Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

A Deep Learning U-Net For Detecting And Segmenting Liver Tumors, Vidhya Cardozo

Theses and Dissertations

Visualization of liver tumors on simulation CT scans is challenging even with contrast-enhancement, due to the sensitivity of the contrast enhancement to the timing of the CT acquisition. Image registration to magnetic resonance imaging (MRI) can be helpful for delineation, but differences in patient position, liver shape and volume, and the lack of anatomical landmarks between the two image sets makes the task difficult. This study develops a U-Net based neural network for automated liver and tumor segmentation for purposes of radiotherapy treatment planning. Non-contrast simulation based abdominal CT axial scans of 52 patients with primary liver tumors were utilized. …

Live Cell Biomass Tracking For Basic, Translational, And Clinical Research, Graeme Murray

Theses and Dissertations

Single cell mass is tightly regulated throughout generations and the cell cycle, making it an important marker of cell health. Abnormal changes in cell size can be the first indication of dysfunction in response to environmental stimuli such as cytotoxic drugs. Described here is the further development of high-speed live cell interferometry (HSLCI) to concurrently measure the changes in single cell mass of thousands of cells over time. Critically, the high-throughput nature of HSLCI provides realistic pictures of tumor heterogeneity. This throughput enabled HSLCI to correctly predict in vivo carboplatin sensitivity of three triple negative breast cancer patient derived xenografts, …

Strengthening Mental Health Diagnostic Detection In Integrated Primary Care, Julia Brechbiel

Theses and Dissertations

Primary care behavioral health (PCBH) is crucial for providing mental health treatment to underserved, minority, and uninsured populations. There is a lack of knowledge about accurate mental health diagnoses at PCBH. Underdetection of mental health symptoms has the potential to worsen racial and socioeconomic disparities. Using an expert review process, I developed an abbreviated diagnostic clinical interview (ADCI) for integrated primary care. Next, patients (N = 82) completed the interview after attending PCBH appointments. According to the interview, 63.4% of participants met criteria for a diagnosis, while 64.7% received a diagnosis from their provider. A large portion of patients …

Pushing The Limits: Increasing The Speed And Specificity Of Sars-Cov-2 Testing, Grayson Way

Theses and Dissertations

The prevalence and spread of the current COVID-19 pandemic have highlighted the importance of continual improvements upon current microbiological testing methods. Rapid and accurate testing can help mitigate spread by improving on the time to quarantine and quarantine duration required. As of the writing of this thesis, COVID-19 has been responsible for more than 500,000 deaths in the United States of America, and greater than 2 million deaths globally. The work done in this thesis has shown improvements in the current SARS-CoV-2 testing methodology by reducing the time it takes for patient testing while maintaining accuracy and the sensitivity required …

Diagnostic Accuracy Of Mcmurry’S Test In The Diagnosis Of Meniscal Tears, Jessica Smyth, Hartwell Rainey

Physician Assistant Capstones, 2020-current

No abstract provided.

Early Diagnosis Of Alzheimer’S Disease In The Primary Care Setting, Raymond R. Romano

Theses and Dissertations (ETD)

The burden of Alzheimer’s disease (AD) affects not just the individual but also families, providers, and society. Early recognition and diagnosis of AD may reduce cost by reducing interaction with the health care system, earlier initiation of treatment, and prolonging time to long- term care. Primary care providers, the first contact for diagnosis of patients with AD, are not fulfilling the potential of early diagnosis for a variety of reasons. Biomarkers of AD emerge on average 15 to 20 years before clinical diagnosis, yet currently established biomarkers are not easily available in the primary care setting. A growing body of …

Extra Axial Chordoma Of The Distal Femoral Metaphysis: A Case Report, Long Nguyen, Irene Vasko, Gord G. Zhu, Veniamin Barshay

Cooper Rowan Medical Journal

Background

Chordomas are malignant bone tumors that are derived from remnant embryonic tissue of the notochord and are typically found in the axial midline. When they are found outside of the axial skeleton, the diagnosis can be challenging and elusive. Often, they are overlooked on initial presentation in lieu of other more common lesions, including cartilage tumors (eg, enchondroma, chondrosarcoma, osteochondromatosis) due to their overlapping features.

Case Report

A 30-year-old female with a four-year history of intermittent left knee pain presented for initial evaluation. Physical exam of the knee was unremarkable except for moderate tenderness on palpation. Radiographs showed a …

Mental Health And Its Wicked Factors, Michael Schuler

English Department: Research for Change - Wicked Problems in Our World

Mental health has long since been an issue in not just our society, but worldwide. While it is difficult to determine exactly what factors affect mental health, there has been significant research done within the past 30 years to show that major factors that affect mental health can be mitigated. Things such as poverty, physical health, and community outreach can all be linked to mental health issues. There are some solutions that will mitigate these factors that can be explored. These solutions can include things like raising awareness for mental illnesses in order to reduce stigma, getting more mental health …

Assessing Disease Severity Of Diabetic Retinopathy Using Novel Graphical Interpretation Of Flicker Electroretinogram, Anjalee Choudhury, Jonas Moses, Victor Gonzalez

MEDI 9331 Scholarly Activities Clinical Years

Purpose: To assess the clinical value of reporting full-field electroretinogram (eg, flicker ERG) findings graphically to determine the severity of diabetic retinopathy (DR) within an office-based setting.

Methods: Patients with type 2 diabetes mellitus were included and classified into varying degrees of DR based on presence and severity. Flicker ERG responses were recorded and compared between groups.

Results: Between the varying disease stages, significant differences in the mean magnitude and phase values were found. There was also a significant difference between the proportions of the magnitude and phase color-coded frequencies between groups of severity and threat to …

Cole Relaxation Frequency As A Prognostic Parameter For Breast Cancer, William D. Gregory, Shahila Mehboob Christie, John Shell, Georges J. Nahhas, Maharaj Singh, Wendy Mikkelson

Journal of Patient-Centered Research and Reviews

We previously reported successful classification of breast cancer versus benign tissue using the Cole relaxation frequency measured on tissue excised during breast surgery as part of a study at two urban hospitals in the U.S. Midwest. Using that health system’s cancer registry, we have discovered retrospectively that outcomes for patients who participated in the initial study can be classified correctly in 3 well-differentiated categories: nonrecurrent (NR); recurrent with no metastasis (RNM); and recurrent with metastasis (RM). As Cole relaxation frequency increases, the classification moves from NR to RNM and finally to RM. Multivariate analysis showed a significant association of “time-cancer-free” …

Age Based Evaluation Of Nut Aspiration Risk., Jill N D'Souza, Taher S Valika, Bharat Bhushan, Jonathan B Ida

School of Medicine Faculty Publications

Objective: To identify an age at which initiation of whole nut into the pediatric diet could be considered safe, by evaluating the age distribution of children undergoing bronchoscopy with removal of nut or seed material from the airway. Method: A retrospective chart review over a ten-year period identifying children age 0–18 that have undergone bronchoscopy with retrieval of airway foreign bodies. A statistical analysis of demographic data was carried out to identify age distribution of aspiration events. Results: Sixty-four cases of foreign body aspiration were identified, of which 43 (67%) were of organic origin, specifically nuts. A Fisher's exact test …

Aci-35 And Aadvac1 Active Immunotherapy As Preventative Treatment Options For Chronic Traumatic Encephalopathy, Emily C. Boehlein

Selected Honors Theses

One of the most common, as well as one of the most dangerous injuries amongst athletes today is mild traumatic brain injury (mTBI), commonly known as concussion. Aside from physical symptoms such as nausea, dizziness, and headaches; concussions have can have longterm effects on brain physiology. A common neurological disease that can result from multiple concussions is Chronic Traumatic Encephalopathy (CTE), characterized by symptoms such as severe depression, anxiety, confusion, and aggression; amongst others.1 On the cellular level, CTE is classified by a unique pathway that leads to the hyperphosphorylation of tau protein and subsequent clumping of tau-containing neurofibrillary tangles …

Genetic Duties, Jessica L. Roberts, Alexandra L. Foulkes

William & Mary Law Review

Most of our genetic information does not change, yet the results of our genetic tests might. Labs reclassify genetic variants in response to advances in genetic science. As a result, a person who took a test in 2010 could take the same test with the same lab in 2020 and get a different result. However, no legal duty requires labs or physicians to inform patients when a lab reclassifies a variant, even if the reclassification communicates clinically actionable information. This Article considers the need for such duties and their potential challenges. In so doing, it offers much-needed guidance to physicians …

Factors Affecting The Characterization Of Post-Exertional Malaise Derived From Patient Input, Carly S. Holtzman, Claire Fisher, Shaun Bhatia, Leonard A. Jason

Journal of Health Disparities Research and Practice

The National Institutes of Health/Center for Disease Control and Prevention (NIH/CDC) Common Data Elements (CDE) established a post-exertional malaise (PEM) workgroup with the task of describing PEM and recommending a standardized way of assessing it in patients with myalgic encephalomyelitis and chronic fatigue syndrome (ME/CFS). As a stigmatized group, patients with ME/CFS are in need of instruments which can properly describe their symptomatic experiences, which can help reduce the disparity between illness seriousness and appropriate attention from healthcare. The current study explored attitudes and preferences among 115 patients with ME/CFS who participated in the creation of a patient-driven instrument to …

Predicting Postoperative Delirium Risk For Intracranial Surgery: A Statistical Machine Learning Approach, Juliet Aygun, Alaina Bartfeld, Sahana Rayan

The Journal of Purdue Undergraduate Research

No abstract provided.

Detection Of Left Ventricular Thrombi On Cardiac Magnetic Resonance Viability Studies, Donya Ahmed Alhassan, Khawaja Bilal Waheed, Muhammad Nasim Sharif, Muhammad Zia Ulhassan, Fazal Ghaffar, Khaled Saleh Saleem, Emad Fouad Mahmoud Said, Bayan Mohammed Altalaq, Zechariah Jebakumar Arulanantham, Ahmad Omar Qarmash

Journal of the Saudi Heart Association

Objective: To highlight detection of left ventricular thrombi on cardiac magnetic resonance (CMR) viability studies.

Method: This retrospective observational study was conducted in the Radiology Department at our Hospital in Dhahran, from April 2015-2019. All recently re-perfused (post-percutaneous coronary intervention/ PCI) patients with ST-segment elevation myocardial infarctions (STEMI), having low ejection fractions (

Results: Of the 125 patients, most were men (71.2%) with a mean age of 56.78 years. Eleven patients had left ventricular thrombi (8.8%), and most of these were anterior wall infarctions with low ejection fractions (

Conclusion: Left ventricular thrombi can be detected on cardiac viability studies …

Development Of A Ct Metal Artifact Management Algorithm For Proton Therapy Planning (Ampp) For Head And Neck Cancer Patients, Daniela Branco

Dissertations and Theses (Open Access)

Purpose: Dental amalgams (high Z materials) are common sources of artifacts in Head and Neck (HN) images. Commercial artifact reduction techniques have been offered, but many are impractical, produce inaccurate CT images or are not clinically available, thus not widely implemented. The goal of this work is to use CT gantry tilts to develop and evaluate a stereoscopic HN metal artifact management algorithm and investigate its improvement in proton treatment planning.

Methods: The in-house CT metal artifact management method for proton planning (AMPP) uses two angled CT scans to generate a single image set with no metal artifacts posterior …

Investigating The Metabolic Progression Of Glioblastoma With Hyperpolarized Magnetic Resonance, Travis Salzillo

Dissertations and Theses (Open Access)

Rapid diagnosis and therapeutic monitoring of aggressive diseases such as glioblastoma (GBM) can improve patient survival by providing physicians the time to optimally deliver treatment. This includes early in development, while the tumor is still manageable, or following initial therapy, when alternative treatments should be considered. The main goal of this project was to determine whether metabolic imaging with hyperpolarized magnetic resonance spectroscopy (MRS) could detect changes in tumor progression more rapidly than conventional anatomic magnetic resonance imaging (MRI) in patient-derived GBM murine models. To comprehensively capture the dynamic nature of cancer metabolism, in vivo pyruvate-to-lactate conversion with hyperpolarized MRI, …

Feasibility And Validity Of Asking Patients To Define Individual Levels Of Meaningful Change On Patient-Reported Outcomes, Salene M.W. Jones, Yuxian Du, Ari Bell-Brown, Kaylin Bolt, Joseph M. Unger

Journal of Patient-Centered Research and Reviews

Purpose: Patient-reported outcomes (PROs) are frequently used in clinical care to monitor treatment response. However, most guidelines on PRO use treat all patients the same. This study tested the feasibility and validity of a method for determining individually meaningful change in PRO measures.

Methods: Participants (n = 398) completed 12 pain and distress questions to define individually meaningful change. This mixed-methods study used both quantitative and qualitative analyses, including descriptive statistics, inferential statistics, and content analysis.

Results: Two-thirds (67%) of the sample reported at least one medical condition, including depression and back pain. Most participants (70%–90%) were able to answer …

Covid-19 Detection From Chest X-Ray Images Using Cnns Models: Further Evidence From Deep Transfer Learning, Mohamed Samir Boudrioua

The University of Louisville Journal of Respiratory Infections

Introduction: The early automatic diagnosis of the novel coronavirus (COVID-19) disease could be very helpful to reduce its spread around the world. In this study, we revisit the identification of COVID-19 from chest X-ray images using deep learning.

Methods: We collected a relatively large COVID-19 dataset—compared with previous studies—containing 309 real COVID-19 chest X-ray images. We also prepared 2,000 chest X-ray images of pneumonia cases and 1,000 images of healthy controls. Deep transfer learning was used to detect abnormalities in our image dataset. We fine-tuned three, pre-trained convolutional neural network (CNN) models on a training dataset: DenseNet 121, NASNetLarge, and …

Assessment And Treatment Of Down Syndrome-Associated Arthritis: A Survey Of Pediatric Rheumatologists., Anna Nicek, Nasreen Talib, Daniel Lovell, Chelsey Smith, Mara L. Becker, Jordan T. Jones

Manuscripts, Articles, Book Chapters and Other Papers

Background: Inflammatory arthritis in children with Down syndrome (DS) was first described in 1984 and is now termed Down syndrome-associated arthritis (DA). Studies have shown that DA is under-recognized with a 19-month average delay in diagnosis. Additionally, most patients present with polyarticular, rheumatoid factor (RF) and anti-nuclear antibody (ANA) negative disease. Current therapies for juvenile idiopathic arthritis (JIA) have been used, but appear to be poorly tolerated, more toxic and less effective in patients with DA. There is currently no standardized approach to the assessment or management of DA. The objective of this study was to describe provider perspectives toward …

Does A Diagnostic Algorithm Reduce The Overuse Of Chest Ct Angiography In Suspected Pulmonary Embolism? : A Pre- And Post-Intervention Retrospective Study In A Critical Access Hospital, Rattanaporn Mahatanan, Brianna Philbrick, William J. Hirschfeld, Gina Gomez

Journal of Maine Medical Center

Background: Pulmonary embolism (PE) is a common and potentially fatal disease. Although CTA is a gold standard for diagnosis, it carries risks for patients. We sought to minimize the overutilization of chest CTA by implementing a diagnostic algorithm in the hospital to evaluate the likelihood of PE and determine the need for imaging with CTA.

Methods: A retrospective medical chart review was performed for all patients suspicious of PE at Redington-Fairview General Hospital 3 months before and after diagnostic algorithm implementation. Patients who underwent either D-dimer testing or chest CTA were included. Patients were excluded if d-dimer testing was …

Frequency Of Monocyte Subsets Is Linked To The Severity Of Atherosclerosis In Patients With Ischemic Heart Disease: A Case-Control Study, Irina V. Kologrivova, Tatiana Suslova, Olga Koshelskaya, Oksana Trubacheva, Olga Haritonova, Irina Vinnitskaya

BioMedicine

Background: Monocytes are recognized as central cells in the progression of atherosclerosis, and are subcategorized into classical (CD14++CD16^lo), intermediate (CD14++CD16^hi) and non-classical (CD14+CD16^hi) subsets.

Purpose: The present study aimed to assess the relationships between different subsets of monocytes, metabolic and inflammatory factors in patients with stable coronary heart disease.

Methods: A total of 26 patients (both men and women) with stable ischemic heart disease (IHD). Among all the recruited patients, 17 patients had significant coronary artery disease defined as diameter stenosis more than 70%. Severity of CHD was assessed by the Gensini score (GS). …

Bedside Point Of Care Ultrasound Diagnosing Bilateral Valve Involvement In Infective Endocarditis, Corey Cole, Alfredo Tirado, Jonathan Schwadron

West Florida Division GME Research Day 2020

Endocarditis is a well known complication of intravenous drug abuse which classically affects the tricuspid valve. It is usually diagnosed by formal echocardiogram and positive blood cultures. Vegetations involving both the mitral and tricuspid valves are rare, occurring in less than 5% of all cases of infective endocarditis. 1 Here we report a case of a patient with vegetations on both valves which was discovered by point of care ultrasound.

Assisting Children With Velocardiofacial Syndrome Who Have Developmental Disabilities And Delays Associated With Speech, Communication, And Education, Mckenzie K. Holty

Honors Thesis

Children with velocardiofacial syndrome (VCFS) have a variety of complex needs. Research shows that VCFS is characterized by a combination of medical problems, developmental delays, and learning disabilities, which vary from child to child. This syndrome also puts adolescents at a higher risk for developing psychiatric and psychotic disorders. The complexity of symptoms that can arise from VCFS can influence the ability of these children to communicate, socialize, and learn effectively. This literature review aims to discuss literature for caregivers, educators, and physicians to aid children effectively and understand their challenges relating to speech, communication, and education. This topic is …

Screening For Post-Menopausal Osteoporosis In Women Ages 30-64 Review Of A Pilot Program In Primary Carescreening For Post-Menopausal Osteoporosis In Women Ages 30-64 Review Of A Pilot Program In Primary Care, Elaine Henson

Doctor of Nursing Practice Final Manuscripts

The risk of an osteoporotic hip fracture is greater than the combined risks of breast cancer, myocardial infarction, and stroke, yet research shows less than 25% of women are being screened. Post-menopause, either surgical or natural, is a risk factor for osteoporosis. Nurse practitioners are in an excellent position to lead the way in osteoporosis screening. This article presents findings in a recent osteoporosis screening program in a primary care office.

Audiologic Clinical Practice Patterns: Infant Assessment, Ursula M. Findlen, Nicole D. Schuller

Journal of Early Hearing Detection and Intervention

The purpose of the present study was to report the current clinical practice patterns for assessment of infants after a referred newborn hearing screening within the context of available guidelines and to examine how the advent of newer stimuli, technology, and/or instrumentation has changed clinical practice patterns for audiologic infant assessment. A mixed-method survey that included both quantitative and qualitative questions was disseminated to pediatric audiologists in 2017. Quantitative data were analyzed via descriptive statistics while qualitative questions were analyzed via content analysis and combined with associated quantitative data. Lastly, infant assessment test battery categorization was completed to ascertain the …

Clinical Validation And Diagnostic Rate/Outcomes Of A Dual Molecular Diagnostic Assay For Myotonic Dystrophy 1., Maxime Cadieux-Dion, Isabelle Thiffault, Midhat S. Farooqi, Joseph Alaimo

Research Days

No abstract provided.

Implementation Of A Computer-Vision System As A Supportive Diagnostic Tool For Parkinson’S Disease, Diego Machado Reyes

Honors Theses

Parkinson’s disease is the second most common neurodegenerative disorder, affecting nearly 1 million people in the US and it is predicted that the number will keep increasing. Parkinson’s disease is difficult to diagnose due to its similarity with other diseases that share the parkinsonian symptoms and the subjectivity of its assessment, thus increasing the probabilities of misdiagnosis. Therefore, it is relevant to develop diagnostic tools that are quantitatively based and monitoring tools to improve the patient’s quality of life. Computer-based assessment systems have shown to be successful in this field through diverse approaches that can be classified into two main …

Novel Detection And Treatment Strategies For Pancreatic Ductal Adenocarcinoma, Joseph Carmicheal

Theses & Dissertations

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies with an estimated 5-year survival rate of less than 9%. The high lethality of PDAC is due to two primary reasons: the discovery of PDAC at later stages, with locally invasive or metastatic disease present at the time of initial diagnosis as well as the lack of efficacious therapeutic interventions that significantly impact survival. In this dissertation, we sought to discover and test novel detection and treatment strategies for PDAC. Firstly, serum EVs were investigated as potential non-invasive liquid biopsy biomarkers, to serve as a means of early cancer …