Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Quantity Over Quality—Findings From A Systematic Review And Environmental Scan Of Patient Decision Aids On Early Abortion Methods, Kyla Z. Donnelly, Glyn Elwyn, Rachel Thompson

Dartmouth Scholarship

Background: The availability and effectiveness of decision aids (DAs) on early abortion methods remain unknown, despite their potential for supporting women’s decision making. Objective: To describe the availability, impact and quality of DAs on surgical and medical early abortion methods for women seeking induced abortion. Search strategy: For the systematic review, we searched MEDLINE, Cochrane Library, CINAHL, EMBASE and PsycINFO. For the environmental scan, we searched Google and App Stores and consulted key informants. Inclusion criteria: For the systematic review, we included studies evaluating an early abortion method DA (any format and language) vs a comparison group on women’s decision …

Intrathecal Administration Of Ayx2 Dna Decoy Produces A Long-Term Pain Treatment In Rat Models Of Chronic Pain By Inhibiting The Klf6, Klf9, And Klf15 Transcription Factors, Julien Mamet, Michael Klukinov, Scott Harris, Donald C. Manning, Simon Xie, Conrado Pascual, Bradley K. Taylor, Renee R. Donahue, David C. Yeomans

Physiology Faculty Publications

Background: Nociception is maintained by genome-wide regulation of transcription in the dorsal root ganglia—spinal cord network. Hence, transcription factors constitute a promising class of targets for breakthrough pharmacological interventions to treat chronic pain. DNA decoys are oligonucleotides and specific inhibitors of transcription factor activities. A methodological series of in vivo–in vitro screening cycles was performed with decoy/transcription factor couples to identify targets capable of producing a robust and long-lasting inhibition of established chronic pain. Decoys were injected intrathecally and their efficacy was tested in the spared nerve injury and chronic constriction injury models of chronic pain in rats using repetitive …

A Preliminary Study Of A Spanish Graphic Novella Targeting Hearing Loss Prevention, Mark Guiberson, Emily Wakefield

Department of Special Education and Communication Disorders: Faculty Publications

Purpose: This preliminary study developed a digital graphic novella targeting hearing protection beliefs of Spanish-speaking agricultural workers. Researchers used pretest–posttest interview surveys to establish if the novella had an immediate influence on the participants’ beliefs about noise-induced hearing loss and usage of hearing protection devices.

Method: Researchers developed a digital graphic novella directed to increase knowledge about noise-induced hearing loss and increase the proper use of hearing protection devices. The novella was tailored to meet the specific linguistic and literacy needs of Spanish-speaking agricultural workers. Thirty-one Spanish-speaking farmworkers of Mexican nationality participated. This study included an interview survey with specific …

Reframing Outcome Measures For Thrombolytics In Acute Ischemic Stroke, Brandon Baker, Charles W. Kropf, Nicholus Yee, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent conversation examining relevant research and discussing the potential benefits and harms of thrombolytic therapy in acute stroke.

Anticoagulation Increases Survival In Patients With Idiopathic Pulmonary Arterial Hypertension, Marvin L. Kajy

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Olsson KM, Delcroix M, Ghofrani HA, et al. Anticoagulation and survival in pulmonary arterial hypertension: Results from the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA). Circulation, 2014;129(1):57-65. doi: 10.1161/CIRCULATIONAHA.113.004526

Investigation Of The Safety Of Focused Ultrasound-Induced Blood-Brain Barrier Opening In A Natural Canine Model Of Aging, Meaghan Anne O'Reilly, Ryan Matthew Jones, Edward Barrett, Anthony P. Schwab, Elizabeth Head, Kullervo Hynynen

Sanders-Brown Center on Aging Faculty Publications

Rationale: Ultrasound-mediated opening of the Blood-Brain Barrier(BBB) has shown exciting potential for the treatment of Alzheimer's disease(AD). Studies in transgenic mouse models have shown that this approach can reduce plaque pathology and improve spatial memory. Before clinical translation can occur the safety of the method needs to be tested in a larger brain that allows lower frequencies be used to treat larger tissue volumes, simulating clinical situations. Here we investigate the safety of opening the BBB in half of the brain in a large aged animal model with naturally occurring amyloid deposits.

Methods: Aged dogs naturally accumulate plaques and show …

Improving Type And Screen Specimen Collection Prior To Elective Surgery, Nordx Blood Bank Staff, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

To avoid delays in the availability of compatible blood for elective surgery patients requiring transfusion, a type and screen specimen should be completed at least 24 hours prior to surgery. Baseline metrics in an acute care inpatient blood bank demonstrated a significant number of cases with no type or screen completed.

The objective of this KPI was to prevent any delays in providing compatible blood products to scheduled surgical patients. Several internal and external system issues were identified as a result of a root cause analysis and a number of actions were initiated.

Outcomes have been positive. Data collection post …

Higher Medication Administration Errors Associated With Automated Dispensing System Usage, Jillian Cramer

Grace Peterson Nursing Research Colloquium

According to a report by The Institute of Medicine, medical errors were associated with up to 98,000 deaths and more than 1 million injuries each year in the United States. These errors can result in poor outcomes, which increase harm or death. According to the Pennsylvania Patient Safety Reporting System, up to 15% of errors reported cite automated dispensing cabinets as the source of the drug involved in the error.Nearly 58% to 70% of hospitals nationwide use automated dispensing cabinets. Nurses play a critical role in promoting patient safety by surveilling and intercepting any possible errors that could occur during …

“Provoking Conversations”: Case Studies Of Organizations Where Option Grid™ Decision Aids Have Become ‘Normalized’, Peter Scalia, Glyn Elwyn, Marie-Anne Durand

Dartmouth Scholarship

Background: Implementing patient decision aids in clinic workflow has proven to be a challenge for healthcare organizations and physicians. Our aim was to determine the organizational strategies, motivations, and facilitating factors to the routine implementation of Option Grid™ encounter decision aids at two independent settings. Method: Case studies conducted by semi-structured interview, using the Normalization Process Theory (NPT) as a framework for thematic analysis. Twenty three interviews with physicians, nurses, hospital staff and stakeholderswere conducted at: 1) CapitalCare Medical Group in Albany, New York; 2) HealthPartners Clinics in Minneapolis, Minnesota. Results: ‘Coherent’ motivations were guided by financial incentives at CapitalCare, …

Cascaded Multi-View Canonical Correlation (Camcco) For Early Diagnosis Of Alzheimer's Disease Via Fusion Of Clinical, Imaging And Omic Features, Asha Singanamalli, Haibo Wang, Anant Madabhushi, Michael Weiner, Paul Aisen, Ronald Petersen, Clifford Jack, William Jagust, John Trojanowki, Arthur Toga, Laurel Beckett, Robert Green, Andrew Saykin, John Morris, Leslie Shaw, Jeffrey Kaye, Joseph Quinn, Lisa Silbert, Betty Lind, Raina Carter, Sara Dolen, Lon Schneider, Sonia Pawluczyk, Mauricio Beccera, Liberty Teodoro, Bryan Spann, James Brewer, Helen Vanderswag, Adam Fleisher, Judith Heidebrink, Charles Smith, Greg A. Jicha, Peter A. Hardy, Partha Sinha, Elizabeth Oates, Gary Conrad

Neurology Faculty Publications

The introduction of mild cognitive impairment (MCI) as a diagnostic category adds to the challenges of diagnosing Alzheimer's Disease (AD). No single marker has been proven to accurately categorize patients into their respective diagnostic groups. Thus, previous studies have attempted to develop fused predictors of AD and MCI. These studies have two main limitations. Most do not simultaneously consider all diagnostic categories and provide suboptimal fused representations using the same set of modalities for prediction of all classes. In this work, we present a combined framework, cascaded multiview canonical correlation (CaMCCo), for fusion and cascaded classification that incorporates all diagnostic …

Influence Of Differential Calcification In The Descending Thoracic Aorta On Aortic Pulse Pressure, Mirza Mujadil Ahmad, Syed Haris Ahmed Pir, Mustafa Noor Muhammad, Sharmeen Hussaini, Immad Arif Kiani, Mirza Nubair Ahmad, Imaad Razzaque, Muhammad Nabeel Syed, Rafath Ullah, Suhail Allaqaband, Anjan Gupta, Steven C. Port, Khawaja Afzal Ammar

Journal of Patient-Centered Research and Reviews

Purpose: Multiple studies have shown pulse pressure (PP) to be a strong predictor of aortic calcification. However, no studies are available that correlate PP with aortic calcification at the segmental level.

Methods: We identified 37 patients with aortic PP measured during cardiac catheterization. Their noncontrast chest computed tomography scans were evaluated for the presence of calcium in different segments (ascending aorta, arch of aorta [arch], descending aorta) and quantified. Patients with calcification (Calcified Group A) were compared against patients without calcification (Noncalcified Group B) in terms of PP, calcification and compliance.

Results: The mean of the total calcium score was …

Higher Midazolam Clearance In Obese Adolescents Compared With Morbidly Obese Adults., Anne Van Rongen, Margreke J E Brill, Janelle D Vaughns, Pyry A J Välitalo, Eric P A Van Dongen, Bert Van Ramshorst, Jeffrey S Barrett, Johannes N Van Den Anker, Catherijne A J Knibbe

Anesthesiology and Critical Care Medicine Faculty Publications

Background

The clearance of cytochrome P450 (CYP) 3A substrates is reported to be reduced with lower age, inflammation and obesity. As it is unknown what the overall influence is of these factors in the case of obese adolescents vs. morbidly obese adults, we studied covariates influencing the clearance of the CYP3A substrate midazolam in a combined analysis of data from obese adolescents and morbidly obese adults.

Methods

Data from 19 obese adolescents [102.7 kg (62–149.5 kg)] and 20 morbidly obese adults [144 kg (112–186 kg)] receiving intravenous midazolam were analysed, using population pharmacokinetic modelling (NONMEM 7.2). In the covariate analysis, …

Diffuse Pulmonary Infiltrates: A Guise Of Adenocarcinoma, Mourad Ismail, Raminderjit Sekhon

NYMC Faculty Publications

Small and non-small cell lung cancer present in a variety of radiologic and clinical patterns, and have been linked to smoking. Primary adenocarcinoma of the lung has been increasingly recognized in females and nonsmokers, often presenting a diagnostic challenge. In the absence of smoking history, these radiographic patterns may be initially misdiagnosed as an infectious or inflammatory condition, often delaying the diagnosis of malignancy. We report two cases of female patients with relatively short or no smoking history presenting with diffuse pulmonary infiltrates not typically seen in primary lung cancer, which created a diagnostic challenge, ultimately diagnosed as primary lung …

Implementation Of An Innovative Early Warning System: Evidenced-Based Strategies For Ensuring System-Wide Nursing Adoption, Shirley S. Paulson

Doctor of Nursing Practice (DNP) Projects

Early deterioration in adult medical-surgical patients is associated with increased intensive care unit and hospital mortality (Goldhill, 2001). Failure to recognize deterioration is a preventable patient safety and quality issue. To address this problem, since 2013, Kaiser Permanente Northern California (KP NCAL) has piloted Advance Alert Monitor (AAM) at two hospitals. This early warning system employs a set of predictive models developed by the KP NCAL Division of Research, which automatically predicts patient deterioration within the next 12 hours based on a complex algorithm of laboratory and clinical data points. Improvements in mortality and length of stay have been realized …

Temporal Resolution Of Cell Death Signaling Events Induced By Cold Atmospheric Plasma And Electroporation In Human Cancer Cells, Danielle M. Krug, Prasoon K. Diwakar, Ahmed Hassanein

The Summer Undergraduate Research Fellowship (SURF) Symposium

Cancer treatment resistance and their invasive and expensive nature is propelling research towards developing alternate approaches to eradicate cancer in patients. Non-thermal, i.e., cold atmospheric plasma (CAP) and electroporation (EP) applied to the surface of cancerous tissue are new methods that are minimally invasive, safe, and selective. These approaches, both independently and synergistically, have been shown to deplete cancer cell populations, but the signaling mechanisms of death and their timelines of action are still widely unknown. To better understand the timeframe of signaling events occurring upon treatment, human cancer cell lines were treated with CAP, EP, and combined CAP with …

Data On The Effect Of Sex On The Size, Cellular Content, And Neuronal Density Of The Developing Brain In Mice Exposed To Isoflurane And Carbon Monoxid, L Wang, A Wang, W W. Supplee, K Koffler, Y Cheng, Z M.N. Quezado, R J. Levy

Anesthesiology and Critical Care Medicine Faculty Publications

The data presented here detail the changes in size, cellular content, and neuronal density of the developing brain over time with respect to sex in C57Bl/6 mice following neonatal exposure to isoflurane, carbon monoxide, or their combination. Specifically, brain weight- and brain volume-to-body weight ratios are presented, representative immunoblots of whole brain cell-specific protein content are depicted, and quantification of the number of neurons in the primary somatosensory cortex and CA3 region of the hippocampus are shown. Three discrete postnatal time points are represented: P7 (prior to exposure), P14 (one-week post exposure), and P42-56 (5–7 weeks post exposure). Major findings …

Lessons To Be Learned: How A Comprehensive Neurobiological Framework Of Atypical Reading Development Can Inform Educational Practice, Ola Ozernov-Palchik, Xi Yu, Yingying Wang, Nadine Gaab

Center for Brain, Biology, and Behavior: Faculty Publications

Dyslexia is a heritable reading disorder with an estimated prevalence of 5–17%. A multiple deficit model has been proposed that illustrates dyslexia as an outcome of multiple risks and protective factors interacting at the genetic, neural, cognitive, and environmental levels. Here we review the evidence on each of these levels and discuss possible underlying mechanisms and their reciprocal interactions along a developmental timeline. Current and potential implications of neuroscientific findings for contemporary challenges in the field of dyslexia, as well as for reading development and education in general, are then discussed.

Frequency Sensitive Mechanism In Low-Intensity Ultrasound Enhanced Bioeffects, April D. Miller, Abdoulkadri Chama, Tobias M. Louw, Anuradha Subramanian, Hendrik J. Viljoen

Department of Chemical and Biomolecular Engineering: Faculty Publications

This study presents two novel theoretical models to elucidate frequency sensitive nuclear mechanisms in low-intensity ultrasound enhanced bioeffects. In contrast to the typical 1.5 MHz pulsed ultrasound regime, our group previously experimentally confirmed that ultrasound stimulation of anchored chondrocytes at resonant frequency maximized gene expression of load inducible genes which are regulatory markers for cellular response to external stimuli. However, ERK phosphorylation displayed no frequency dependency, suggesting that the biochemical mechanisms involved in enhanced gene expression is downstream of ERK phosphorylation. To elucidate such underlying mechanisms, this study presents a theoretical model of an anchored cell, representing an in vitro …

Biomechanical Testing Of An Exercise For Strengthening The Proximal Femur., Alyssa Osbourne

Electronic Theses and Dissertations

Based on the principles of cutting edge bone remodeling research, a unique therapeutic exercise device was designed specifically to improve bone quality at the most critical location of the proximal femur prone to fracture: the superior-lateral femoral neck where the fracture first initiates during a fall. The exercise/device is intended to work by inducing enough strain in the bone to stimulate the body’s natural bone remodeling mechanisms to increase bone density in the proximal femur and consequently prevent a fracture from arising if a fall to the side does occur.

In order to test the proposed exercise, experiments simulating the …

Quantitative Dwi As An Early Imaging Biomarker Of The Response To Chemoradiation In Esophageal Cancer, Benjamin C. Musall

Dissertations and Theses (Open Access)

For patients diagnosed with stages IIa-IIb esophageal cancer, the current standard of care treatment is tri-modality therapy (TMT), where neoadjuvant chemoradiation (nCRT) is followed by surgical resection. Histopathology of resected tumors reveals that pathological complete response (pCR) is achieved in 20-30% of patients through nCRT alone. Because of the high mortality and morbidity associated with esophagectomy, it may be advantageous for patients exhibiting pCR from nCRT alone to be placed under observation rather than completing their TMT. Therefore, a method for predicting response at an early time-point during nCRT is highly desirable. Conventional methods such as endoscopic ultrasound, re-biopsy, and …

Improvements In Four-Dimensional And Dual Energy Computed To Mography, Rachael M. Martin

Dissertations and Theses (Open Access)

Dual energy and 4D computed tomography (CT) seek to address some of the limitations in traditional CT imaging. Dual energy CT, among other purposes, allows for the quantification and improved visualization of contrast materials, and 4D CT is often used in radiation therapy applications as it allows for the visualization and quantification of object motion. While much research has been done with these technologies, areas remain for potential improvement, both in preclinical and clinical settings, which will be explored in this dissertation. Preclinical dual energy cone-beam CT (CBCT) can benefit from wider separation between the peak energy of the two …

Predicting Potential Alzheimer Medical Condition In Elderly Using Iot Sensors - Case Study, Zhi Hao Kevin Chong, Yu Xuan Tee, Ling Jing Toh, Shi Jia Phang, Jie Ying Liew, Bertran Queck, Swapna Gottipati

Research Collection School Of Computing and Information Systems

Ageing population would cause profound problems and the impact is already being felt today in many developed countries such as Singapore. The main concern for the Government is to help the citizens with active ageing through home ownership and good healthcare. With Internet of Things (IoT) gaining traction globally, Singapore is set to take advantage of this technology and leverage it to extend its capabilities towards a graceful Ageing-In-Place for the elderly. This ties in nicely with the expertise of SHINE Seniors project by SMU-iCity Lab, which integrates IT with healthcare in ways that creates innovative IT health solutions that …

Antimicrobial Hydroxyapatite-Gelatin-Silica Composite Pastes With Tunable Setting Properties, Vuk Uskoković, Shreya Ghosh, Victoria M. Wu

Pharmacy Faculty Articles and Research

Bone grafting is one of the commonest surgical procedures, yet all bone substitutes developed so far suffer from specific weaknesses and the search for a bone graft material with ideal physical and biological properties is still ongoing. Calcium phosphate pastes are the most frequently used synthetic bone grafts, yet they (a) often take an impractically long time to set, (b) release the drug content too fast, and (c) do not form pores large enough to accommodate host cells and foster osseointegration. To make up for these deficiencies, we introduced gelatin and silica to pastes composed of 5–15 nm sized hydroxyapatite …

Convolutional Neural Networks In Medical Imaging, Mitchell Finzel

Scholarly Horizons: University of Minnesota, Morris Undergraduate Journal

Over the past 5 years there has been an increase in the use of convolutional neural networks in a broad variety of medical imaging applications. This is due in part to the increase in their popularity since their success in the 2012 ImageNet competition, but is also due to their adaptability across a range of medical imaging applications. These applications vary greatly; from the segmentation of knee cartilage to the detection of Alzheimer's disease in MRIs and much more. In this paper we will go over some of the cutting edge techniques being used specifically for the tasks of brain …

Alzheimer’S Disease: Dawn Of A New Era?, Farideh Amirrad, Emira Bousoik, Kiumars Shamloo, Hassan Al-Shiyab, Viet-Hong Nguyen, Hamidreza Montazeri Aliabadi

Pharmacy Faculty Articles and Research

Alzheimer’s disease (AD) is an irreversible neurodegenerative disease characterized by a progressive decline in cognition and memory, leading to significant impairment in daily activities and ultimately death. It is the most common cause of dementia, the prevalence of which increases with age; however, age is not the only predisposing factor. The pathology of this cognitive impairing disease is still not completely understood, which has limited the development of valid therapeutic options. Recent years have witnessed a wide range of novel approaches to combat this disease, so that they greatly increased our understanding of the disease and of the unique drug …

Alternative Interventions For Children Coping With Chronic Conditions: A Critical Review Of The Literature, Nina M. Pelsi, Kim S. Amer

DePaul Discoveries

Reduction of stressors and anxiety levels in adolescents with chronic illnesses is a critical concept in pediatric health care in America today. The many stressors associated with chronic illness include displaying physical and mental differences, social stigma, financial difficulty, and family stress. These stressors may affect the adolescent’s ability to learn and cope in everyday life. The current research was a critical review of the literature examining studies done with adolescents coping with chronic diseases and illnesses. The aim was to analyze the most efficacious non-pharmacological methods for reducing stressors in adolescents with chronic illness. A critical review of the …

Oncology Section Edge Task Force On Urogenital Cancer Outcomes: Clinical Measures Of Lymphedema—A Systematic Review, Joy C. Cohn, Hannah Geyer, Jeannette Lee, Mary Insana Fisher

Physical Therapy Faculty Publications

Background: Valid and reliable tools to assess lymphedema are necessary to accurately evaluate status and to objectively document and measure the results of interventions. Understanding the advantages and disadvantages of each measure can inform the clinician's choice of the appropriate tool to be used in the clinic or research setting.

Purpose: To identify reliable and valid measurement techniques that are sensitive to change for assessing edema volume or soft tissue change in the lower extremities or genital region of patients with lymphedema.

Methods: A systematic review of the literature was conducted to assess the published psychometric properties and clinical feasibility …

Ua10/1 Cec Newsletter, Wku Suzanne Vitale Clinical Education Complex

CEC Publications

Newsletter created by and about the Suzanne Vitale Clinical Education Complex.

• Moore, Mary. Director's Corner
• Autism After 21 Day
• LifeSkills Run for Autism Is a Success!
• Thank You, President & Mrs. Ransdell
• Family Resource Program Fun Day Is a Success!
• Family Resource Program Holds Coffee Hour May 12 & July 28
• KAP College Circle of Support Has a Great Semester!
• Congratulations KAP Graduates
• Planting the Seeds for Tomorrow - Community Garden
• Creating without Rules
• Serving Up Autism Awareness
• CEC Receives WHAS Crusade for Children Grant
• Upcoming Events

Neuroanatomical Tracing Of The Gut -- Brain Axis, Ricardo P. Torres, Elizabeth A. Davis, Coltan G. Parker, Megan J. Dailey

PRECS student projects

This poster summarizes a variety of methods to further characterize the gut-brain axis by tracing motor and sensory nerves between the gut and brain and identifying cell bodies in the sensory ganglia. Determines the meth method to trace the sensory and motor nerves was through fluorescence and the best method to identify sensory neuron cell bodies was the Nissi stain.

Re-Tubularization Of Highly-Ischemic Anti-Mesenteric Border (Rehab): A Novel Bowel Preservation Technique In Complex Gastroschisis., Richard J. Hendrickson, Ashwini S. Poola, Katherine W. Gonzalez, Joel Lim, Tolulope A. Oyetunji

Manuscripts, Articles, Book Chapters and Other Papers

Complex gastroschisis with bowel necrosis poses an operative challenge. Surgeons must weigh the decision between resection versus preservation of ischemic bowel. As one of the leading causes of short bowel syndrome, aggressive resection in complicated gastroschisis subjects children to prolonged dependence on parenteral nutrition and its attendant complications. Herein, we describe a novel technique aimed towards bowel preservation in complex gastroschisis patients with severe bowel ischemia with the ultimate goal for enteral autonomy.