Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Digging Deeper: Quality Of Patient-Provider Communication Across Hispanic Subgroups, Lorraine S. Wallace, Jennifer E. Devoe, Edwin S. Rogers, Joanne Protheroe, Gillian Rowlands, George E. Fryer

Faculty Publications and Other Works -- UT Graduate School of Medicine

Background

Recent research suggests that ethnic subgroup designation plays an important role in health-related disparities among Hispanics. Our objective was to examine the influence of Hispanics' self-reported ethnic subgroup designation on perceptions of their health care providers' communication behaviors.

Methods

Cross-sectional analysis of the 2005 Medical Expenditure Panel Survey (MEPS). Participants included non-institutionalized Hispanics (n = 5197; US population estimate = 27,070,906), aged ≥18 years, reporting visiting a health care provider within the past 12 months. Six (n = 6) items were used to capture respondents' perceptions of their health care providers' communication behaviors.

Results

After controlling for socio-demographic covariates, …

A Neural-Genetic Algorithm For Feature Selection And Breast Abnormality Classification In Digital Mammography, Ping Zhang, Brijesh Verma, Kuldeep Kumar

Kuldeep Kumar

Digital mammography is one of the most suitable methods for early detection of breast cancer. It uses digital mammograms to find suspicious areas. However, it is very difficult to distinguish benign and malignant cases, especially for the small size lesions in the early stage of cancer. This is reflected in the high percentage of unnecessary biopsies that are performed and many deaths caused by late detection or misdiagnosis. A computer based feature selection and classification system can provide a second opinion to the radiologists. This work proposes a neural-genetic algorithm for feature selection in conjunction with neural network based classifier. …

Neural Vs Statistical Classifier In Conjunction With Genetic Algorithm Feature Selection In Digital Mammography, Ping Zhang, Brijesh Verma, Kuldeep Kumar

Kuldeep Kumar

Digital mammography is one of the most suitable methods for early detection of breast cancer. It uses digital mammograms to find suspicious areas containing benign and malignant microcalcifications. However, it is very difficult to distinguish benign and malignant microcalcifications. This is reflected in the high percentage of unnecessary biopsies that are performed and many deaths caused by late detection or misdiagnosis. A computer based feature selection and classification system can provide a second opinion to the radiologists in assessment of microcalcifications. The research proposes and investigates a neural-genetic algorithm for feature selection in conjunction with neural and statistical classifiers to …

Automatic Exposure Control And Estimation Of Effective System Noise In Diffuse Fluorescence Tomography, Dax L. Kepshire, Hamid Dehghani, Frederic Leblond, Brian W. Pogue

Dartmouth Scholarship

A diffuse fluorescence tomography system, based upon time-correlated single photon counting, is presented with an automated algorithm to allow dynamic range variation through exposure control. This automated exposure control allows the upper and lower detection levels of fluorophore to be extended by an order of magnitude beyond the previously published performance and benefits in a slight decrease in system effective noise. The effective noise level is used as a metric to characterize the system performance, integrating both model-mismatch and calibration bias errors into a single parameter. This effective error is near 7% of the reconstructed fluorescent yield value, when imaging …

Charge Switch Nucleotides, John G. K. Williams, Gregory R. Bashford, Jiyan Chen, Dan Draney, Nara Narayanan, Bambi Reynolds, Pamela Sheaff

Biomedical Imaging and Biosignal Analysis Laboratory

The present invention provides compounds, methods and systems for sequencing nucleic acid using single molecule detection. Using labeled NPs that exhibit charged-switching behavior, single-molecule DNA sequencing in a microchannel sorting system is realized. In operation, sequencing products are detected enabling real-time sequencing as successive detectable moieties flow through a detection channel. By electrically sorting charged molecules, the cleaved product molecules are detected in isolation Without interference from unincorporated NPs and Without illuminating the polymerase-DNA complex.

Effect Of Donor Ethnicity On Kidney Survival In Different Recipient Pairs: An Analysis Of The Optn/Unos Database., C O. Callender, W S. Cherikh, P Traverso, A Hernandez, Tolulope A. Oyetunji, D Chang

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Previous multivariate analysis performed between April 1, 1994, and December 31, 2000 from the Organ Procurement Transplant Network/United Network for Organ Sharing (OPTN/UNOS) database has shown that kidneys from black donors were associated with lower graft survival. We compared graft and patient survival of different kidney donor-to-recipient ethnic combinations to see if this result still holds on a recent cohort of US kidney transplants.

METHODS: We included 72,495 recipients of deceased and living donor kidney alone transplants from 2001 to 2005. A multivariate Cox regression method was used to analyze the effect of donor-recipient ethnicity on graft and patient …

Chitosan/Ellagic Acid Composite Materials For Local Cancer Therapy, Sung Woo Kim

Theses and Dissertations (ETD)

Current advances in the drug delivery have improved the therapeutic efficacy of the drug and minimized risks of side effects associated with toxicity of the drug. Implantable polymeric delivery system has gained increasing attentions for controlled drug release and localized treatments. In comparison to conventional chemotherapy, polymeric delivery systems are implantable at a local targeted site and biodegradable after a sufficient therapeutic span. The objectives of this project were to fabricate and characterize an implantable polymeric vehicle for a local chemotherapy and investigate its biological properties against cancer cells including human WM115 melanoma, human U87 glioblastoma, and rat C6 glioma …

Diagnosis In General Practice: Using Probabilistic Reasoning, Jenny Doust

Jenny Doust

Diagnostic tests—whether clinical signs, imaging, or laboratory tests—are imperfect: there is always a possibility that test results are inaccurate and our diagnosis is wrong. However, we need to make decisions about whether to treat or not to treat patients, and so we need to feel confident that our diagnosis is above a certain threshold before we decide to treat a patient and below a certain threshold if we decide to withhold treatment. The threshold depends on the disease and the potential harms and benefits of treating or not treating patients. Unless we have clear strategies to cope with the uncertainties …

Parent- Versus Child-Reported Functional Health Status After The Fontan Procedure., Linda M. Lambert, L Luann Minich, Jane W. Newburger, Minmin Lu, Victoria L. Pemberton, Ellen A. Mcgrath, Andrew M. Atz, Mingfen Xu, Elizabeth Radojewski, Darlene Servedio, Brian W. Mccrindle, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: We sought to compare perceptions of functional health status between children who had undergone a Fontan procedure and their parents.

METHODS: Fontan procedure survivors 10 to 18 years of age were included in the study if the child completed the Child Health Questionnaire (CHQ) and the parent completed the parent form to assess the child's functional health status. Comparisons were made between raw domain scores for the parent- and child-completed CHQs.

RESULTS: Between March 2003 and April 2004, 1078 Fontan survivors were screened. Of the 546 eligible and consented patients, 354 were 10-18 years of age and 328 parent/child …

Wnt Pathway Reprogramming During Human Embryonal Carcinoma Differentiation And Potential For Therapeutic Targeting, Grace E. Snow, Allison C. Kasper, Alexander M. Busch, Elisabeth Schwarz, Katherine E. Ewings, Thomas Bee, Michael J. Spinella, Ethan Dmitrovsky, Sarah J. Freemantle

Dartmouth Scholarship

Testicular germ cell tumors (TGCTs) are classified as seminonas or non-seminomas of which a major subset is embryonal carcinoma (EC) that can differentiate into diverse tissues. The pluripotent nature of human ECs resembles that of embryonic stem (ES) cells. Many Wnt signalling species are regulated during differentiation of TGCT-derived EC cells. This study comprehensively investigated expression profiles of Wnt signalling components regulated during induced differentiation of EC cells and explored the role of key components in maintaining pluripotency.

Statistical Hypothesis Testing For Postreconstructed And Postregistered Medical Images, Eugene Demidenko

Dartmouth Scholarship

Postreconstructed and postregistered medical images are typically treated as the raw data, implicitly assuming that those operations are error free. We question this assumption and explore how the precision of reconstruction and affine registration can be assessed by the image covariance matrix and confidence interval, called the confidence eigenimage, using a statistical model-based approach. Various hypotheses may be tested after image reconstruction and registration using classical statistical hypothesis testing vehicles: Is there a statistically significant difference between images? Does the intensity at a specific location or area of interest belong to the “normal” range? Is there a tumor? Does the …

Using Cone Beam Computed Tomography To Identify A Prediction Model For Obstructive Sleep Apnea, Jodi Parker

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Obstructive Sleep Apnea (OSA) patients have increased risk of morbidity and mortality. Early diagnosis may reduce morbidity and mortality. Prediction of OSA from imaging may help to identify OSA patients earlier in life. CBCT can be used for OSA diagnostic imaging due to its three-dimensional (3D) visualization of the upper airway and craniofacial complex. Magnification associated with conventional 2D radiography is eliminated with CBCT, and radiation to the patient is significantly less than previous modalities used to measure craniofacial & airway measurements associated with OSA. During a CBCT scan, the patient's image is taken supine, rather than the upright …

Sleep-Disordered Breathing Affects Auditory Processing In 5–7 Year-Old Children: Evidence From Brain Recordings, Alexandra P.F. Key, Dennis L. Molfese, Louise O’Brien, David Gozal

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Poor sleep in children is associated with lower neurocognitive functioning and increased maladaptive behaviors. The current study examined the impact of snoring (the most common manifestation of sleep-disordered breathing) on cognitive and brain functioning in a sample of 35 asymptomatic children ages 5–7 years identified in the community as having habitual snoring (SDB). All participants completed polysomnographic, neurocognitive (NEPSY) and psychophysiological (ERPs to speech sounds) assessments. The results indicated that sub-clinical levels of SDB may not necessarily lead to reduced performance on standardized behavioral measures of attention and memory. However, brain indices of speech perception and discrimination (N1/P2) are sensitive …

Observer Reliability Of Cephalometric Landmark Identification On 3-D Mr Images, Michael S. Pollack

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Cephalometric analysis is a cornerstone of orthodontic diagnosis, yet much information is lost when 3-dimensional structures are assessed with 2-dimensional methods. CBCT offers 3-dimensional imaging but at the cost of higher levels of ionizing radiation. Magnetic resonance imaging provides 3-dimensional imaging without ionizing radiation and additionally imparts visualization of soft tissue structures. Prior to employing MR images for cephalometric analysis, reliability of landmark identification must be assessed. The purpose of this study was to evaluate intra- and interobserver reliability in 3-dimensional landmark identification using MR images.

Materials and Methods: Fifteen cranial MR images (3.0 T, MP-RAGE) from subjects between …

Effects Of Functional Appliances On The Tmj And Mandibular Length Of Skeletal Class Ii Patients: A Cone Beam Computed Tomography Study, David C. Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Functional appliances have been efficiently used in the treatment of Class II malocclusions caused by retrognathic mandibles. Cone beam computed tomography has enabled us to make more accurate linear measurements by eliminating superimposition of other structures and to analyze skeletal anatomic detail in all three planes of space. This retrospective study evaluated the osseous changes in the temporomandibular joint (TMJ) and length of the mandible in skeletal Class II malocclusion patients treated with the fixed functional appliances and compared measurements with Class I malocclusion patients treated with orthodontic mechanics that did not alter skeletal relationships.

Materials and Methods: Twelve …

Operations Research Methods For Optimization In Radiation Oncology, M Ehrgott, Allen Holder

Mathematical Sciences Technical Reports (MSTR)

Operations Research has a successful tradition of applying mathematical analysis to a wide range of applications, with one of the burgeoning areas of growth being in medical physics. The original application was in the optimal design of the influence map for a radiotherapy treatment, a problem that has continued to receive attention. However, operations research has been applied to other clinical problems like patient scheduling, vault design, and image alignment. The overriding theme of this article is to present how techniques in operations research apply to clinical problems, which we accomplish in three parts. First, we present the perspective from …

Acute Respiratory Infections, Sharon Sanders, Jenny Doust, Chris Del Mar

Jenny Doust

Extract: Acute respiratory infections may be classified in several different ways: by their symptoms (fever, sore throat, cough, ear pain, runny nose); by their clinical manifestations (coryza, pharyngitis, tonsillitis, epiglottitis, otitis media, influenza, bronchitis, pneumonia); or by causative organism. Furthermore, their symptoms and sometimes the whole clinical picture may be shared by conditions that are not infections (asthma, allergic rhinitis). Some of this complexity is shown in Figure 46.1. Elucidating the exact location or responsible organism is usually clinically unhelpful. In this chapter, we focus on diagnostic questions that have the greatest impact on the patient with an acute respiratory …

Acute Respiratory Infections, Sharon Sanders, Jenny Doust, Chris Del Mar

Christopher Del Mar

Extract: Acute respiratory infections may be classified in several different ways: by their symptoms (fever, sore throat, cough, ear pain, runny nose); by their clinical manifestations (coryza, pharyngitis, tonsillitis, epiglottitis, otitis media, influenza, bronchitis, pneumonia); or by causative organism. Furthermore, their symptoms and sometimes the whole clinical picture may be shared by conditions that are not infections (asthma, allergic rhinitis). Some of this complexity is shown in Figure 46.1. Elucidating the exact location or responsible organism is usually clinically unhelpful. In this chapter, we focus on diagnostic questions that have the greatest impact on the patient with an acute respiratory …

Artificial Intelligence – I: A New Hybrid Agent-Based Modeling & Simulation Decision Support System For Breast Cancer Data Analysis, Amnah Siddiqa, Muaz Niazi, Farah Mustafa, Habib Bokhari, Amir Hussain, Noreen Akram, Shabnum Shaheen, Fouzia Ahmed, Sarah Iqbal

International Conference on Information and Communication Technologies

In this paper, we present a novel technique of building hybrid decision support systems which integrates traditional decision support systems with agent based models for use in breast cancer analysis for better prediction and recommendation. Our system is based on using queries from data (converted to a standardized electronic template) to provide for simulation variables in an agent-based model. The goal is to develop an ICT tool to assist non-specialist biologist researcher users in performing analysis of large amounts of data by applying simple simulation techniques. To demonstrate the effectiveness of this novel decision support system, an extensive breast cancer …

Issues For Dsm-V: The Role Of Culture In Psychiatric Diagnosis, Renato D. Alarcón, Anne E. Becker, Roberto Lewis-Fernández, Robert C. Like, Prakash Desai, Edward Foulks, Junius Gonzales, Helena Hansen, Alex Kopelowicz, Francis G. Lu, María A. Oquendo, Annelle Primm

Publications from Provost Junius J. Gonzales

No abstract provided.

A Clustering Approach For Optimizing Beam Angles In Imrt Planning, Gino J. Lim, Allen Holder, Josh Reese

Mathematical Sciences Technical Reports (MSTR)

In this paper we introduce a p-median problem based clustering heuristic for selecting efficient beam angles for intensity-modulated radiation therapy. The essence of the method described here is the clustering of beam angles according to probability that an angle will be observed in the final solution and similarities among different angles and the selection of a representative angle from each of the p resulting cluster cells. We conduct experiments using several combinations of modeling parameters to find the conditions where the heuristic best performs. We found a combination of such parameters that outperformed all other parameters on three of the …

Functional State Following The Fontan Procedure., Ismee A. Williams, Lynn A. Sleeper, Steven D. Colan, Minmin Lu, Elizabeth A. Stephenson, Jane W. Newburger, Welton M. Gersony, Meryl S. Cohen, James F. Cnota, Andrew M. Atz, Richard V. Williams, Renee Margossian, Andrew J. Powell, Mario P. Stylianou, Daphne T. Hsu, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Despite improvements in outcomes after completion of the Fontan circulation, long-term functional state varies. We sought to identify pre- and postoperative characteristics associated with overall function.

METHODS AND RESULTS: We analyzed data from 476 survivors with the Fontan circulation enrolled in the Pediatric Heart Network Fontan Cross-sectional Study. Mean age at creation of the Fontan circulation was 3.4 plus or minus 2.1 years, with a range from 0.7 to 17.5 years, and time since completion was 8.7 plus or minus 3.4 years, the range being from 1.1 to 17.3 years. We calculated a functional score for the survivors by …

Nanofiber Scaffolds With Gradations In Mineral Content For Mimicking The Tendon-To-Bone Insertion Site, Xiaoran Li, Jingwei Xie, Justin Lipner, Xiaoyan Yuan, Stavros Thomopoulos, Younan Xia

MIIR Faculty Research

We have demonstrated a simple and versatile method for generating a continuously graded, bonelike calcium phosphate coating on a nonwoven mat of electrospun nanofibers. A linear gradient in calcium phosphate content could be achieved across the surface of the nanofiber mat. The gradient had functional consequences with regard to stiffness and biological activity. Specifically, the gradient in mineral content resulted in a gradient in the stiffness of the scaffold and further influenced the activity of mouse preosteoblast MC3T3 cells. This new class of nanofiberbased scaffolds can potentially be employed for repairing the tendon-to-bone insertion site via a tissue engineering approach.

Field Testing Adolescent Females For Cardiovascular Disease Risk, C. Jayne Brahler, Wesley R. Stephens, Betsy Donahoe Fillmore

Physical Therapy Faculty Publications

Over-fatness and poor cardiovascular (CV) fitness are well-documented risk factors for cardiovascular disease (CVD) in adults, but less is known about their association with disease risk in adolescents. This study aimed to determine the relationship between anthropometrics, fitness, and CVD risk.

Six anthropometric indicators of body fatness, seven measures of fitness, and seven metabolic and hemodynamic CVD risk factors were measured in a convenience sample of 28 female high school students (15-18 years of age). A tally was made of the number of factors for which each subject was outside the normal reference range (CVD risk).

Correlation analyses were completed …

The Role Of Inflammation In The Early Radiation Response, Christy Marie Wilson

Theses and Dissertations (ETD)

Radiation is one of the principal treatments for adults and children with brain tumors, and is one of the oldest established treatments for tumors of all types. Currently, the limiting factor for the use of radiation is the effect on normal tissue adjacent to the tumor. Toxicity, including early and late effects from radiation, limits the dose administered to the tumor and reduces the probability of cure. This work has three aims in its attempt to understand and limit early radiation damage: characterize the role of the inflammatory molecules tumor necrosis factor alpha (TNF) and intracellular adhesion molecule-1 (ICAM-1) in …

The Use Of Spectroscopic Techniques In The Characterization Of Mycobacterial Metabolites, Engy Abdelhameed Mahrous

Theses and Dissertations (ETD)

The mycobacterial cell wall metabolites have always imposed great challenges to researchers due to their unusual complexity and structural diversity. A lot of research efforts have been directed towards the evaluation of these metabolites and the role they play in the pathogenesis and virulence of different serious human pathogens including Mycobacterium tuberculosis the causative agent of tuberculosis (TB). In the genomic era, it is crucial to develop new methodologies to analyze these components from a global perspective in a comprehensive and well-validated manner.

Towards this end, we developed a rapid NMR-based approach to produce metabolic profiles in the form of …

Diffusion Tensor Imaging In Pediatric Brain Tumor Patients, Nicholas S. Phillips

Theses and Dissertations (ETD)

In this dissertation, we outline our efforts to introduce an advanced MRI imaging technique called Diffusion Tensor Imaging (DTI) to the pediatric brain tumor population. We discuss the theory and application of DTI as it was performed in a series of translational investigations at St. Jude Children’s Research Hospital. We present evidence of how the introduction of this technique impacted diagnosis, and treatment. And finally, we demonstrate how DTI was used to investigate cognitive morbidities associated with cancer treatment and how this research provided insight into the underlying pathophysiology involved in the development of these treatment sequela.

This research has …

Spatial Resolution Analysis Of A Variable Resolution X-Ray Cone-Beam Computed Tomography System, Bahram Dahi

Theses and Dissertations (ETD)

A new cone-beam computed tomography (CBCT) system is designed and implemented that can adaptively provide high resolution CT images for objects of different sizes. The new system, called Variable Resolution X-ray Cone-beam CT (VRX-CBCT) uses a CsI-based amorphous silicon flat panel detector (FPD) that can tilt about its horizontal (u) axis and vertical (v) axis independently. The detector angulation improves the spatial resolution of the CT images by changing the effective size of each detector cell. Two components of spatial resolution of the system, namely the transverse and axial modulation transfer functions (MTF), are analyzed in …

Feasibility Study Of Liquid-Based Cytology For Post-Treatment Surveillance Of Patients With Vulvar Intraepithelial Neoplasia, Wendy Likes

Theses and Dissertations (ETD)

Introduction: Colposcopy and tissue biopsy remain the gold standard for diagnosing vulvar intraepithelial neoplasia (VIN). Vulvar colposcopy is fairly nonspecific. As a result, many women undergo unwarranted painful biopsies. Vulvar cytology, which is relatively painless, inexpensive and allows a larger area to be sampled, may likely reduce false negative diagnoses. However, previous cytological studies that used conventional methodologies were largely unsuccessful in diagnosing VIN. In this study, liquid based cytology and HPV typing by PCR have been assessed as possible alternatives to biopsy for follow-up surveillance of women treated for VIN.

Methods: Women with a history of VIN and a …

Biomechanical Comparison Of Lumbar Disc Replacements, Peter Wong

Theses and Dissertations (ETD)

Surgical options for lumbar spinal disorders are rapidly expanding. One seemingly promising area is the lumbar disc replacement. Design specifications vary among the manufacturers based upon differing perceptions of ideal motion. Comparison studies are important in quantifying different features for future improvements but are currently lacking. The objective of this study was to compare the biomechanical properties of three currently available treatments: disc replacement with ProDisc-L, disc replacement with Maverick, and a pedicle screw fixation. It was hypothesized that structural designs differences of ProDisc-L and Maverick could be distinguished in both motion and loading patterns. It was also hypothesized that …