Medicine and Health Sciences Commons^™

The Role Of Human Msc Derived Exosomes In The Treatment Of Periodontal Diseases, Sonia S. Talegaonkar

Theses and Dissertations

Periodontal disease affects 47% of Americans over 30. Characterized by microbial dysbiosis and unregulated inflammation, severe periodontitis causes degradation of bone and soft tissue around teeth. Current treatments have limited regenerative outcomes and frequent reinfection by harmful bacteria. Human mesenchymal stem cells (hMSCs) have been shown to promote wound healing and tissue regeneration. Many therapeutic benefits of hMSCs are due to their secretome products, like exosomes. Our long-term goal is to develop periodontal therapies with hMSC exosomes. The objectives of this study were to determine the effect of hMSC-derived exosomes on cellular activity of hMSCs and investigate whether hMSC exosome …

Investigation Of Polymeric Composites For Controlled Drug Release, Hsi-Wei Yeh

Theses and Dissertations

The Electrospray (ES) technique is a promising particle generation method for drug delivery due to its capabilities of producing monodisperse PLGA composite particles with unique configurations and high drug encapsulation efficiency. In the dissertation work, the coaxial dual capillary ES was used to generate drug-loaded core-shell PLGA particles to study the effects of particle filling materials, drug loading locations and particle shell thicknesses on the resultant in vitro release behaviors of the hydrophilic and/ or hydrophobic model drugs. Through release profile characterization of drug-loaded PLGA particles (particle size: 400 nm and 1 μm), it was confirmed that the co-encapsulation of …

An Algorithm To Improve Deformable Image Registration Accuracy In Challenging Cases Of Locally-Advanced Non-Small Cell Lung Cancer, Christopher L. Guy

Theses and Dissertations

A common co-pathology of large lung tumors located near the central airways is collapse of portions of lung due to blockage of airflow by the tumor. Not only does the lung volume decrease as collapse occurs, but fluid from capillaries also fills the space no longer occupied by air, greatly altering tissue appearance. During radiotherapy, typically administered to the patient over multiple weeks, the tumor can dramatically shrink in response to the treatment, restoring airflow to the lung sections which were collapsed when therapy began. While return of normal lung function is a positive development, the change in anatomy presents …

Sentinel Lymph Node Biopsy Pathology And 2-Year Postsurgical Recurrence Of Breast Cancer In Kenyan Women, Nathan R. Brand, Ronald Wasike, Khalid Makhdomi, Rajendra Chauhan, Zahir Moloo, Samuel Gakinya, Alfred I. Neugut, Jo Anne Zujewski, Shahin Sayed

General Surgery, East Africa

Purpose: The goal of this study was to describe the pathologic findings and early follow-up experience of patients who underwent a sentinel lymph node biopsy (SLNB) at Aga Khan University Hospital (AKUH) between 2008 and 2017.

Patients and Methods: We performed a retrospective analysis of women with breast cancer who underwent an SLNB at AKUH between 2008 and 2017. The SLNB was performed on patients with stage I and stage II breast cancer, and identification of the sentinel lymph node was made by radioactive tracer, blue dye, or both, per availability and surgeon preference. Demographic, surgical, and pathologic data, …

Health-Related Quality Of Life And Physical Activity In University Employees, Meghan Hoefs

Theses and Dissertations (Comprehensive)

Background: Health-related quality of life (HRQL) reflects an individual’s subjective perception. The relationship between health-related quality of life and physical activity has been investigated in various populations, but is not well-documented in University employees. Additionally, variables such as an individual’s beliefs about physical activity and their satisfaction with functioning at work have yet to be investigated in this population. Little is known about the relationship between HRQL and these variables. Purpose: Evaluate the relationships among multiple measures of HRQL and physical activity in University employees and provide a descriptive picture of the University population. Methods: Participants (N …

Auditory Erp Differences Across A Continuum Of Psychotic Symptoms In Non-Clinical Population, Anaya Rehman

Theses and Dissertations (Comprehensive)

Psychosis is a term given to a mental state described as a loss of contact with the real world. The aim of this thesis was to examine early non-specific psychotic experiences in a healthy population by means of two self-report screening tools: Prime Screen and Youth Psychosis At-Risk Questionnaire-Brief, and place individuals on a psychosis continuum. Across this psychosis continuum, three event related potential (ERP) components were assessed: P300, Mismatch Negativity and N100. There is evidence that P300 and mismatch negativity amplitudes diminish in individuals with psychosis. Similarly, impaired N100 amplitude suppression (increased N100 amplitudes) during vocalization has been observed …

Learning And Working Together: Invoking Systems’ Change Through Inter-Organizational Collaborative Principles And A Learning Community Framework, Brandon Hey

Theses and Dissertations (Comprehensive)

Local communities face significant challenges such as increased inequality, immigration, and global climate change. In order to address these challenges whole cities have to innovate and learn together. In this thesis, I introduce the Learning Community (LC) model, a new way of collaborating and creating collective impact that emphasizes learning, alongside collective impact, as a central strategy to addressing complex social challenges. In a LC, members value the continuous pursuit of knowledge, feedback, and experimentation as well as the flow of information and resources between academic institutions and practice groups. The value of learning is built into key structures …

Developing And Testing Quality Indicators For Seriously-Ill Home Care Clients In Ontario, Lisa Harman

Theses and Dissertations (Comprehensive)

Introduction Currently in Ontario, there is no set of quality indicators for use in palliative care settings. Palliative care research tends to focus heavily on those with cancer diagnoses, and therefore potentially misses those with other life limiting illnesses. The current study aims to develop a preliminary set of quality indicators relevant for seriously-ill individuals for use in the community. Methods Secondary analysis of Resident Assessment Instrument for Home Care (RAI-HC) data from 2006-2013 (n=263,767) was used to develop QIs thought to be relevant to the needs of seriously-ill home care clients. Seriously-ill clients were defined as those with a …

The Effect Of Twist On The Mechanical Properties Of The Intervertebral Disc, Maxine Harvey-Burgess

Theses and Dissertations (Comprehensive)

Introduction: Intervertebral disc (IVD) herniation is a common injury to the IVD and a frequent source of low back pain. IVD herniation occurs when the nucleus pulposus migrates through both the inter- and intralamellar matrices of the annulus fibrosus (AF). There are a number of mechanical risk factors associated with herniation, including repetitive flexion and twist. In vivo, twist combined with repetitive flexion has been associated with increased experience of low back pain and herniation. Additionally, in vitro, when repetitive flexion is combined with twist, IVD herniation occurs more easily than repetitive flexion alone. However, the mechanisms behind …

Exploring Police Officers' Perceptions Of Mobile Crisis Rapid Response Teams Within A Nodal Policing Framework, Trevor Viersen

Theses and Dissertations (Comprehensive)

An increasing portion of police service resources are being dedicated to interactions involving persons with mental illness (PMI). As a result, Mobile Crisis Rapid Response Teams (MCT) comprised of mental health professionals have been recently implemented to assist police officers in more efficiently handling police calls for service involving PMI. The current ethnographic study used data collected through researcher ride-alongs with police officers at a mid-sized police service in Ontario to assess how police officers interact with and perceive MCTs. Results from thematic analysis indicated that officers value the skill sets possessed by MCT workers, had relatively positive perceptions towards …

The Effects Of Orthotics And Increased Plantar Sole Mechanoreceptor Activation On Turning Performance In Individuals With Parkinson’S Disease, Kelly A. Robb

Theses and Dissertations (Comprehensive)

Locomotion and turning are complex movement patterns essential to activities of daily living. Individuals with Parkinson’s disease (PD) report difficulties turning, often coupled with impaired balance and increased fear of falling. The purpose of this within-subject study was to determine if orthotics, with and without a textured top cover, can improve gait stability and turning performance within Parkinson’s participants. Seven participants with a diagnosis of idiopathic Parkinson’s disease, aged 55-80 years old, participated in the study. Participants completed three testing sessions; baseline, 4 weeks post-baseline, and 5 weeks post-baseline. The ‘footwear only’ and ‘footwear + non-textured orthotic’ conditions were tested …

The Effects Of A 12-Week Custom Foot Orthotic Intervention On The Intrinsic Muscles Of The Foot, And Dynamic Stability During Unexpected Gait Termination In Healthy Young Adults, Katrina Protopapas

Theses and Dissertations (Comprehensive)

Introduction: Custom-made foot orthotics (CFO’s) are a commonly prescribed intervention to help individuals that are suffering from foot pain and foot disorders. However, the mechanisms of CFO’s are still poorly understood and are not well known. With the plantar intrinsic muscles of the foot being in direct contact with the CFO, it puts these structures at risk for disuse muscle atrophy as a result of being offloaded. Therefore, the purpose of the current study was to determine the effect of a 12-week custom-made foot orthotic intervention on the intrinsic muscles of the foot and dynamic stability during unexpected gait termination. …

Sports Cardiology: Core Curriculum For Providing Cardiovascular Care To Competitive Athletes And Highly Active People., Aaron L. Baggish Md, Robert W. Battle Md, James G. Beckerman Md, Alfred A. Bove Md, Phd, Rachel J. Lampert Md, Benjamin D. Levine Md, Mark S. Link Md, Matthew W. Martinez Md, Silvana M. Molossi Md, Phd, Jack Salerno Md, Meagan M. Wasfy Md, Rory B. Weiner Md, Michael S. Emery Md

Department of Medicine

The last few decades have seen substantial growth in the populations of competitive athletes and highly active people (CAHAP). Although vigorous physical exercise is an effective way to reduce the risk of cardiovascular (CV) disease, CAHAP remain susceptible to inherited and acquired CV disease, and may be most at risk for adverse CV outcomes during intense physical activity. Traditionally, multidisciplinary teams comprising athletic trainers, physical therapists, primary care sports medicine physicians, and orthopedic surgeons have provided clinical care for CAHAP. However, there is increasing recognition that a care team including qualified CV specialists optimizes care delivery for CAHAP. In recognition …

Tct-546 Performance Of The Dual Antiplatelet Therapy (Dapt) Score In The Adapt-Des Study., Sorin J. Brener, Ajay J. Kirtane Md, Michael J. Rinaldi Md, Bernhard Witzenbichler Md, Franz-Josef Neumann Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest Mazzaferri Md, Bruce R. Brodie Md, Roxana Mehran Md, Thomas Mcandrew, Gregg W. Stone Md

Department of Medicine

Background

The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) remains in dispute, particularly after 12 months. The DAPT Score was developed from the DAPT trial to identify pts who may benefit the most from extended therapy. We sought to assess the performance of the DAPT risk score in the all-comers Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents (ADAPT-DES) registry, and to test the utility of additional predictors of events on its performance.

Methods

Patients free from ischemic or hemorrhagic events after 1 year of DAPT after successful DES implantation were analyzed. The DAPT score …

Impact Of Cross-Level Measurement Noninvariance On Hospital Rankings Based On Patient Experiences With Care In 7 European Countries, Benedict O. Orindi, Emmanuel Lesaffre, Walter Sermeus, Luk Bruyneel

All Peer-Reviewed Publications

Background: Hospital-level findings on patient experiences with care are increasingly reported publicly. A critical aspect left unexamined is the commonality of composite measures of patient experiences across different groups of patients, nursing units, hospitals, and countries. Absence of commonality is termed measurement noninvariance and is hypothesized to have a strong impact on performance assessment. Aim: The aim of this study is to examine measurement invariance across groups and levels under study (patients, nursing units, hospitals, and countries) and illustrate the degree to which this method of analysis impacts hospital rankings. Research Design: Data were collected from 11,289 patients in 7 …

Randomised Controlled Trial Of Two Sequential Artemisinin-Based Combination Therapy Regimens To Treat Uncomplicated Falciparum Malaria In African Children: A Protocol To Investigate Safety, Efficacy And Adherence, Henk D.F.H. Schallig, Halidou Tinto, Patrick Sawa, Harparkash Kaur, Stephan Duparc, Deus S. Ishengoma, Pascal Magnussen, Michael Alifrangis, Colin J. Sutherland

All Peer-Reviewed Publications

Background Management of uncomplicated Plasmodium falciparum malaria relies on artemisininbased combination therapies (ACTs). These highly effective regimens have contributed to reductions in malaria morbidity and mortality. However, artemisinin resistance in Asia and changing parasite susceptibility to ACT in Africa have now been well documented. Strategies that retain current ACT as efficacious treatments are urgently needed. Methods We present an open-label, randomised three-arm clinical trial protocol in three African settings representative of varying malaria epidemiology to investigate whether prolonged ACTbased regimens using currently available formulations can eliminate potentially resistant parasites. The protocol investigates whether a sequential course of two licensed ACT …

Is Feedback To Medical Learners Associated With Characteristics Of Improved Patient Care?, Victoria Hayes, Robert Bing-You, Kalli Varaklis, Robert Trowbridge, Heather Kemp, Dina Mckelvy

MaineHealth Maine Medical Center

Our Research Question: "What is the association of medical learner feedback with characteristics of improved patient care?"

Multi-Scale Cardiovascular Flow Analysis By An Integrated Meshless-Lumped Parameter Model, Leonardo A. Bueno, Eduardo A. Divo, Alain J. Kassab

Publications

A computational tool that integrates a Radial basis function (RBF)-based Meshless solver with a Lumped Parameter model (LPM) is developed to analyze the multi-scale and multi-physics interaction between the cardiovascular flow hemodynamics, the cardiac function, and the peripheral circulation. The Meshless solver is based on localized RBF collocations at scattered data points which allows for automation of the model generation via CAD integration. The time-accurate incompressible flow hemodynamics are addressed via a pressure-velocity correction scheme where the ensuing Poisson equations are accurately and efficiently solved at each time step by a Dual-Reciprocity Boundary Element method (DRBEM) formulation that takes advantage …

Towards A Continuous Assessment Of Cognitive Workload For Smartphone Multitasking Users, Angel Jimenez-Molina, Hernan Lira

H-Workload 2017: Models and Applications (Works in Progress)

The intermeshing of Smartphone interactions and daily activities depletes the availability of cognitive resources. This excessive demand may lead to several undesirable cognitive states, which can be avoided by continuously assessing the user cognitive workload. Recently, many attempts have emerged to assess this workload by using psycho physiological signals. This paper provides evidence that it is possible to train models that accurately identify in short time windows such cognitive workload by processing heart rate and blood oxygen saturation signals. This assessment could be applied in Smartphone notification delivery, interface adaptations or cognitive capabilities evaluation.

Human Performance Modelling In Manufacturing: Mental Workload And Task Complexity, Maria Chiara Leva, Lorenzo Comberti, Micaela Demichela, Rebecca Duane

H-Workload 2017: Models and Applications (Works in Progress)

No abstract provided.

Distress And Worry As Mediators In The Relationship Between Psychosocial Risks And Upper Body Musculosketal Complaints In Highly Automated Manufacturing, Fiona Wixted, Leonard O'Sullivan

H-Workload 2017: Models and Applications (Works in Progress)

As a result of an upward trend in automation, the requirement for supervisory monitoring and consequently, cognitive demand has increased in automated manufacturing. The incidence of musculoskeletal disorders has also increased in the manufacturing sector. A model was developed based on survey data to test if distress and worry mediate the relationship between psychosocial factors (job control, cognitive demand, social isolation and skill discretion), stress states and upper body musculoskeletal complaints in highly automated manufacturing companies (n=235). Cognitive demand was shown to be related to higher distress in employees. The data raise the question about the link between job control …

Moving Between Automated And Manual Driving: Mental Workload And Performance Implications, Totsapon Butmee, Terry C. Lansdown

H-Workload 2017: Models and Applications (Works in Progress)

Automated driving has been predicted to take-over from manual vehicle control in the near future. The driver’s role may then change from active operator to passive observer. Such technology offers the tantalising promise of improving driving safety. However, many studies have presented findings suggesting potentially adverse effects from automated driving systems, e.g., reduced situation awareness. Mental workload is also a key issue of concern for researchers in this area. Excessive mental workload has repeatedly been shown to be associated with degraded driving performance. Previously, most traffic psychology studies on mental workload have focused the manual driving task. However, a shift …

Managing Operator Mental Workload With Standards Based Decision Support, Maurice Wilkins

H-Workload 2017: Models and Applications (Works in Progress)

H-Workload 2017: The first international symposium on human mental workload, Dublin Institute of Technology, Dublin, Ireland, June 28-30.

Facing Human Workload: The Resilient Ego: A Psychoanalytic Point Of View, Glauco Maria Genga, Maria Gabriella Pediconii

H-Workload 2017: Models and Applications (Works in Progress)

The paper aims to show new connections among Human Factors, Human Workload and Resilience. We intend: 1) to highlight the role of subject in facing the human workload, inflected as demanding tasks and emergency situations; 2) to show how psychoanalysis can provide novel insights, not only into human errors, but also into human resilience. They have a common denominator, at least in part: the role of subjective contributions even in demanding situations. Human workload includes a work for satisfaction. We recall also the case study of US Airways Flight 1549 water landing (the so called “Miracle on the Hudson”), which …

Petrochemical Plant Console Operator Workload:The Issues, David A. Strobhar

H-Workload 2017: Models and Applications (Works in Progress)

The console operators of certain petrochemical processes must maintain high levels of performance during process upsets or endanger personnel safety and the environment. Mismanagement of an upset can result in explosions, fires, and the release of hazardous chemicals to the environment. The change in workload from steady state to upset operation is significant, with alarms and control changes that are of an order of magnitude. This paper describes the state of console activity in process plants, particularly the increase with key upsets. Quantitative data on the nature of the console operator’s position, its workload during normal operation, and the requirements …

Long Days Enhance Recognition Memory And Increase Insulin-Like Growth Factor 2 In The Hippocampus, Adriano Dellapolla, Ian Kloehn, Harshida Pancholi, Ben L. Callif, David Wertz, Kayla Rohr, Matthew M. Hurley, Kimberly Baker, Samer Hattar, Marieke R. Gilmartin, Jennifer A. Evans

Biomedical Sciences Faculty Research and Publications

Light improves cognitive function in humans; however, the neurobiological mechanisms underlying positive effects of light remain unclear. One obstacle is that most rodent models have employed lighting conditions that cause cognitive deficits rather than improvements. Here we have developed a mouse model where light improves cognitive function, which provides insight into mechanisms underlying positive effects of light. To increase light exposure without eliminating daily rhythms, we exposed mice to either a standard photoperiod or a long day photoperiod. Long days enhanced long-term recognition memory, and this effect was abolished by loss of the photopigment melanopsin. Further, long days markedly altered …

Pilot Evaluation Of An Online Weight Management Programme, Shona Cawley, S. Farrell, D. G. Byrne, M. J. Turner, B. Clune, Daniel Mccartney

Articles

This intervention examined the efficacy of a six-week online weight loss programme. Student and staff of a third level institution (n=183) were recruited to the programme which provided individualised dietary advice for weight loss. Eighty-five participants (mean age 29.7 years, mean BMI 28.9kg/m2, 33% male) met the minimum inclusion criterion of logging on to the study website at least twice.

The "Eyes" Have It?-Intra- And Inter-Observer Reproducibility Of The Pd-L1 Companion Diagnostic Assay, Steven G. Gray, Mark Wright, Stephen Finn

Articles

No abstract available.

Impact Of Supplemental Home Enteral Feeding Postesophagectomy On Nutrition, Body Composition, Quality Of Life, And Patient Satisfaction, C.L. Donohoe, L.A. Healy, M. Fanning, Suzanne Doyle, A. Mchugh, J. Moore, N. Ravi, J.V. Reynolds

Articles

The aim of this prospective cohort study is to analyze the impact of supplemental home enteral nutrition (HEN) post-esophageal cancer surgery on nutritional parameters, quality of life (QL), and patient satisfaction. A systematic review reported that over 60% of patients lose >10% of both body weight and BMI by 6 months after esophagectomy. Enteral feeding (EF) is increasingly a modern standard postoperatively; however, the impact of extended HEN postdischarge has not been systematically studied. One hundred forty-nine consecutive patients [mean age 62 ± 9, 80% male,76% adenocarcinoma, 66% on multimodal protocols, and 69% with BMI ≥ 25 kg/m2] were studied. …

Cancer Incidence In Ireland—The Possible Role Of Diet, Nutrition And Lifestyle, Daniel Mccartney, Declan Byrne, Marie Cantwell, Michael Turner

Articles

Aim This observational ecological study aims to compare Ireland’s age-specific cancer incidence rates (ASRs) with equivalent European and global data and to highlight possible dietary, nutritional and lifestyle contributors to cancer in Ireland.

Subjects and methods Using the International Agency for Research on Cancer’s (IARC) GLOBOCAN database, Irish ASRs for all-site cancer and for "lifestyle-related" cancers such as those of the colo-rectum, oesophagus, breast, lung and prostate were compared with European and global incidence data. Irish dietary and nutrient intake data were reviewed and evaluated in the context of these cancer incidence data and in relation to the established dietary, …