Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Prediction Of Anal Cancer Recurrence After Chemoradiotherapy Using Quantitative Image Features Extracted From Serial (18)F-Fdg Pet/Ct, Michael Chuong

Michael Chuong

No abstract provided.

Proton Pump Inhibitors Increase The Severity Of Hepatic Encephalopathy In Cirrhotic Patients, Matthew J. Fasullo, Prashanth Rau, Dong-Qi Liu, Erik Holzwanger, Jomol Mathew, Yurima Guilarte-Walker, Gyongyi Szabo

Gyongyi Szabo

BACKGROUND: Liver cirrhosis is the late stage of hepatic fibrosis and is characterized by portal hypertension that can clinically lead to decompensation in the form of ascites, esophageal/gastric varices or encephalopathy. The most common sequelae associated with liver cirrhosis are neurologic and neuropsychiatric impairments labeled as hepatic encephalopathy (HE). Well established triggers for HE include infection, gastrointestinal bleeding, constipation, and medications. Alterations to the gut microbiome is one of the leading ammonia producers in the body, and therefore may make patients more susceptible to HE.

AIM: To investigate the relationship between the use of proton pump inhibitors (PPIs) and HE …

Robustness Of A Newly Proposed Risk Schema For Lymphatic Dissemination In Endometrioid Endometrial Cancer, Danielle M. Greer, Jessica J.F. Kram, Callie M. Cox Bauer, Scott A. Kamelle

Aurora Ob/Gyn Faculty

Background: Surgical management for endometrioid endometrial cancer (EEC) includes complete lymph node dissection for all patients at risk of lymphatic dissemination. The standard risk schema, defined by Mayo Clinic, identifies low-risk patients as those with grade 1/2 EEC, myometrial invasion (MI) ≤ 50%, and tumor diameter (TD) ≤ 2 cm. We recently proposed (and published) a risk schema containing modified forms of grade, MI and TD that suggests a significant decrease in false-negative rate and need for lymphadenectomy in low-risk women.

Purpose: Evaluate robustness of our proposed schema for lymphatic dissemination risk stratification in a subsequent EEC patient cohort.

Methods: …

Segmental Distribution Of Hepatocellular Carcinoma Correlates With Microvascular Invasion In Liver Explants Undergoing Transplantation, Yasir Al-Azzawai, Eva Rouanet, Ryan J. Hendrix, Lidia Spaho, Hesham Malik, Deepika Devuni, Gyongyi Szabo, Graham Barnard

Gyongyi Szabo

Introduction: Microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients is a poor prognostic factor after liver transplantation and/or resection. Any correlation between MVI and segmental location of HCC has yet to be studied. Our aim is to evaluate the segmental location of HCC and any correlation with the presence of MVI, portal vein thrombosis (PVT) in explanted livers, and the recurrence of HCC after transplantation. Another objective of the study is to assess the treatment history (ablation or transarterial chemoembolization (TACE)) and size of the tumor with respect to the risk of MVI.

Methods: A single center, retrospective chart review, …

Changes In Anticoagulant Utilization Among United States Nursing Home Residents With Atrial Fibrillation From 2011 To 2016, Matthew Alcusky, David D. Mcmanus, Anne L. Hume, Marc Fisher, Jennifer Tjia, Kate L. Lapane

Jennifer Tjia

Background: Nursing home residents with atrial fibrillation are at high risk for ischemic stroke and bleeding events. The most recent national estimate (2004) indicated less than one third of this high-risk population was anticoagulated. Whether direct-acting oral anticoagulant ( DOAC ) use has disseminated into nursing homes and increased anticoagulant use is unknown.

Methods and Results: A repeated cross-sectional design was used to estimate the point prevalence of oral anticoagulant use on July 1 and December 31 of calendar years 2011 to 2016 among Medicare fee-for-service beneficiaries with atrial fibrillation residing in long-stay nursing homes. Nursing home residence was determined …

Management Of Patients With Brain Metastases From Non-Small Cell Lung Cancer And Adverse Prognostic Features: Multi-National Radiation Treatment Recommendations Are Heterogeneous, Minesh Mehta

Minesh Mehta

No abstract provided.

National Pancreatic Fistula Rates After Minimally Invasive Pancreaticoduodenectomy Are Improving With Time: A Nsqip Analysis, Horacio Asbun

Horacio J. Asbun

No abstract provided.

Characterizing The Recovery Trajectories Of Knee Range Of Motion For One Year After Total Knee Replacement, Saurabh Mehta, Andrew Rigney, Kyle Webb, Jacob Wesney, Paul W. Stratford, Franklin D. Shuler, Ali Oliashirazi

Franklin D. Shuler

DESIGN: Retrospective analysis of routinely collected clinical data.

OBJECTIVE: This study modeled the recovery in knee flexion and extension range of motion (ROM) over 1 year after total knee replacement (TKR).

BACKGROUND: Recovery after TKR has been characterized for self-reported pain and functional status. Literature describing target knee ROM at different follow-up periods after TKR is scarce.

METHODS: Data were extracted for patients who had undergone TKR at a tertiary care hospital at 2, 8, 12, 26, and 52 weeks after TKR. A linear mixed-effects growth model was constructed that investigated the following covariates age, sex, pre-TKR range, body mass …

Bridging From Intramuscular To Limb Perfusion Delivery Of Raav: Optimization In A Non-Human Primate Study, Alisha Gruntman, Gwladys Gernoux, Qiushi Tang, Guo-Jie Ye, Dave R. Knop, Gensheng Wang, Janet Benson, Kristen E. Coleman, Allison M. Keeler, Christian Mueller, Louis G. Chicoine, Jeffrey D. Chulay, Terence R. Flotte

Christian Mueller

Phase 1 and phase 2 gene therapy trials using intramuscular (IM) administration of a recombinant adeno-associated virus serotype 1 (rAAV1) for replacement of serum alpha-1 antitrypsin (AAT) deficiency have shown long-term (5-year) stable transgene expression at approximately 2% to 3% of therapeutic levels, arguing for the long-term viability of this approach to gene replacement of secreted serum protein deficiencies. However, achieving these levels required 100 IM injections to deliver 135 mL of vector, and further dose escalation is limited by the scalability of direct IM injection. To further advance the dose escalation, we sought to bridge the rAAV-AAT clinical development …

Role Of Serum Biomarkers In Early Detection Of Diabetic Cardiomyopathy In The West Virginian Population, Adam Shaver, Alexandra Nichols, Ellen A. Thompson, Amrita Mallick, Nandini Manne, Shanmuga Sundaram, Joseph I. Shapiro Md, Komal Sodhi

Joseph I Shapiro MD

Objectives: Diabetic cardiomyopathy (DCM) is an established complication of diabetes mellitus. In West Virginia, the especially high incidence of diabetes and heart failure validate the necessity of developing new strategies for earlier detection of DCM. Since most DCM patients remain asymptomatic until the later stages of the disease when the fibrotic complications become irreversible, we aimed to explore biomarkers that can identify early-stage DCM.

Methods: The patients were grouped into 4 categories based on clinical diabetic and cardiac parameters: Control, Diabetes (DM), Diastolic dysfunction (DD), and Diabetes with diastolic dysfunction (DM+DD), the last group being the preclinical DCM group.

Results: …

Role Of Serum Biomarkers In Early Detection Of Diabetic Cardiomyopathy In The West Virginian Population, Adam Shaver, Alexandra Nichols, Ellen A. Thompson, Amrita Mallick, Nandini Manne, Shanmuga Sundaram, Joseph I. Shapiro Md, Komal Sodhi

Komal Sodhi

Objectives: Diabetic cardiomyopathy (DCM) is an established complication of diabetes mellitus. In West Virginia, the especially high incidence of diabetes and heart failure validate the necessity of developing new strategies for earlier detection of DCM. Since most DCM patients remain asymptomatic until the later stages of the disease when the fibrotic complications become irreversible, we aimed to explore biomarkers that can identify early-stage DCM.

Methods: The patients were grouped into 4 categories based on clinical diabetic and cardiac parameters: Control, Diabetes (DM), Diastolic dysfunction (DD), and Diabetes with diastolic dysfunction (DM+DD), the last group being the preclinical DCM group.

Results: …

Superior Episodic Memory Is Associated With Interhemispheric Processing, Ruth E. Propper, Stephen D. Christman

Ruth Propper

The dependence of episodic memories on interhemispheric processing was tested. In Experiment 1, positive familial sinistrality (FS+; e.g., the presence of left-handed relatives) was associated with superior episodic memory and inferior implicit memory in comparison with negative familial sinistrality (i.e., FS-). This reflected a greater degree of interhemispheric interaction in FS+ participants, which was hypothesized as facilitating episodic memory. In Experiment 2, the authors directly manipulated inter- versus intrahemispheric processing using tests of episodic (recognition) and semantic (lexical decision) memory in which letter strings were presented twice within trial blocks. Semantic memory was superior when the 2nd presentation went to …

Effect Of Exercise Position On Percent Changes In Serratus Anterior Muscle Thickness, Joseph M. Day

Joseph M. "Matt" Day

Objective: A reliable method for measuring SA thickness with ultrasound imaging has been reported, yet the ability to detect differences in levels of contractility has yet to be established. The purpose of this study was to determine if there are differences in the percent change in thickness of the SA during four different exercise positions performed by healthy individuals.

Design: Observational study

Setting: Laboratory

Participants: Twenty-eight healthy participants, mean age 26 (SD 4, 57% female, 100% right handed)

Methods: Volunteers were positioned in a standardized sitting posture and anatomical landmarks were marked for ultrasound probe positioning. Two resting and two …

Characterizing The Recovery Trajectories Of Knee Range Of Motion For One Year After Total Knee Replacement, Saurabh Mehta, Andrew Rigney, Kyle Webb, Jacob Wesney, Paul W. Stratford, Franklin D. Shuler, Ali Oliashirazi

Ali Oliashirazi

DESIGN: Retrospective analysis of routinely collected clinical data.

OBJECTIVE: This study modeled the recovery in knee flexion and extension range of motion (ROM) over 1 year after total knee replacement (TKR).

BACKGROUND: Recovery after TKR has been characterized for self-reported pain and functional status. Literature describing target knee ROM at different follow-up periods after TKR is scarce.

METHODS: Data were extracted for patients who had undergone TKR at a tertiary care hospital at 2, 8, 12, 26, and 52 weeks after TKR. A linear mixed-effects growth model was constructed that investigated the following covariates age, sex, pre-TKR range, body mass …

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Mechanisms Of Left Ventricular Thrombus Formation In Heart Failure With Reduced Ejection Fraction: Novel Insights From Two-Dimensional Speckle Tracking Echocardiography, Dhruv Chawla, Tracy Hammonds, Tadele Mengesha, Matt Umland, Khawaja Afzal Ammar, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

Background: Patients suffering from heart failure with reduced ejection fraction (HFrEF) are at increased risk for left ventricular (LV) thrombus and subsequent thromboembolism, yet anticoagulation is not routinely recommended for left ventricular ejection fraction (LVEF) alone. We sought to determine the role of two-dimensional speckle tracking echocardiography (2D-STE) to quantify regional changes in cardiac function associated with LV thrombus, which may prospectively guide anticoagulation.

Purpose: Help enable cardiovascular clinicians to use 2D-STE to evaluate regional strain patterns among patients with HFrEF with and without LV thrombus. Our results suggest that statistically lower regional longitudinal strain patterns in a well-matched cohort …

Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

Background: Congestive heart failure afflicts 5.7 million people in the United States with annual incidence of 600,000 and mortality of 280,000. Heart failure accounts for greater than 1 million hospitalizations annually and the single largest inpatient Medicare expense. As the U.S. population ages and greater emphasis is placed on population health as a means to bend projected health care expenditures, large health care organizations will need to develop algorithms to identify patients at high risk with heart failure and possibly preempt hospitalizations. Doppler echocardiography is routinely performed in clinical assessment of severe heart failure.

Purpose: We sought to determine echocardiographic …

Limiting Antibiotic Use In Acute Sinusitis: Partly A Matter Of Vocabulary?, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In his issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews comments on an included article that describes the successful use of an electronic medical record best practice alert to reduce the rate of antibiotic prescription for acute sinusitis. Various methods previously tried to improve antibiotic stewardship in this illness are briefly reviewed. Borrowing on the model of acute bronchitis, it is suggested that a change in conveyed diagnostic vocabulary to “sinus cold” when describing acute sinusitis may help limit antibiotics for this predominantly viral infection.

Investigation Of Zebrafish Larvae Behavior As Precursor For Suborbital Flights: Feasibility Study, Pedro Llanos, Kristina Andrijauskaite, Mark Rubinstein, Sherine S.L. Chan

Pedro J. Llanos (www.AstronauticsLlanos.com)

Use Of Urine Antigen Testing For Blastomyces In An Integrated Health System, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Purpose: Blastomycosis, an endemic fungal infection, mimics many other diseases. We explored the use of Blastomyces urine antigen (BuAg), reportedly the most sensitive noninvasive test, in clinical practice and compared it to other noninvasive tests.

Methods: A total of 836 BuAg tests performed on unique patients (first test only) at one large integrated health system from June 2013 to May 2016 were retrospectively reviewed to examine test characteristics and demographic features. Of these, 100 cases from 2015, a year containing a large local blastomycosis outbreak, were randomly selected for detailed analysis.

Results: Demographics for the BuAg-tested population: mean age 54.9 …

Designing A Mobile Application To Support The Indicated Prevention And Early Intervention Of Childhood Anxiety, Mandar Patwardhan, Ashish Amresh, Ryan Stoll, Kevin A. Gary, Derek B. Hamel, Armando Pina

Ashish Amresh

This paper presents the design of an mHealth application for prevention and early intervention of childhood anxiety. The application is based on REACH, a preventative-early intervention protocol for childhood anxiety. This paper describes the multidisciplinary design process, sharing lessons learned in developing an effective mHealth application. This mHealth application is unique due to participant age, preventive-early intervention focus, and utilization of mobile technology in a situated manner. A design process inspired by user-centered leveraging key informant interviews was used to identify application features, including game based strategies and an animated motivational avatar. Validation was performed through external review and a …

Make Your Garden Grow: Designing A Physical Activity Estimation Improvement Game, Ashish Amresh, Leigh Small

Ashish Amresh

We present a novel game and virtual world based application that is aimed at improving the physical activity estimation skills of parents. It has been well established that lack of proper estimation of preschool children’s activity levels may be one of the main causes for childhood obesity. Childhood obesity has several long term health effects ranging from cardio-vascular disease to type II diabetes and obese preschool children are at risk for later life. We have developed an application that caters to both the parent and the child and uses a virtual garden as a fledgling ecosystem controlled both by the …

Interactive Cause And Effect Comic-Book Storytelling For Improving Nutrition Outcomes In Children, Ashish Amresh, Madhumita Sinha, Rebecca Birr, Rahul Salla

Ashish Amresh

Obesity among children and adolescents is increasingly becoming a major public health problem. Poverty and lower socio-economic status as well as lack of parental awareness regarding a balanced diet and adequate exercise all contribute towards childhood obesity. Unfortunately minority children have been especially vulnerable, among them inner-city Latino children continue to have the highest incidence rates of overweight and obesity; hence targeted intervention for this population group is of paramount importance. Access and affordability of smartphones and mobile internet devices provide an opportunity to create nutrition education interventions that can significantly impact and change attitude and knowledge regarding healthy diet …

Developing A Bilingual, Computer-Tailored, Hpv Vaccination Promotion Intervention Targeting Latino Parents, Angela Chia-Chen Chen, Ashish Amresh

Ashish Amresh

In this paper we present an innovative, computer-tailored application aimed at increasing Latino parents' intention to vaccinate their adolescent children against Human Papilloma Virus (HPV). HPV infection is the most common sexually transmitted infection in the United States. Latinas have the highest age-adjusted incidence rate for HPV-associated cervical cancer compared with their counterparts in other racial/ethnic groups. HPV vaccines offer hope against HPV-associated diseases. Because parental consent is required for children under age 18 to receive t h e HPV vaccination in most U. S. states, parents' attitudes and intention to have their children vaccinated are keys for promoting HPV …

A Complex Systems Framework Approach Towards Multidisciplinary Tumor Boards, Rahul Salla, Robert Pahle, Ashish Amresh

Ashish Amresh

Multidisciplinary tumor boards (MTBs) are universally recommended and have been used in treatment of late stage cancers. Tumor boards have the advantage of including all the stakeholders in the decision making process and improving quality of care, however several studies have pointed to their lack of efficiency and tend to be lackluster while not producing the desired benefits for the participants. In this paper we present the design of a web based immersive framework for collaborative decision making that has the potential to improve several inefficiencies in conducting tumor boards and improve overall clinical outcomes. We present the design of …

Hyperpolarization Of Silicon Nanoparticles With Tempo Radicals, Jingzhe Hu, Nicholas Whiting, Pratip Bhattacharya

Nicholas Whiting