Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Protocol For Safe, Affordable, And Reproducible 1 Isolation And Quantitation 2 Of Sars-Cov-2 Rna From Wastewater, Monica Trujillo, Kristen Cheung, Anna Gao, Irene Hoxie, Sherin Kannoly, Nanami Kubota, Kaung Myat San, Davida S. Smyth, John J. Dennehy

Publications and Research

The following protocol describes our workflow for processing wastewater with the goal of detecting the genetic signal of SARS-CoV-2. The steps include pasteurization, virus concentration, RNA extraction, and quantification by RT-qPCR. We include auxiliary steps that provide new users with tools and strategies that will help troubleshoot key steps in the process. This protocol is one of the safest, cheapest, and most reproducible approaches for the detection of SARS-CoV-2 RNA in wastewater. Furthermore, the RNA obtained using this protocol, minus the pasteurization step, can be sequenced both using a targeted approach sequencing specific regions or the whole genome. The protocol …

Diagnosis And Intervention Of Posterior Shoulder Impingement In A Non-Throwing Athlete, K Orrick

Clinical Practice in Athletic Training

Background: Posterior impingement, also commonly called internal impingement, is identified by a repetitive compression of the posterosuperior aspect of the glenoid by the greater tuberosity of the humeral head when the arm is in an abducted and externally rotated position. There are multiple possible causes of this impingement. One of the most frequent contributors is scapular dyskinesis, where the scapula does not track properly with overhead movement due to weakness. Other contributors include kinetic chain instabilities found in the spine, core, and lower extremity, as well as glenohumeral instability causing a shift in the humeral head. Posterior impingement is commonly …

Treatment And Management Of Complex Knee Injury: A Case Report, K Braunreiter, S Kerwin

Clinical Practice in Athletic Training

Background: The “unhappy triad” injury includes tears of the anterior cruciate ligament, medial collateral ligament, and medial meniscus. There is limited research on the prevalence and outcome of this injury. The unique surgical repair consisting of lateral extra-articular tenodesis (LET) was utilized to reinforce the anterior cruciate ligament repair (ACLR) and to prevent rerupture. Due to this extensive surgery, the patient struggled to regain full range of motion and quadriceps activation. This case is a Level 2 case study that explores the different interventions used to address the aforementioned objective deficits and return him safely to play. Patient: The patient …

Firefighters Self-Efficacy Of Injuries And Willingness To Report Injuries Within The Southeast Region Of The United States, Marissa Villafuerte

College of Graduate Studies: Theses & Dissertations

CONTEXT: Firefighting is a dangerous profession often leading to minor and severe injuries. Injuries range from basic first aid to fatalities. Over a third of injuries linked to muscular-skeletal injuries (MSKI). To address MSKI, the fire service has turned to preventative and rehabilitation care such as on-site health care professionals.

OBJECTIVE: The purpose of this study was 1) to understand rural firefighters' self-efficacy of injury care and willingness to report MSKIs, 2) compare on-site preventative care fire departments to traditional fire departments and 3) describe the influence of on-site self-efficacy of MSKI care and willingness to report injuries based on …

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. …

Understanding Predictors Of Telemedicine Adoption Before, During, And After The Covid-19 Pandemic, Bradford S. Pierce

Theses and Dissertations

This study examined change in physicians’ use of telemedicine before, during, and expectations after the COVID-19 pandemic. It also examined the ability of personal and environmental variables to predict telemedicine adoption, and applied the theory of reasoned action and technology acceptance model to physicians’ adoption of telemedicine during the pandemic. A total of 230 licensed physicians currently practicing in the United States were recruited. Telemedicine accounted for 3.72% of physicians’ clinical work prior to the pandemic, 46.03% during the pandemic, and predicted 25.44% after the pandemic ends. Physicians within hospitals reported less telemedicine use during the pandemic (M = …

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 …

A Multivariable Model Of Parent Satisfaction, Pain, And Opioid Administration In A Pediatric Emergency Department, Candice D. Donaldson, Thomas W. Heyming, Louis Ehwerhemuepha, Brooke N. Jenkins, Michelle A. Fortier, William Feaster, Zeev N. Kain

Psychology Faculty Articles and Research

Introduction: Children and adolescents are not impervious to the unprecedented epidemic of opioid misuse in the United States. In 2016 more than 88,000 adolescents between the ages of 12–17 reported misusing opioid medication, and evidence suggests that there has been a rise in opioid-related mortality for pediatric patients. A major source of prescribed opioids for the treatment of pain is the emergency department (ED). The current study sought to assess the complex relationship between opioid administration, pain severity, and parent satisfaction with children’s care in a pediatric ED.

Methods: We examined data from a tertiary pediatric care facility. A health …

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 …

Assessment Of The Clinical Validity Of Ctdna Analysis For Melanoma Management, Anda-Gabriela Marsavela

Theses: Doctorates and Masters

Metastatic melanoma is responsible for almost 80% of all skin cancer-related deaths and the incidence of people affected continues to rise worldwide. The emergence of targeted therapy and immune-checkpoint inhibitors has improved the clinical management of melanoma, but durable survival benefit is only seen in a minority of patients. The use of these very expensive systemic therapies on all appropriate patients also poses a high economic burden on health systems across numerous countries. Currently, surveillance for treatment failure is not optimal. Thus, reliable and accurate biomarkers of patient disease status are urgently required.

Circulating tumour DNA (ctDNA) analysis has emerged …

Synthesis, Characterization And Photophysical Properties Of Ytterbium Complexes Of Functionalized Porphyrins And Porpholactone, Beibei Liu

Masters Theses

The unique structure and superior properties of lanthanide porphyrins enable them to be used in a broad variety of applications, especially in medical diagnosis fields. This research focuses on modifying the porphyrin ligands in various places, resulting in broader absorption in the red region and strong emission in the near-infrared region for these ytterbium(III) porphyrin complexes. The design, synthesis and characterization for DMPH₂-BDP, DMPH₂-COOH, TPLH₂ ligands and YbDMP-BDP, YbDMP-COOH complexes are described. The photophysical properties of these ligands and complexes including their absorbance, fluorescence and quantum yields are also presented. Both the synthesized ligands and …

A Deblurring/Denoising Corrected Scintigraphic Planar Image Reconstruction Model For Targeted Alpha Theory, Charles Ross Schmidtlein, Matthew Maroun, Andrzej Krol, Howard Gifford, Lisa Bodei, Joseph O'Donoghue, Ida Häggström, Yuesheng Xu, Si Li

Mathematics & Statistics Faculty Publications

Scintigraphy is a common nuclear medicine method to image molecular target’s bio-distribution and pharmacokinetics through the use of radiotracers and gamma cameras. The patient’s images are obtained by using a pair of opposing large flat gamma ray detectors equipped with parallel-hole lead or tungsten collimators that preferentially detect gamma-rays that are emitted perpendicular to the plane of the detector. The resulting images form an anterior/posterior (A/P) planar image pairs. The obtained images are contaminated by noise and contain artifacts caused by gamma-ray attenuation, collimator penetration, scatter and other detrimental factors. Post-filtering of the images can reduce the noise, but at …

Rest And Therapeutic Interventions Following Sport-Related Concussion: An Evidence-To-Practice Review, Alyssa L. Bolno, Brittni G. Hoover, Ryan J. Michels, Allison B. Smith, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Sport-related concussion (SRC) is among the most common injuries seen in both sports and recreation, especially collision and full contact sports. However, there has been controversy surrounding which recovery protocol would be best used in the rehabilitation of a person who has suffered from SRC. Symptoms and dysfunctions can vary from patient to patient. The average recovery time for adults is 14 days post incidence. Although most patients recover over the first few days/weeks post-injury, 15% reported recovery time of 30 or more days. Previous research determined a need for cognitive and physical rest of 24-48 hours, or until acute …

Bi-Lateral Hand Compartment Syndrome Secondary To Autoimmune Disorder In A Former High School Multi-Sport Athlete, Alyssa Vaniman

Clinical Practice in Athletic Training

Patient is a 21-year-old female former multiple-sport athlete who has suffered from the development of multiple cases of compartment syndrome throughout their body. At the time the medical staff encountered the patient, they were diagnosed with bilateral hand compartment syndrome. An autoimmune disorder known as Scleromyositis was diagnosed as the source of the multiple diagnosed cases of compartment syndrome. Prior to surgical intervention, the patient was unable to complete everyday tasks as a student. As pressure within their hypothenar, thenar, and interosseous compartments grew, the patient was no longer able to complete everyday fine motor skill tasks. A post-surgical rehabilitation …

Effectiveness Of Take-Home Naloxone Programs In Athletic Training: An Evidence-To-Practice Review, Michael J. Palm, Amanda N. Flanscha, Zachary K. Winkelmann

Clinical Practice in Athletic Training

The number of opioid overdoses (ODs) has risen in recent years and has become more complex due to the co-involvement of both prescription and illicit opioid drug use. Provisional programs for take-home naloxone (a medication designed to rapidly reverse opiate OD symptoms) kits have been distributed to combat this potentially fatal epidemic. Although there is strong evidence to support the efficacy of naloxone in the reversal of opiate OD, there is limited evidence to support the efficacy of take-home naloxone (THN) kits. The purpose of this evidence-to-practice review was to summarize a systematic review on the efficacy of THN programs. …

Evaluation And Treatment Of The Water-Polo Player With Anterior Glenohumeral Instability, M Zimmerman

Clinical Practice in Athletic Training

Background: Glenohumeral (GH) instability is a common shoulder condition with a range of characteristics from laxity within the GH joint to complete dislocation of the humerus. The GH joint is held in place by static and dynamic stabilizers that need to be functioning appropriately to center the humerus in the glenoid fossa. Acquired shoulder instability is defined as chronic stress of the humerus in an externally rotated and abducted position on the shoulder joint from repetitive overhead (OH) sports causing anterior instability of the shoulder. Diagnosing shoulder instability is reliant on the patient’s history and physical examination findings during testing. …

A Proposed Return-To-Ride Protocol For United States Jockeys Following Concussion, Carolina Quintana, Kimberly I. Tumlin, Matthew C. Hoch, Nicholas R. Heebner, Bianca L. Grimshaw, Carl G. Mattacola

Clinical Practice in Athletic Training

Professional horse racing jockeys participate in a high-risk sport, however there is limited research and policies regarding welfare and safety. Despite the high incidence and risk of concussions, there are not standardized protocols for returning these unique athletes to participation following concussion. A return-to-ride concussion protocol for thoroughbred horse racing athletes must take into account the unique considerations and practices of the sport. Current concussion management strategies suggest removal from riding and activity when a concussion is suspected. This is followed by further evaluation for diagnosis, a period of both cognitive and physical rest before a gradual return-to-activity prior to …

Cost Outcomes Of Physical Therapist Providers Compared To Primary Care Providers In The Treatment Of Musculoskeletal Patients In A Military Treatment Facility: A Retrospective Chart Review”, Troy E. Mcgill, Debra F. Stern, Morey J. Kolber, John Mcgee

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to compare the cost of physical therapist (PT) management of patients with musculoskeletal (MSK) disorders to management by traditional primary care managers (PCMs); medical doctors (MDs), doctors of osteopathic medicine (DOs), advanced registered nurse practitioners (ARNPs), and physician assistants (PAs). Methods: This is a retrospective study of electronic medical records using an exploratory, non-experimental, cross-sectional, and quantitative design method. The records of patients with MSK disorders were assessed at an Air Force military medical clinic for 18 months from January 2016 through June 2017. Results: PT management of MSK patients resulted in a …

The Influence Of Sonographer Experience On Skeletal Muscle Image Acquisition And Analysis, Joshua C. Carr, Gena R. Gerstner, Caleb C. Voskuil, Joel E. Harden, Dustin Dunnick, Kristin M. Badillo, Jason I. Pagan, Kylie K. Harmon, Ryan M. Girts, Jonathan P. Beausejour, Matt S. Stock

Human Movement Studies & Special Education Faculty Publications

The amount of experience with ultrasonography may influence measurement outcomes while images are acquired or analyzed. The purpose of this study was to identify the interrater reliability of ultrasound image acquisition and image analysis between experienced and novice sonographers and image analysts, respectively. Following a brief hands-on training session (2 h), the experienced and novice sonographers and analysts independently performed image acquisition and analyses on the biceps brachii, vastus lateralis, and medial gastrocnemius in a sample of healthy participants (n = 17). Test–retest reliability statistics were computed for muscle thickness (transverse and sagittal planes), muscle cross-sectional area, echo intensity and …

Test-Retest Reliability And Minimal Detectable Change Of The Computerized Dynamic Posturography Proprio For Adults With Chronic Traumatic Brain Injury, Guilherme Manna Cesar, Thad W. Buster, Judith M. Burnfield

Department of Mechanical and Materials Engineering: Faculty Publications

Purpose: Balance deficits after brain injury, including reactive recovery from unexpected perturbations, can persist well after rehabilitation is concluded. While traditional clinical assessments are practical, the anticipatory nature of the tasks may mask perceptible balance control. Computerized dynamic posturography can directly quantify capacity to respond to unexpected, external perturbations. This study examined the reliability of the computerized dynamic posturography assessment with the device PROPRIO® 4000 in adults with traumatic brain injury and created the minimal detectable change for its standardized test.

Methods: Ten adults (ages 21–55 years) with chronic (average 10 ± 6 years post-injury) severe (loss of consciousness 2–75 …

Identifying Molecular Pathways Underlying Noise-Induced Tinnitus, Mckenzie Rice

Williams Honors College, Honors Research Projects

Tinnitus is a serious neurological condition effecting 10-15% of adults, and can lead to other symptoms such as difficulty concentrating and sleeping, anxiety, and depression. Currently there are no FDA approved drugs to prevent or treat tinnitus, mainly due to a lack of understanding of its cellular and molecular pathways. T- and L- type calcium channels have been implicated in the modulation of tinnitus, as well as the dysfunction of gamma-aminobutyric acid (GABA) neurons. This study used the sound-based avoidance detection (SBAD) method in order to detect tinnitus and determine whether pharmacological treatments had an effect in mediating tinnitus. T-type …

Development And Characterization Of An Adaptable Aerosolized Methylene Diphenyl Diisocyanate Generation System, Simon Aubin, Loïc Wingert, Sébastien Gagné, Livain Breau, Jacques Lesage

Études primaires

Reactive semivolatile contaminants, such as isocyanates, can be particularly difficult to assess in occupational environments. While standard methods exist for isocyanates, there are still significant differences between the results they provide for various occupational environments or processes. This study presents the validation of a laboratory system for the generation of controlled atmospheres of isocyanates. A system consisting of different modules generated airborne methylene diphenyl diisocyanate (MDI) by nebulizing a solution into mixing and exposure chambers with control of flow rate, temperature, and relative humidity. Sampling was performed through an eight-port flow splitter that allowed only very slight within-test variability. MDI …

The Influence Of The Psychophysical Assessment Paradigm On Pitch Discrimination For Adults (And A Pilot Sample Of Children), Ashley G. Flagge, Lucile Puranen, Madhuri S. Mulekar

Ashley Flagge Publications

Pitch discrimination ability has been of research interest due to its potential relationship to language and literacy. However, assessment protocols for pitch discrimination have varied widely. Prior studies with both children and adults have produced conflicting performance findings across different pitch discrimination research paradigms, though they have consistently shown that discrimination accuracy is based on the psychophysical assessment method applied. In the present study, we examined pitch discrimination performance among convenience samples of 19 adult women and ten female children across six different adaptive psychophysical measurement conditions. We found pitch discrimination performance in both groups to be impacted by the …

Impact Of Hemodynamic Vortex Spatial And Temporal Characteristics On Analysis Of Intracranial Aneurysms, Kevin W. Sunderland

Dissertations, Master's Theses and Master's Reports

Subarachnoid hemorrhage is a potentially devastating pathological condition in which bleeding occurs into the space surrounding the brain. One of the prominent sources of subarachnoid hemorrhage are intracranial aneurysms (IA): degenerative, irregular expansions of area(s) of the cerebral vasculature. In the event of IA rupture, the resultant subarachnoid hemorrhage ends in patient mortality occurring in ~50% of cases, with survivors enduring significant neurological damage with physical or cognitive impairment. The seriousness of IA rupture drives a degree of clinical interest in understanding these conditions that promote both the development and possible rupture of the vascular malformations. Current metrics for the …

Nebulizer-Based Systems To Improve Pharmaceutical Aerosol Delivery To The Lungs, Benjamin M. Spence

Theses and Dissertations

Combining vibrating mesh nebulizers with additional new technologies leads to substantial improvements in pharmaceutical aerosol delivery to the lungs across therapeutic administration methods. In this dissertation, streamlined components, aerosol administration synchronization, and/or Excipient Enhanced Growth (EEG) technologies were utilized to develop and test several novel devices and aerosol delivery systems. The first focus of this work was to improve the poor delivery efficiency, e.g., 3.6% of nominal dose (Dugernier et al. 2017), of aerosolized medication administration to adult human subjects concurrent with high flow nasal cannula (HFNC) therapy, a form of continuous-flow non-invasive ventilation (NIV). The developed Low-Volume Mixer-Heater (LVMH) …

Adaptive Physics-Based Non-Rigid Registration For Immersive Image-Guided Neuronavigation Systems, Fotis Drakopoulos, Christos Tsolakis, Angelos Angelopoulos, Yixun Liu, Chengjun Yao, Kyriaki Rafailia Kavazidi, Nikolaos Foroglou, Andrey Fedorov, Sarah Frisken, Ron Kikinis, Alexandra Golby, Nikos Chrisochoides

Computer Science Faculty Publications

Objective: In image-guided neurosurgery, co-registered preoperative anatomical, functional, and diffusion tensor imaging can be used to facilitate a safe resection of brain tumors in eloquent areas of the brain. However, the brain deforms during surgery, particularly in the presence of tumor resection. Non-Rigid Registration (NRR) of the preoperative image data can be used to create a registered image that captures the deformation in the intraoperative image while maintaining the quality of the preoperative image. Using clinical data, this paper reports the results of a comparison of the accuracy and performance among several non-rigid registration methods for handling brain deformation. A …

In Silico Investigation Of Cardiac Arrhythmia Susceptibility In Long Qt Phenotype, Anthony Owusu-Mensah, Victoria Lam, Bright Tsevi, Michel Audette, Makarand Deo

Electrical & Computer Engineering Faculty Publications

Long QT Syndrome (LQTS) is associated with cardiac arrhythmia and sudden cardiac death. The Long QT Type 2 (LQT2) phenotype, which accounts for 35–40 % of all LQTS patients, is caused by mutations in HERG gene. The mechanisms of arrhythmia in presence of LQT2 conditions are not fully understood. We utilized anatomically and electrophysiologically realistic numerical simulations to elucidate the mechanisms of arrhythmia initiation in presence of blockade in rapid component of delayed rectifier potassium current, I_Kr. We utilized a 3D finite element model of rabbit ventricles integrated with His-purkinje network to simulate whole heart response to LQT2 …

Evaluation Of Spinal Anatomy Segmentation Methods Using Synthetic Computed Tomography Volumes, Austin Tapp, Michel Audette

Electrical & Computer Engineering Faculty Publications

Severe adolescent idiopathic scoliosis (AIS) is corrected by surgical procedures that necessitate ligament releases. To determine appropriate release allotments, soft tissues must be localized on a patient-specific basis, However, routine computer tomography (CT) imaging precludes traditional, voxel-based soft tissue localization. Fortunately, recent studies have proposed top-down segmentation methods, which elucidate soft tissues using pre-operative CT volumes. While the accuracy of vertebral segmentations obtained from these methods has not been determined, the accuracy of soft tissue segmentations has not. To ensure the soft tissue segmentation methods are clinically applicable, soft tissue validation must occur. This study presents an evaluation measure for …

Tri-Molybdenum Phosphide (Mo3P) And Multi-Walled Carbon Nanotube Junctions For Volatile Organic Compounds (Vocs) Detection, Baleeswaraiah Muchharla, Praveen Malali, Brenna Daniel, Alireza Kondori, Mohammad Asadi, Wei Cao, Hani E. Elsayed-Ali, Mickaël Castro, Mehran Elahi, Adetayo Adedeji, Kishor Kumar Sadasivuni, Muni Raj Mauya, Kapil Kumar, Abdennaceur Karoui, Bijandra Kumar

Electrical & Computer Engineering Faculty Publications

Detection and analysis of volatile organic compounds’ (VOCs) biomarkers lead to improvement in healthcare diagnosis and other applications such as chemical threat detection and food quality control. Here, we report on tri-molybdenum phosphide (Mo₃P) and multi- walled carbon nanotube (MWCNT) junction-based vapor quantum resistive sensors (vQRSs), which exhibit more than one order of magni- tude higher sensitivity and superior selectivity for biomarkers in comparison to pristine MWCNT junctions based vQRSs. Transmission electron microscope/scanning tunneling electron microscope with energy dispersive x-ray spectroscopy, x-ray diffraction, and x-ray photo- electron spectroscopy studies reveal the crystallinity and the presence of Mo and …

Harnessing Acoustic Streaming For Bioanalysis In Microfluidics, Xiaojun Li

Graduate Theses, Dissertations, and Problem Reports (ETD)

In the past few decades, microfluidic technology has been developed rapidly in both fabrication methods and multifunctionality integrations, making it a powerful tool for a wider variety of biological applications. The device fabrication method has expanded from conventional polymer-based micro devices to 3D-printed micro devices, and allows multiple functions such as electric, optic, magnetic and acoustic to be integrated on a single platform. This dissertation focuses on method development of acoustic streaming-based microfluidics in bioanalysis such as immunoassay, enzyme kinetics and DNA fragmentation analysis. In this dissertation, a micromixer was developed based on acoustic streaming generated from sharp-edge structure vibration …