventory Management Within The Healthcare Supply Chain, Mohammad A. Shbool

Graduate Theses and Dissertations

This work is composed of a number of topics in the healthcare area, which are approached separately with appropriate methodologies. The two topics deal with physician preference items via two different approaches. The first one investigates stock keeping unit (SKU) proliferation in healthcare organizations due to physician preference items (PPI). It captures perspectives of physicians and supply chain professionals about this problem through two surveys. The second topic builds a decision-making framework for the PPI selection process that can be used by healthcare organizations to make more objective decisions. A Multi-criteria decision making technique is implemented to illustrate the framework.

Microwire Regenerative Peripheral Nerve Interfaces With Wireless Recording And Stimulation Capabilities, Ali Ajam

Theses and Dissertations

A scalable microwire peripheral nerve interface was developed, which interacted with regenerated peripheral nerves in microchannel scaffolds. Neural interface technologies are envisioned to facilitate direct connections between the nervous system and external technologies such as limb prosthetics or data acquisition systems for further processing. Presented here is an animal study using a handcrafted microwire regenerative peripheral nerve interface, a novel neural interface device for communicating with peripheral nerves. The neural interface studies using animal models are crucial in the evaluation of efficacy and safety of implantable medical devices before their use in clinical studies.16-electrode microwire microchannel scaffolds were developed for …

Influence Of The 3d Microenvironment On Glioblastoma Migration And Drug Response, Ruth Marisol Herrera Perez

Open Access Dissertations

Glioblastoma (GBM) is a highly invasive brain cancer characterized by poor prognosis. Despite significant efforts by the basic and clinical research community our understanding of GBM progression and recurrence has been incremental. Improvements in therapeutic response have been dismal, and GBM continues to be the deadliest tumor of the central nervous system, with patient average survival rate of 12 months. Synergistic relationships that the tumor cells establish with the brain microenvironment have been proven fundamental for successful tumor progression and maintenance. Yet, many in vitro GBM studies are performed in formats that fail to recapitulate the most essential component of …

Densified Collagen-Fibril Biomaterials For Bone Tissue Engineering, Lauren E. Watkins

Open Access Theses

Millions of craniofacial bone defects occur annually as a result of trauma, congenital defects, disease, or tooth extraction. When present in the oral cavity, these defects are associated with adverse impacts on speech, mastication, and aesthetics. Thus, there is a clinical need for interventional strategies to restore and preserve alveolar bone mass to improve the success of future treatment options intended to reestablish functionality and aesthetics. Guided bone regeneration using bone grafts and a membrane represent the current standard of care for repairing alveolar bone defects, but face a number of limitations related to resorption time and structural integrity. Improvements …

Using Security Risk Analysis: Is The Bring Your Own Device Policy Becoming A Liability Risk Within Healthcare?, Lee Alexander Cavett

Open Access Theses

Using computer simulation modeling, this research examined the problems contributing to data breaches within healthcare industry. The study attempted to answer two questions: 1) is the Bring Your Own Device policy becoming a liability risk within hospitals causing an increase in data breaches and 2) is there a lower risk compared to using wired desktops. An iPad was the primary focused device as one of many Bring Your Own Devices. The study used a randomly generated sample of an approximate 2,700 patients, one nurse and doctor on a eight hour work-day within the clinic (eight A.M five P.M) considering a …

Using Information Technology To Model Hand-Washing Behavior And To Improve Policies Impacting Elementary School Absenteeism Due To Influenza, Galina V. Miller

Open Access Dissertations

This dissertation revealed several problems on the analysis of in?uenza propagation by indicating how agent-based modeling can be employed to measure the e?ectiveness of control measures and assist in improving health policy to decrease absenteeism among elementary students. The primary question posed was as following: “What is the e?ect of hand hygiene on the possible incidence rates among school children?” After creating an agent-based model representing the in?uenza transmission dynamic, the incidence rates were calculated based on the hand-washing success rates. The statistical results from the simulation model were displayed in graphical format.

Finally, the author addressed the issue of …

Computational Analysis Of The Sir Mathematical Model For The Dengue Fever, Joseph Phillip Diaz

Theses and Dissertations

Dengue fever is a disease affecting people in more than 100 countries. Here we consider a host and vector model for the transmission of dengue fever. This SIR model consists of three compartments of susceptible, infective and removed for host (human) and two compartments of susceptible and infective for vector (dengue mosquitos). These five compartments yield five coupled nonlinear ordinary differential equations (ODEs). After non-dimensionalization, we have a system of three nonlinear ODEs. Reproductive number and two equilibrium points are calculated for various cases. Simulation is carried out for susceptible, infective and removed and the results are presented in graphical …

Preventive Maintenance Decision Modeling In Health And Service Systems, Mahboubeh Madadi

Graduate Theses and Dissertations

This dissertation focuses on the preventive maintenance decision modeling in healthcare and service systems. In the first part of this dissertation, some issues in preventive health decisions for breast cancer are addressed, and in the second part, the required characteristics for preventive maintenance of an unreliable queuing system are derived.

Adherence to cancer screening is the first issue that is addressed in this dissertation. Women’s adherence or compliance with mammography screening remained low in the recent years. In this dissertation, we first develop a design-based logistic regression model to quantify the probability of adherence to screening schedules based on women’s …

Understanding Technology Diffusion And Spatial Accessibility In The Home Healthcare Industry, Mehmet Serdar Kilinç

Graduate Theses and Dissertations

Home healthcare is becoming an important alternative to institutionalized care. It not only reduces costs but also increases health outcomes and patient satisfaction. However, the availability and efficiency of home healthcare services need to be improved as the aging population increases in the US. Hence, understanding home healthcare utilization and access are the essential steps to develop strategies ensuring effective and sustainable services to patients.

This research aims to study two main issues in the US home healthcare system: diffusion and long-term impacts of home telehealth and potential spatial accessibility of home healthcare services. Home telehealth is a promising technology …

Numerical Simulation Of Terahertz Wave Interaction With Breast Cancer Tumor Tissue Sections, Abayomi Omotola Omolewu

Graduate Theses and Dissertations

This thesis presents numerical simulation of terahertz (THz) wave interaction with breast cancer tumor tissue sections. The obtained results are expressed in THz images of heterogeneous material that mimics the excised breast cancer tissue sections. The finite-element software package ANSYS High Frequency Structural Simulator (HFSS) was used in this work. HFSS is a full wave frequency domain three-dimensional (3D) electromagnetic simulation package. In this work, four breast cancer tissue models based on pathology images were simulated and images of the models were obtained at 1 THz. An incident Gaussian beam was raster scanned over tissue model configurations and the reflected …

Comparison Of Mechanical And Optical Properties Between Three Different Cad/Cam Materials, Aasem Mutlaq Alhenaki

Student Theses, Dissertations and Capstones

Objective. This study aims to compare several mechanical and optical properties between three different CAD/CAM materials. The properties tested are: flexural strength, modulus of elasticity, hardness, translucency and surface gloss. Background. Typically, CAD/CAM restorations are either ceramic based or resin based. A new resin-ceramic hybrid material has recently been introduced and is thought to combine the advantages of both materials. Methods. Samples were divided into three groups, leucite-reinforced porcelain (IPS Empress CAD), lithium dicilicate (IPS e.max CAD) and resin-ceramic hybrid material (Vita Enamic). Twenty-six bar-shaped specimens were fabricated for each group by cutting standard CAD/CAM blocks. 3-point bending test and …

Effect Of Surface Preparation On The Shear Bond Strength Of Orthodontic Brackets Bonded To Zirconia : An In-Vitro Study, Nathaniel Wieder

Student Theses, Dissertations and Capstones

Objectives: The purpose of this in-vitro study was to evaluate the effects of three different surface preparation methods on the shear bond strength of orthodontic brackets bonded to zirconia and determine the most appropriate method. Methods: 45 zirconia and 30 leucite-reinforced porcelain mandibular premolar crowns were divided into 5 groups and received the following surface preparations: 37% phosphoric acid and non-hydrolyzed silane, 4% hydrofluoric acid and hydrolyzed silane, microetch with 50μ Al ₂ O₃ particles. A universal adhesive primer containing MDP was applied and the brackets were bonded with a bis-GMA composite resin. Shear bond strength (SBS) at bond …

Comparison Of The Effectiveness Of Mechanical And Chemical Procedures To Decontaminate Titanium Disks And To Promote Osteoblast Attachment, Flavia Goncalves

Student Theses, Dissertations and Capstones

Objective: This study was conducted to determine the effectiveness of physical and mechanical disinfection of P. gingivalis from implant disks and to evaluate bone cells growth and attachment to the disks. Background. Each year, over three million of Americans replacing missing teeth with dental implants. An inflammatory process around an implant that causes bone loss, characterizes peri-implantitis, first diagnosed in the 1980s. The prevalence is approximately 22%. To date, no treatment protocol of peri-implantitis has been proposed. Methods. 207 implants disks. Four different implant surfaces utilized. Disks were contaminated by p. gingivalis and consequentially disinfected by physical means (spraying prophy …

Designing A Sustainable And Transferable Inventory Management System For Small Healthcare Facilities, Shree Frazier

Open Access Theses

Managing the costs of supplies within healthcare facilities has been a task that has plagued the health industry for many years. Many facilities are accustomed to using a par system approach. This involves bringing an inventory item to an amount sufficient for daily operation. This method often requires daily inspection by a healthcare worker, which reduces his/her time spent performing value added tasks. Employees at small healthcare facilities have multiple responsibilities, therefore they cannot afford to spend much time on inventory management. A proposed approach is the Kanban method, which allows for strict monitoring of inventory items without the need …

Feasibility Of Pulsed Proton Induced Acoustics For 3d Dosimetry, Fahed M. Alsanea

Open Access Theses

Proton therapy has the potential to deposit its energy in tissue with high conformity to the tumor and significantly reduced integral dose to normal tissue compared to conventional radiation, such as x-rays. As a result, local control can be enhanced while reducing side-effects and secondary cancers. This is due to the way charged Particles deposit their energy or dose, where protons form a Bragg peak and establish a well-defined distal edge as a function of depth (range). To date, the dose delivered to a patient from proton therapy remains uncertain, in particular the positioning of the distal edge of the …

Controlling Protein Release Using Biodegradable Microparticles, Benjamin Patrick Kline

Open Access Theses

Research in the field of protein therapeutics has exploded over the past decade and continues to grow in both academia and in industry. Protein drugs have advantages of being highly specific and highly active making them coveted targets for high profile disease states like cancer and multiple sclerosis. Unfortunately, their many advantages are complemented by their obstacles. Because proteins are highly active and highly specific, the window between efficacy and toxicity is very narrow and drug development can be long and arduous. In addition, protein activity is dependent on its specific folding conformation that is easily disrupted by a variety …

Modeling And Optimization Of Care Transitions, Yuming Mo

Open Access Theses

More than 145 million people live with at least one chronic condition, and almost half of them have multiple conditions. As a result, many managed care and integrated delivery systems have taken a great interest in alleviating the many deficiencies in managing the current care system that spans across various care delivery settings. In addition, many Americans have to rely on some social health insurance plan to cover her care expenses. As a result, these patients often may not been sufficiently cured but have to be transitioned to less expensive but less medically intensive facilities, due to the increasing pressure …

In Vitro Comparison Of Force Decay Between Three Orthodontic Sliding Retraction Methods, Pamela Steiger

Student Theses, Dissertations and Capstones

Objective: The purpose of this in vitro study was to determine if there is a difference in force decay between three sliding retraction methods under a standardized force delivery system (200 gm at 25 mm stretch) at 2, 4, 6, and 8 weeks. Background: In order to achieve proper esthetics, occlusion and stability, orthodontic treatment may require extractions. Elastomeric chains, Nickel Titanium (NiTi) coils, and active ligatures are commonly used to close these extraction spaces. Methods: Twenty samples of each retraction method (elastomeric chains, NiTi Coils and active ligatures) were evaluated under standardized conditions (200 gm at 25 mm). The …

Cephalometric Regional Superimpositions -- Digital Vs. Analog Accuracy And Precision : 3. The Cranial Base, Douglas Shaw

Student Theses, Dissertations and Capstones

Objective. To assess the accuracy and precision in measurement of pairwise implant displacement across three methods of cranial base superimposition. Background. Cephalometric superimposition is the principal radiographic method used to evaluate changes within the craniofacial skeleton. Many studies have examined the accuracy of software intended to produce cephalometric superimposition. Such studies have utilized anatomic landmarks, selected by the respective software manufacturers, as registration points for constructing superimpositions and their analysis. As a result, these studies are only as accurate as the stability and validity of anatomic registration landmarks used. To our knowledge, no other study has utilized metallic implants to …