Medicine and Health Sciences Commons^™

Quantification Of Imrt Severity Scores For Improvement Of Fmea Results, Jacqueline T. Faught

Dissertations and Theses (Open Access)

Accurate delivery of intensity modulation radiation therapy (IMRT) requires perfect execution of a long, complicated chain of events; failure of any component of this process may contribute to dose delivery errors, compromising treatment quality and, more importantly, patient safety. Prospective, process-wide risk mitigation techniques are becoming more prevalent in radiotherapy to establish comprehensive quality management (QM) programs, such as failure modes and effects analysis (FMEA). The subjective nature of the ordinal scores used for FMEA leads questionable reliability and validity of the results. Additionally, physics components are commonly grouped together, leaving out valuable details important to physics QM. While the …

Functional Analysis Of Synthetic Gene Circuits Controlling A Protein Pump In Yeast, Junchen Diao

Dissertations and Theses (Open Access)

Synthetic biology aims to build biological devices to understand living systems and explore new applications. Synthetic gene circuits such as genetic switches, oscillators and logic gates are at the core of many synthetic biology applications. These gene circuits often include a sensor/regulator protein capable to detect small molecules and then transduce them into a regulatory signal to generate measurable output. Similar signal transduction networks are also abundant in nature. However, in many natural and engineered scenarios, the output also affects the regulator/sensor protein. How such interactions between the regulator/sensor and the output affect synthetic gene circuit function has not been …

Yap1 Expression Predicts Sensitivity To Dual Akt/P70s6k Inhibition In Ovarian And Uterine Malignancies, Rebecca A. Previs

Dissertations and Theses (Open Access)

Purpose: The PI3K/AKT/P70S6K pathway is an attractive therapeutic target in ovarian and uterine malignancies due to its high rate of dysregulation and key roles in tumor growth. Here, we examined the biological effects of MSC2363318A, which is a novel inhibitor of AKT1, AKT3, and P70S6K.

Experimental Design: Orthotopic murine models of ovarian and uterine cancer were utilized to study the effect of MSC2363318A on survival and regression. Moreover, in vitro experiments (MTT, Western blot analysis, plasmid transfection, and reverse phase protein array [RPPA]) were carried out to characterize underlying mechanisms and potential biomarkers of response.

Results: MSC2363318A decreased tumor growth …

Assessment Of Uncertainty In Planning And Dose Delivery Of Proton Therapy In An Iroc- Houston Qa Phantom Due To Variable Ct Technique And Proton Energy, Mattie M. Mcinnis

Dissertations and Theses (Open Access)

As proton therapy increases in popularity, so does the need for effective quality assurance. Proton therapy institutions participating in NCI funded clinical trials rely heavily on the credentialing and auditing services of IROC-H and therefore the process must be well understood. The purpose of this project is to understand the uncertainties in proton therapy treatment planning for the IROC-H proton phantom QA program due to variations in CT technique and proton energy. It was hypothesized that variations in CT technique and proton energy will alter the delivered dose distributions of typical proton treatments by reducing the percent of passing pixels …

Association Between Arsenic Exposure From Drinking Water And Longitudinal Change In Blood Pressure Among Heals Cohort Participants, Jieying Jiang, Mengling Liu, Faruque Parvez, Binhuan Wang, Fen Wu, Mahbub Eunus, Sripal Bangalore, Jonathan D. Newman, Alauddin Ahmed, Tariqul Islam, Muhammed Rakibuz-Zaman, Rabiul Hasan, Golam Sarwar, Diane Levy, Vesna Slavkovich, Maria Argos, Molly Scannell Bryan, Shohreh F. Farzan, Richard B. Hayes, Joseph H. Graziano, Habibul Ahsan, Yu Chen

Dartmouth Scholarship

Background:

Cross-sectional studies have shown associations between arsenic exposure and prevalence of high blood pressure; however, studies examining the relationship of arsenic exposure with longitudinal changes in blood pressure are lacking.

Method:

We evaluated associations of arsenic exposure in relation to longitudinal change in blood pressure in 10,853 participants in the Health Effects of Arsenic Longitudinal Study (HEALS). Arsenic was measured in well water and in urine samples at baseline and in urine samples every 2 years after baseline. Mixed-effect models were used to estimate the association of baseline well and urinary creatinine-adjusted arsenic with annual change in blood pressure …

Antidepressant Effects In Hybrid Striped Bass: Moving From External Exposures To Internal Doses, Lauren Sweet

All Dissertations

Over 47 percent of Americans take at least one prescription drug per month and of these pharmaceuticals, antidepressants are the third most prescribed drug. Their widespread and prolonged use coupled with incomplete removal during wastewater treatment processes has made them one of the most commonly detected pharmaceuticals in the aquatic environment. Antidepressants are intended to modify human behavior by altering brain chemistry and the neurotransmitter receptor targets of these chemicals are highly conserved in many vertebrate species; thus, aquatic organisms may be at risk. Previous research in our lab has shown that exposure of hybrid striped bass (HSB) (Morone saxatilis …

Kaposi’S Sarcoma-Associated Herpesvirus Transmission And Infection Among Young Zambian Children, Landon N. Olp

School of Biological Sciences: Dissertations, Theses, and Student Research

Kaposi’s sarcoma-associated herpesvirus (KSHV) is the etiologic agent for all forms of Kaposi’s sarcoma (KS)—one of the most common pediatric cancers in sub-Saharan Africa during the AIDS epidemic. KS was endemic in sub-Saharan Africa prior to the HIV/AIDS epidemic, but KS cases drastically increased thereafter. Our laboratory previously observed that KSHV infection is common among Zambian children and saliva is the major route of transmission. However, additional factors associated with the transmission of KSHV to children are poorly understood. Since a vaccine against KSHV is not currently available, it is paramount to understand factors associated with transmission so that alternative …

The Acute Effects Of Ballistic And Non-Ballistic Concentric-Only Half-Squats On Squat Jump Performance, Timothy J. Suchomel

Electronic Theses and Dissertations

The purposes of this dissertation were to examine bilateral asymmetry as a factor of postactivation potentiation, examine and compare the acute effects of ballistic and non-ballistic concentric-only half-squats on squat jump performance, and compare the potentiation and temporal profiles of strong and weak subjects following potentiation protocols that included ballistic and non-ballistic concentric-only half-squats. The following are major findings of the dissertation. Squat jump performance may be acutely enhanced following ballistic concentriconly half-squats; however the changes in performance do not appear to be related to bilateral symmetry. Ballistic concentric-only half-squats acutely improve various squat jump performance variables at various time …

Relationship Between Concentric Velocity At Varying Intensity In The Back Squat Using Wireless Inertia Sensor, Kevin M. Carroll

Electronic Theses and Dissertations

The purpose of this study was to determine the relationship between the Minimal Velocity Threshold (MVT) of 1RM and repetitions until failure testing conditions using the back squat exercise. Fourteen injury-free males with experience in the back squat volunteered to perform a 1RM and a submaximal (70% 1RM) repetitions until failure test, each during different testing sessions. Mean Concentric Velocity (MCV) was collected using a wireless inertia-measuring device. The last successful repetition in either condition was considered the MVT. A very small relationship between 1RM and repetitions until failure MVT was found (r=-0.135). There were no significant differences …

Analysis Of Countermovement Vertical Jump Force-Time Curve Phase Characteristics In Athletes, Christopher J. Sole

Electronic Theses and Dissertations

The purposes of this dissertation were to examine the phase characteristics of the countermovement jump force-time curve between athletes based on jumping ability, examine the influence of maximal muscular strength on the countermovement jump force-time curve phase characteristics of athletes, and to examine the behavior of the countermovement jump force-time curve phase characteristics over the course of a training process in athletes of varying strength levels. The following are the major findings of these dissertations. The analysis of athletes by jumping ability suggested that proficient jumpers are associated with greater relative phase magnitude and phase impulse throughout the phases contained …

Sex Differences In Arm Muscle Fatigability With Cognitive Demand In Older Adults, Hugo M. Pereira, Vincent C. Spears, Bonnie Schlinder-Delap, Tejin Yoon, April L. Harkins, Kristy A. Nielson, Marie K. Hoeger Bement, Sandra K. Hunter

Physical Therapy Faculty Research and Publications

Background

Muscle fatigability can increase when a stressful, cognitively demanding task is imposed during a low-force fatiguing contraction with the arm muscles, especially in women. Whether this occurs among older adults (> 60 years) is currently unknown.

Questions/purposes

We aimed to determine if higher cognitive demands, stratified by sex, increased fatigability in older adults (> 60 years). Secondarily, we assessed if varying cognitive demand resulted in decreased steadiness and was explained by anxiety or cortisol levels.

Methods

Seventeen older women (70 ± 6 years) and 13 older men (71 ± 5 years) performed a sustained, isometric, fatiguing contraction at 20% …

Combined Unilateral Blockade Of Cholinergic, Peptidergic, And Serotonergic Receptors In The Ventral Respiratory Column Does Not Affect Breathing In Awake Or Sleeping Goats, Clarissa Muere, Suzanne Neumueller, Samantha Olesiak, Justin Robert Miller, Thomas Langer, Matthew Hodges, Lawrence Pan, Hubert Forster

Physical Therapy Faculty Research and Publications

Previous work in intact awake and sleeping goats has found that unilateral blockade of excitatory inputs in the ventral respiratory column (VRC) elicits changes in the concentrations of multiple neurochemicals, including serotonin (5-HT), substance P, glycine, and GABA, while increasing or having no effect on breathing. These findings are consistent with the concept of interdependence between neuromodulators, whereby attenuation of one modulator elicits compensatory changes in other modulators to maintain breathing. Because there is a large degree of redundancy and multiplicity of excitatory inputs to the VRC, we herein tested the hypothesis that combined unilateral blockade of muscarinic acetylcholine (mACh), …

Losartan Treatment Attenuates Tumor-Induced Myocardial Dysfunction, Sarah C.W. Stevens, Markus Velten, Dane J. Youtz, Yvonne Clark, Runfeng Jing, Peter J. Reiser, Sabahattin Bicer, Raymond D. Devine, Donna O. Mccarthy, Loren E. Wold

College of Nursing Faculty Research and Publications

Fatigue and muscle wasting are common symptoms experienced by cancer patients. Data from animal models demonstrate that angiotensin is involved in tumor-induced muscle wasting, and that tumor growth can independently affect myocardial function, which could contribute to fatigue in cancer patients. In clinical studies, inhibitors of angiotensin converting enzyme (ACE) can prevent the development of chemotherapy-induced cardiovascular dysfunction, suggesting a mechanistic role for the renin–angiotensin–aldosterone system (RAAS). In the present study, we investigated whether an angiotensin (AT) 1-receptor antagonist could prevent the development of tumor-associated myocardial dysfunction. Methods and results: Colon26 adenocarcinoma (c26) cells were implanted into female CD2F1 mice …

Predictors Of Engagement In Postpartum Weight Self-Management Behaviours In The First 12 Weeks After Birth, Jennifer M. Ohlendorf, Marianne E. Weiss, Debra L. Oswald

College of Nursing Faculty Research and Publications

Aim

To explore factors that influence postpartum weight self-management behaviours. Transitions Theory and the Integrated Theory of Health Behaviour Change guided selection of variables. Transition conditions, level of patient activation and social facilitation were examined for association with postpartum weight self-management behaviours.

Background

Retention of pregnancy weight increases risk of overweight and obesity later in life. Little is known about what women do to self-manage return to pre-pregnant weight and how providers can influence their behaviours.

Design

Prospective, longitudinal, correlational.

Methods

Data collection occurred from March through October, 2013. One hundred and twenty-four women completed surveys during postpartum hospitalization; telephone …

Current Medical Research: Summer/Fall 2014, Richard J. Fehring

College of Nursing Faculty Research and Publications

No abstract provided.

Association Of Obesity With Infertility Among Pakistani Men: A Case Control Study, Nida Zahid, Sarah Saleem, Syed Iqbal Azam, Tariq Moatter

Community Health Sciences

Background: The reported prevalence of infertility in Pakistan is 21% of which 35% is contributed by male factor. Male infertility has multifactorial etiologies ranging from modifiable to genetic risk factors. Among all the risk factors that may account for male infertility, obesity is one of the emerging public health problems. Therefore, the aim of the study was to determine the association of obesity with infertility in Pakistani men.
Methods: We conducted a case control study. Cases were men with impaired semen parameters and controls did not have impaired semen parameters.
Results: The final multivariable logistic regression model after adjusting for …

Customized Occlusal Reduction Guide Made From A Thermoplastic Sheet, Seok-Hwan Cho, William W. Nagy

School of Dentistry Faculty Research and Publications

No abstract provided.

Does Upgrade To Tri-Ventricular Pacemaker Improve Long-Term Clinical Response In Non-Responders To Biventricular Cardiac Resynchronization Therapy?, Sharon Hw Man, Jeilan Mohamed, Shoaib Siddiqui, G. André Ng

Internal Medicine, East Africa

Up to one third of patients with biventricular (BiV) cardiac resynchronization therapy (CRT) are non-responders.1 § Greater clinical response to CRT has been shown in patients given TriV CRT compared to BiV CRT as de novo device therapy. 2 This abstract investigates if upgrade to TriV CRT in non-responders to BiV CRT will improve long-term clinical outcome

Optimization Of Chest Wall Hyperthermia Treatment Using A Virtual Human Chest Model, Dario B. Rodrigues, Mark D. Hurwitz, Paolo F. Maccarini, Paul R. Stauffer

Department of Radiation Oncology Faculty Papers

This work explores different coupling configurations (direct contact, air and water coupling) between a single 915 MHz waveguide applicator and human tissue in the setting of chest wall recurrence (CWR) of breast cancer. The objective is to treat chest wall tumours with microwave hyperthermia, while avoiding hot spots in critical areas such as scars and ribs. The best coupling configuration was a customized 24×29 cm water bolus developed by our team. It helps the applicator deliver an effective field size of 268 cm2 at 1 cm depth and a penetration depth of 2-3 cm. Water bolus thickness can be adjusted …

Scarnas Regulate Splicing And Vertebrate Heart Development., Prakash Patil, Nataliya Kibiryeva, Tamayo Uechi, Jennifer A. Marshall, James E. O'Brien, Michael Artman, Naoya Kenmochi, Douglas C. Bittel

Manuscripts, Articles, Book Chapters and Other Papers

Alternative splicing (AS) plays an important role in regulating mammalian heart development, but a link between misregulated splicing and congenital heart defects (CHDs) has not been shown. We reported that more than 50% of genes associated with heart development were alternatively spliced in the right ventricle (RV) of infants with tetralogy of Fallot (TOF). Moreover, there was a significant decrease in the level of 12 small cajal body-specific RNAs (scaRNAs) that direct the biochemical modification of specific nucleotides in spliceosomal RNAs. We sought to determine if scaRNA levels influence patterns of AS and heart development. We used primary cells derived …

Improving Medication Adherence In Stroke Patients Through Short Text Messages (Sms4stroke)-Study Protocol For A Randomized, Controlled Trial., Ayeesha Kamran Kamal, Quratulain Nauman Shaikh,, Omrana Pasha, Iqbal Azam Syed, Muhammad Islam, Adeel Ali Memon,, Hasan Rehman,, Muhammad Affan,, Sumaira Nazir, Salman Aziz,, Muhammad Jan, Anita Andani, Abdul Muqeet, Bilal Ahmed,, Shariq Khoja

Department of Medicine

Background: Stroke is a major cause of morbidity and mortality, especially in low and middle income countries. Medical management is the mainstay of therapy to prevent recurrence of stroke. Current estimates are that only 1 in 6 patients have perfect adherence to medication schedules. Using SMS (Short Messaging Service) as reminders to take medicines have been used previously for diseases such as diabetes and HIV with moderate success. We aim to explore the effectiveness and acceptability of SMS in increasing adherence to medications in patients with stroke.

Methods: This will be a randomized, controlled, assessor blinded single center superiority trial. …

A Qualitative Exploration Of The Emotional Wellbeing And Support Needs Of New Mothers From Afghanistan Living In Melbourne, Australia, Alana Russo, Belinda Lewis, Andrew Joyce, Belinda Crockett, Stanley Luchters

Population Health, East Africa

Background: The Afghan community is a priority population for many health and social services within the southeast region of Melbourne, which is home to the largest population of Afghanistan-born people within the state of Victoria. The majority of Afghan women arriving in Australia are of childbearing age, and evidence suggests that they are at increased risk of emotional challenges following birth as a result of the refugee and migration experience. This research aimed to explored the experiences of Afghan women living in Melbourne throughout pregnancy, birth, and early motherhood, and gain insight into the aspects of their experiences that they …

A Sensorless Haptic Interface For Robotic Minimally Invasive Surgery, Baoliang Zhao

Department of Mechanical and Materials Engineering: Dissertations, Theses, and Student Research

Robotic minimally invasive surgery (R-MIS) has gained in popularity due to its advantages of improving the accuracy and dexterity of surgical interventions while minimizing trauma to the patient. However, because of the loss of direct contact with the surgical site, the surgeon cannot perceive tactile information, which may adversely affect surgical efficiency and/or efficacy. The lack of haptic feedback is regarded as a limiting factor in existing R-MIS technology.

To solve this problem, researchers have incorporated force sensors on the surgical tools to measure the tool-tissue interaction forces, and reproduce these forces at the surgeon console. However, the employment of …

Compassion Satisfaction And Compassion Fatigue Among Critical Care Nurses, Tara L. Sacco, Susan M. Ciurzynski, Megan Elizabeth Harvey, Gail L. Ingersoll

Nursing Faculty/Staff Publications

BACKGROUND Although critical care nurses gain satisfaction from providing compassionate care to patients and patients’ families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life.

OBJECTIVES To establish the prevalence of compassion satisfaction and compassion fatigue in adult, pediatric, and neonatal critical care nurses and to describe potential contributing demographic, unit, and organizational characteristics.

METHODS In a cross-sectional design, nurses were surveyed by using a demographic questionnaire and the Professional Quality of Life Scale to measure levels of compassion fatigue and compassion satisfaction.

RESULTS Nurses (n = 221) reported …

Mobile Cloud Computing Based Non Rigid Registration For Image Guided Surgery, Arun Brahmavar Vishwanatha

Computer Science Theses & Dissertations

In this thesis we present the design and implementation of a Mobile Cloud computing platform for non-rigid registration required in Image Guided Surgery (MCIGS). MCIGS contributes in flexible, portable and accurate alignment of pre-operative brain data with intra-operative MRI, for image guided diagnosis and therapy and endoscopic skull base surgery. Improved precision of image guided therapy and specifically neurosurgery procedures is known to result in the improved prognosis for brain tumor patients. MCI GS system is tested with Physics Based Non-Rigid Registration method form ITK. Our preliminary results for brain images indicate that the proposed system over Wi-Fi can be …

Symptomatic Surgically Treated Non-Neoplastic Cysts Of The Central Nervous System: A Clinicopathological Study From Pakistan, Nasir Ud Din, Huma Arshad, Zubair Ahmad, Sheema H Hasan, Mohammad Ehsan Bar

Department of Pathology and Laboratory Medicine

Objective: To report clinicopathologic features of symptomatic surgically removed non-neoplastic cysts of the central nervous system (CNS). Study Design: Case series. Place and Duration of Study: The Aga Khan University Hospital, Karachi, from 2003 to 2012. Methodology: All non-neoplastic CNS cysts reported during the study period were retrieved and reviewed. Age, gender, location, histologic type and clinical features were noted. Results: A total of 124 cysts were diagnosed in the study period. These included 44 epidermoid cysts (mean age 30.5 ± 13.8 years), 35 colloid cysts (mean age 31 ± 13.2 years), 32 arachnoid cysts (mean age 24.8 ± 20.2 …

Metabolites As Novel Biomarkers For Childhood Obesity-Related Traits In Mexican-American Children, V. S. Farook, L. Reddivari, G. Chittoor, S. Puppala, Rector Arya, S. P. Fowler, Joanne E. Curran, John Blangero, Ravi Duggirala

School of Medicine Publications

Background/Objectives Although newer approaches have identified several metabolites associated with obesity, there is paucity of such information in paediatric populations, especially among Mexican-Americans (MAs) who are at high risk of obesity. Therefore, we performed a global serum metabolite screening in MA children to identify biomarkers of childhood obesity. Methods We selected 15 normal-weight, 13 overweight and 14 obese MA children (6-17 years) and performed global serum metabolite screening using ultra-performance liquid chromatography/quadruple orthogonal acceleration time of flight tandem micro mass spectrometer. Metabolite values were analysed to assess mean differences among groups using one-way analysis of variance, to test for linear …

Diagnostic Tcd For Intracranial Stenosis In Acute Stroke Patients: Experience From A Tertiary Care Stroke Center In Karachi, Pakistan., Ayeesha Kamran Kamal, Hasan Rehman, Nasir Mustafa, Bilal Ahmed, Mohammad Jan, Faisal Wadivalla, Syed Kamran

Department of Medicine

Background: Stroke is a common cause of morbidity and mortality around the world. Intracranial large artery atherosclerosis (ICAD) is a frequent etiology of stroke in the South Asian population. There is a need for widely available screening tools to identify patients that are at high risk of stroke due to ICAD for aggressive risk management. This study describes the experience of using the transcranial Doppler (TCD) as a screening tool for this purpose at a tertiary care hospital in a developing country.

Methods: 86 Patients admitted with stroke due to ICAD underwent TCD for six arteries (Right and left …

Unusual Presentation With Polymenorrhagia And Markedly High 17-Hydroxy Progesterone Levels In A Lady With Non-Classic Congenital Adrenal Hyperplasia., Azra Rizwan, Marium Hayat

Department of Medicine

Congenital adrenal hyperplasia is generally associated with oligo-amenorrhea, and its presentation with polymenorrhagia is rare. Here we present a case of an Asian female who presented with polymenorrhagia since menarche, increased body hair growth and enlargement of clitoris for 7-8 years. Examination revealed a normal Body Mass Index, moderate hirsutism, Tanner 5 breasts and significant clitoromegaly. Serum testosterone and 17-hydroxyprogesterone levels were elevated. Ultrasonography revealed normal adrenal glands and polycystic ovaries. adrenocorticotropic hormone stimulation test uncovered borderline cortisol deficiency. Oral dexamethasone was commenced and six months later, she showed improvement though there was no change in hirsutism or clitoromegaly. The …

Evaluation Of Vaccination Policies Among Outpatient Oncology Clinics In Utah: A Pilot Study, Sarah Louise Stocksdale

Theses and Dissertations

Background: In Utah, all major hospital facilities have employee vaccination policies. However, the presence of health care worker vaccination policies in the Utah outpatient oncology setting was unknown. Objectives: The objectives were to identify Utah oncology outpatient employee vaccination policies and to identify what consequences, if any, were present for unvaccinated employees. Methods: This was a cross-sectional, descriptive study design in which clinic managers from outpatient oncology clinics in Utah were asked, via questionnaire, to describe the clinic's employee vaccination policy and the consequences for refusing the policy. Findings: Most vaccination policies applied to employees primarily assigned to work in …