Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Development Of Advanced Mr-Guided Adaptive Radiation Therapy Methods For Head & Neck Cancers On The 1.5t Mr-Linac, Brigid Mcdonald

Dissertations and Theses (Open Access)

The 1.5T hybrid MRI/linear accelerator (MR-linac) has recently been introduced into clinical practice and used for the treatment of head and neck cancers (HNC). This device enables on-line adaptive radiation therapy (ART) based on anatomical changes throughout treatment and variations in patient position. This novel technology also has the potential for advanced ART strategies such as dose-optimized ART, in which the treatment plan is optimized based on the accumulated dose over previous fractions, or biological image-guided ART, in which the plan is adapted based on individual tumor response as measured through quantitative imaging techniques such as diffusion-weighted imaging (DWI). The …

Roles Of Oxidative Stress And Dna Methylation In Cigarette Smoking-Induced Accelerated Acute Myeloid Leukemia Progression, Mary Figueroa

Dissertations and Theses (Open Access)

Acute myeloid leukemia (AML) is a commonly diagnosed cancer in smokers. When current or former smokers have AML, they have worse survival compared to never smoking patients. This has been observed clinically for decades, but then it is unknown how smoking leads to worsened AML survival. Smoking causes oxidative stress and altered DNA methylation that persists for decades in peripheral blood mononuclear cells, but these changes from smoking have not been evaluated in the context of AML. We hypothesize that smoking-induced molecular changes, including altered DNA methylation associated with poor AML prognosis, promote AML. We developed a novel model to …

Radioluminescence Based Biochemical Sensing And Imaging Strategies To Measure Local Drug Release And Ph, Gretchen B. Schober

All Dissertations

In this dissertation we describe methods for measuring infection relevant biochemical analytes using radioluminescent and ultrasound luminescent materials. Films and nanoparticles fabricated with europium doped gadolinium oxysulfide (Gd₂O₂S:Eu³⁺) are used to quantitatively measure radiolabeled pharmaceutical concentration, specifically tritium labeled vancomycin (³H-vancomycin). Europium and dysprosium doped strontium aluminate is used to fabricate an ultrasound modulated, pH sensing film. These methods are indicated for theranostic evaluation of implant associated infection. Bacterial biofilms are inherently resistant to traditional antibiotic treatment and can coat biomedical implants. These biofilm related infections are difficult or impossible to eradicate …

How Valuable Are Clinical Neuropsychological Assessments? A Meta-Analysis Of Neuropsychological Tests With Comparison To Common Medical Tests And Treatments, Murphy N. Harrell

Graduate Theses and Dissertations (2019 - present)

There has been a general decrease in neuropsychological assessments at a time when medical diagnostic technology and treatments have expanded, leading to a faulty assumption that medical tests and healthcare treatments provide more reliable or valid data than psychological assessments. A landmark report from the American Psychological Association’s (APA) Psychological Assessment Work Group (PAWG) found that validity coefficients for many psychological tests were indistinguishable from those of medical tests (Meyer et al., 2001). An updated systematic review of the advancement in neuropsychological testing is essential to the continued advancement of the value of neuropsychological assessment in healthcare. This meta-analysis sought …

Neuropsychology Of Primary Headache Disorders: A Meta-Analysis, Jasmin H. Pizer

Graduate Theses and Dissertations (2019 - present)

Objective: A meta-analysis was conducted comparing cognition on clinical measures between individuals with a primary headache disorder (PHD) and healthy controls (HC). Data Selection: The University of South Alabama Libraries’ OneSearch and PubMed, with a uniform search-strategy, were used to locate original research comparing cognition between PHD and HC samples. Analyses were modeled under random effects. Hedge’s g was used as a bias-corrected estimate of effect size. Between-study heterogeneity was assessed using Cochran’s Q and I2. Data Synthesis: The initial search interval spanned inception–May 2021 and yielded 6692 results. Fifty-seven studies were analyzed. Meta-analysis showed a significant combined effect size …

Monte Carlo Simulation Of Thallium-Bromide Semiconductor Detector For Range Verification Of A Carbon Ion Radiotherapy Beam Through Prompt Gamma-Ray Detection, Peter Dimpfl

UNLV Theses, Dissertations, Professional Papers, and Capstones

Thallium-Bromide is a semiconductor material which is well suited for photon detection. Composed of high atomic number elements and a high mass density of 7.56 g/cm3, TlBr has superb photon stopping power. External beam radiation therapy is an ever-changing environment with technology rapidly improving. With proton therapy facilities becoming more widely available, and carbon ion facilities showcasing the benefits of carbon ion radiation therapy, there is an industry need toprovide accurate dosimetric treatment plans to verify patients are receiving proper care. Current clinical practices apply safety margins to clinical target volumes to safe treatment. Through research to improve detection techniques, …

Confirming Multiplex Rt-Qpcr Use In Covid-19 With Next-Generation Sequencing: Strategies For Epidemiological Advantage, Rob E. Carpenter, Vaibhav Tamrakar, Harendra Chahar, Tyler Vine, Rahul Sharma

Human Resource Development Faculty Publications and Presentations

Rapid identification and tracking of emerging SARS-CoV-2 variants are critical for understanding the transmission dynamics and developing strategies for interrupting the transmission chain. Next-Generation Sequencing (NGS) is an exceptional tool for whole-genome analysis and deciphering new mutations. The technique has been instrumental in identifying the variants of concern (VOC) and tracking this pandemic. However, NGS is complex and expensive for large-scale adoption, and epidemiological monitoring with NGS alone could be unattainable in limited-resource settings. In this study, we explored the application of reverse transcription-quantitative polymerase chain reaction (RT-qPCR) based detection of the variant identified by NGS. We analyzed a total …

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …

Heart To Heart, Mom To Mom, Karis L. Tekwani

Journal of Patient-Centered Research and Reviews

This essay describes the human connection forged between two young moms, one the physician and one the patient, when their paths collided one night in the emergency department of a busy hospital. It describes a challenging and most memorable care experience in the career of a young emergency physician, the clinical outcome, and the patient’s appreciative follow-up message years later.

Cardiac Metastasis After Curative Treatment Of Hepatocellular Carcinoma: Risk Factors, Treatment Options, And Prognosis, Gaurav Jain, Mathew Otto, Mubeen Khan Mohammed Abdul, Manpreet Chadha, Ajay Sahajpal

Journal of Patient-Centered Research and Reviews

Hepatocellular carcinoma (HCC) is primary hepatic malignancy with a high incidence of recurrence. The risk of recurrence directly correlates to patient’s overall prognosis. Management of advanced HCC involves a combination of surgical resection, locoregional therapy, and systemic treatment. Distant metastases are rare, and intraventricular cardiac metastases are even more infrequent. This brief review details an illustrative case of cardiac metastasis after curative treatment of primary HCC and then summarizes the literature on risk factors, treatment options, and patient prognosis in the setting of distant metastases from HCC. Prognosis of metastasis to the heart is generally poor, and available evidence emphasizes …

Is Home Blood Pressure Monitoring Effective At Controlling Hypertension In African American Patients? A Clin-Iq, Rebecca Nye, Wilhelm Lehmann, Deborah Simpson

Journal of Patient-Centered Research and Reviews

African Americans are disproportionately affected by hypertension, a modifiable contributor to multiple chronic diseases and premature death. Primary care physicians play an important role in hypertension control. Home blood pressure monitoring (HBPM) is an evidence-based method for confirming diagnosis and monitoring hypertension over time. Some studies have found that HBPM may lead to clinically relevant reductions in blood pressure when combined with additional interventions, but few studies have focused specifically on African American populations. Evidence of effectiveness could increase clinical recommendation of HBPM. This clinical inquiry examined whether HBPM improves blood pressure control in African Americans with uncontrolled hypertension. Reviewed …

Partnering To Advance Health Equity And A Welcome Opportunity To Gather: Proceedings From The 28th Annual Conference Of The Health Care Systems Research Network, Robert T. Greenlee

Journal of Patient-Centered Research and Reviews

In April 2022, the Health Care Systems Research Network (HCSRN) — a consortium of 20 research institutions affiliated with large health systems spread across the United States (and one in Israel) — held its 28th annual conference in Pasadena, California, with 275 researchers, health care colleagues, and external academic partners in attendance. With a conference theme of “Promoting Collaboration and Partnerships to Advance Health Equity,” the scientific program was assembled by a multisite planning committee with input from representatives of informal local host Kaiser Permanente Southern California. Objectives of the annual conference are to showcase scientific findings from HCSRN projects …

Successful Treatment Of Radiation-Induced Colitis And Enteritis With Hyperbaric Oxygen Therapy, Mark D. Ringle, Jeffrey S. Cooper

Graduate Medical Education Research Journal

Introduction

Previously irradiated tissue is characterized by changes including decreased vascularity, impaired cellular proliferation, and local hypoxia consistent with fibroblastic atrophy which can persist long after radiation therapy. Hyperbaric oxygen therapy has been shown to be beneficial in the treatment of complications arising from these late effects of radiation on normal tissue through enhancing fibroblast proliferation, collagen maturation, stem cell recruitment, and angiogenesis.

Methods

We report on three patients with debilitating radiation enterocolitis causing issues including recurrent bowel obstruction, anorexia requiring total parenteral nutrition, pain, diarrhea, fecal incontinence, dehydration, and malnutrition.

Results

In all three cases marked improvement was the …

Hyperbaric Oxygen Therapy For Cerebral Radiation Necrosis Secondary To Stereotactic Radiation: A Case Series, Sruti Prathivadhi-Bhayankaram, Jeffrey S. Cooper

Graduate Medical Education Research Journal

Introduction: Stereotactic radiosurgery (SRS) is an excellent option for the treatment of numerous central nervous system diseases. There exist several forms of SRS, including gamma-knife surgery (GKS) and cyber-knife surgery. The most significant complication of SRS is the delayed effects of therapeutic radiation, also known as radionecrosis. The current treatment options for radionecrosis have a significant side effect profile and posit challenges for medical management. More recently, hyperbaric oxygen therapy (HBO2) has emerged as an option for treatment with minimal side effects.

Methods: We present a retrospective case series examining ten patients treated with HBO2 after receiving radiotherapy. Of …

Utility Of Av Nodal Characteristics In Identification Of Atrioventricular Nodal Reentrant Tachycardia And Risk Of Recurrence, Kimberly M. Decarr

Longitudinal Scholar's Project

Background: Catheter ablation of the slow atrioventricular (AV) nodal pathway is a safe and effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). While AVNRT occurs frequently in both children and adults, pediatric patients experience higher rates of AVNRT recurrence.

Objective: The purpose of this study was to characterize changes in AV nodal conduction properties following catheter ablation and correlate these properties with AVNRT recurrence in pediatric patients.

Methods: This was a retrospective review of patients aged(AVRT) at a single tertiary care center between January 01, 2010 and September 01, 2021. Demographics, pre- and post-ablation ECG intervals, and AV nodal conduction …

Screening And Assessment Of Cancer-Related Fatigue: A Clinical Practice Guideline For Health Care Providers, Mary I. Fisher, Joy C. Cohn, Shana Harrington, Jeannette Lee, Daniel Malone

Physical Therapy Faculty Publications

Cancer-related fatigue (CRF) is the most common side effect of cancer treatment. Regular surveillance is recommended, but few clinical practice guidelines transparently assess study bias, quality, and clinical utility in deriving recommendations of screening and assessment methods. The purpose of this clinical practice guideline (CPG) is to provide recommendations for the screening and assessment of CRF for health care professions treating individuals with cancer. Following best practices for development of a CPG using the Appraisal of Guidelines for Research and Evaluation (AGREE) Statement and Emergency Care Research Institute (ECRI) Guidelines Trust Scorecard, this CPG included a systematic search of the …

Trustworthiness And Quality In Research For Clinical Application, Mary I. Fisher

Physical Therapy Faculty Publications

No abstract provided.

Project Ankle-Brachial Index: Implementation Of An Evidence-Based Peripheral Artery Disease Protocol, Melaney Banks

Doctor of Nursing Practice Projects

Background: Peripheral artery disease (PAD) is a narrowing or blocking of the arteries due to plaque buildup, which prevents oxygen, blood, and other nutrients from getting to the legs. When this buildup reaches a certain point, it becomes atherosclerosis, which is more prevalent in a smoker. Smoking intensifies the problem of plaque buildup if an individual already suffers from PAD. When an individual smokes, the nicotine causes the arteries to constrict and narrow, reducing blood flow further. The ankle-brachial index (ABI) is a simple, cost-effective diagnostic test to identify the presence of PAD which will improve patient outcomes.

Purpose: This …

Effect Of Injury Mechanism And Severity On The Molecular Pathophysiology Of Traumatic Brain Injury, Brandon Mcdonald

Department of Agricultural and Biological Systems Engineering: Dissertations, Theses, and Student Research

Traumatic brain injury (TBI) mechanism and severity are heterogenous clinically, resulting in a multitude of physical, cognitive, and behavioral deficits. However, approximately 80% suffer from milder injuries. Thus, examining pathophysiological changes associated with mild TBI is imperative for improving clinical translation and evaluating the efficacy of potential therapeutic strategies. Through this work, we developed models of TBI, ranging in both injury mechanism and severity, using an electromagnetic controlled cortical impact (CCI) device. First, we characterized and optimized a closed head, mild TBI model (DTBI) to determine the clinical translatability and practicality of producing repeated mild injuries. Interestingly, we determined that …

Sepsis: Do The Clinical Criteria Support The Medical Coding?, April M. Insco

Theses and Dissertations (ETD)

Background: Sepsis is a condition that can be very costly and very deadly. Diagnosing sepsis can be challenging as there is not one specific test that will identify whether a patient has sepsis and there are varying opinions as to the true definition of sepsis. The definition of sepsis used for this research is a combination of System Inflammatory Response Syndrome (SIRS) with an identified infection. Medical Coders must review the documentation provided in a medical record to accurately assign an ICD-10-CM code. Administrative data is then used to provide statistical information for research purposes. When coded data is not …

Otulin's Novel Regulatory Mechanisms In Genotoxic And Inflammatory Nf-Kb Signaling, Mingqi Li

Theses and Dissertations (ETD)

Triple negative breast cancer (TNBC) is aggressive but cannot be treated with hormone therapy or molecular therapy due to the lack of a target. Chemotherapy is a systemic treatment that works by attacking rapidly growing cells, which is initially more effective for TNBC patients than those individuals with the hormone receptor-positive breast cancer. However, patients with TNBC tend to develop resistance to chemo drugs, called chemoresistance. After years of effort, the signaling pathways involved in TNBC chemoresistance are gradually revealed, including the nuclear factor-kappa B (NF-kB) pathway. Transcription factor NF-kB is widely involved in cancer development and progression, and its …

Perspectives Of African American Women About Barriers To Breast Cancer Prevention And Screening Practices: A Qualitative Study, Abosede F. Obikunle, Jochebed Bosede Ade-Oshifogun

Faculty Publications

Breast cancer is a severe illness that often has fatal consequences. Adherence to the recommendations for breast cancer surveillance is poorly practiced among African American women. The study aimed to identify barriers to preventative screening for breast cancer among African American women (AAW) using a qualitative research design. We explored the influence of personal barriers, stereotypes, socioeconomic status, culture, attitudes, and beliefs on African American women's behavior regarding breast cancer screening. Fourteen African American women were interviewed. Data analysis was completed with Interpretative Phenomenology Approach (IPA). This study's findings demonstrated that African American women perceived the barriers to breast cancer …

Evaluation Of Apical Debris Extrusion Of Two Full-Rotating Instruments, Hyflex Edm And Race Evo, Versus Two Reciprocating Instruments, Reciproc Blue And R-Motion: An In-Vitro Study., Carla Abi Saad, Roula Abiad

BAU Journal - Science and Technology

Complete cleaning and shaping of the root canal space is a mandatory stage for the success of root canal treatment. Extrusion of different materials apically during this step such as dentine debris, pulp tissue remnants, necrotic fragments, microorganisms and irrigants may occur. These extruded materials lead to periapical irritation, pain and/or swelling. To evaluate the apical debris extrusion of Race EVO and Hyflex EDM which are full-rotating instruments, versus R-motion and Reciproc Blue as reciprocating instruments. Forty extracted human mandibular premolar teeth were selected with single canals not affected by fluorosis, resorption, or fracture. Teeth were then randomly divided into …

A Review Of The Pathogenesis, Clinical Features And Diagnostic Indicators Of The Novel Condition Vaccine-Induced Thrombotic Thrombocytopenia, Ada Fleming

International Undergraduate Journal of Health Sciences

The introduction of vaccination against SARS-CoV-2 infection was a welcome and significant event in the COVID-19 pandemic. While vaccine administration was for the most part successful, it did come with the emergence of a novel condition, Vaccine-Induced Thrombotic Thrombocytopenia (VITT). This condition presents after the administration of adenoviral vector-based vaccines against COVID-19, causing thrombocytopenia and thrombosis in affected individuals. There have been 10 suspected cases of VITT in Ireland. While its mechanism is not fully understood, the condition is characterised by the presence of Platelet Factor 4 (PF4) antibodies. There are several laboratory indicators which may suggest that a patient …

Gender Dysphoria Versus Acute Psychosis: Can One Properly Diagnose Gender Dysphoria Solely During Acute Psychosis?, Kristy A. Fisher, Samantha Scemla, Clara L. Alvarez Villalba, Jessica Kroin

HCA Healthcare Journal of Medicine

Gender dysphoria occurs when a discrepancy between one’s sex assigned at birth and one’s gender identity causes distress or impairment in function, which can lead ultimately to seeking treatment in the forms of psychotherapy, hormonal therapy, and/or gender-affirming surgery. Clinical care guidelines also recommend pharmacological treatment of psychiatric comorbidities if indicated. A review of the current literature demonstrates comorbidity between gender dysphoria and psychosis, including cases of gender dysphoria with schizophrenia and the occurrence of gender dysphoria symptoms during manic or psychotic episodes. The existing literature has yet to specifically examine gender dysphoria amongst individuals with schizoaffective disorder. The authors …

Review: Conventional Thrombectomy With Intraoperative Fluoroscopy In Acute Limb Ischemia Rutherford Iib, Heru Angkoso, Dedy Pratama

The New Ropanasuri Journal of Surgery

Introduction. Acute limb ischemia (ALI) is a severe condition affecting the extremities and the patient’s survival that requires immediate treatment. It can be treated with either surgical or endovascular revascularization or both (hybrid procedure). It is crucial to evaluate the defect using intraoperative fluoroscopy or angiography in each case. The review aimed to find out the outcomes of the thrombectomy with intraoperative fluoroscopy for ALI Rutherford IIb.

Method. According to the PRISMA protocol, the literature search proceeded in online databases, i.e., Cochrane, Scopus, PubMed, and EBSCOhost, with no year limitation on the publication. All articles were screened and critically appraised. …

Assessing The Reidentification Risks Posed By Deep Learning Algorithms Applied To Ecg Data, Arin Ghazarian, Jianwei Zheng, Daniele Struppa, Cyril Rakovski

Mathematics, Physics, and Computer Science Faculty Articles and Research

ECG (Electrocardiogram) data analysis is one of the most widely used and important tools in cardiology diagnostics. In recent years the development of advanced deep learning techniques and GPU hardware have made it possible to train neural network models that attain exceptionally high levels of accuracy in complex tasks such as heart disease diagnoses and treatments. We investigate the use of ECGs as biometrics in human identification systems by implementing state-of-the-art deep learning models. We train convolutional neural network models on approximately 81k patients from the US, Germany and China. Currently, this is the largest research project on ECG identification. …

The Effect Of Disease Modifying Therapies On Deep Gray Matter: A Longitudinal Comparative Study, Wendy Jin, Evanthia Bernitsas

Medical Student Research Symposium

Summary

Cerebral gray matter (GM) atrophy is an important factor in determining disability in Multiple Sclerosis^4,9. Disease modifying therapies reduce the GM atrophy to some degree, both in the cortical and deep gray matter (dGM). A previous study has shown that fingolimod (FTY720), asphingosine 1 phosphate immunomodulator can significantly reduced GM and thalamic volume loss in patients with relapsing-remitting Multiple Sclerosis(RRMS)¹. In addition to its effect on reducing dGM volume loss, fingolimod is also believed to have protective effect on focal and diffuse dGM damage^2,8. The effect of natalizumab on GM atrophy, however, is …

Complications Of Pediatric Cochlear Implant Surgery, Andrew Stefan, Sabrina Bernardo, William Azkoul Ii, Bianca Siegel

Medical Student Research Symposium

Background:

Cochlear implantation (CI) surgery is the standard of care treatment for pediatric patients diagnosed with severe to profound sensorineural hearing loss. While considered a relatively safe operation, any invasive procedure involving the cranium has risks. However, there are few recent studies in the United States that have analyzed complication rates among children who have received CI. Furthermore, existing studies fail to discuss specific risk factors that led to post-operative complications, nor offer solutions to reduce their incidence. This study aims to 1) determine the incidence of specific complications in pediatric CI patients and 2) identify evidence-based risk factors for …

Endoscopic Cricoid Split As A Treatment For Subglottic Stenosis: A Systematic Review, Silvia Aluia, Katherine Akers, Michael Chung Md

Medical Student Research Symposium

Introduction: Subglottic stenosis, a fibrotic narrowing of the airway below the vocal cords extending to the lower border of the cricoid cartilage, can be classified as congenital, idiopathic, or acquired in neonates from prolonged intubation. Treatment has more recently expanded from open surgical intervention to include endoscopic procedures. This systematic review aims to evaluate existing literature on anterior and posterior endoscopic cricoid split procedures as a treatment for congenital and acquired subglottic stenosis in order to explore the efficacy of these techniques.

Methods: Literature searches were conducted in PubMed/MEDLINE, EMBASE, Web of Science, Cochrane Library, and Google scholar, which produced …