Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Effectiveness Of Stabilized Hypochlorous Acid In Acute Peritonitis Treatment: A Murine Surgical Study, Benjamin Michael Pomeroy

Graduate Theses/Dissertations

Peritonitis is an inflammatory condition affecting the mesothelial cells that line the peritoneal cavity and is commonly induced by bowel perforations. This medical emergency is treated through antibiotic therapy and surgical intervention followed by tissue irrigation (lavage). Acute treatments aim to remove the bacterial burden, however recurring peritoneal infections occur at high rates and contribute to patient morbidity. These recurring infections are likely due to the inability of lavage solutions to remove the entire massive intra-abdominal bacterial load due to intestinal perforation. Numerous antiseptic solutions and antibiotic additives have been evaluated in their ability to improve source control by abdominal …

Graston Technique® Combined With Therapeutic Intervention As An Alternative Treatment For A Grade Iii Ucl Thumb Sprain: A Disablement Model Case Study, Raul Anaya Jr., Kim Bacalla, Annette D. Monk

Clinical Practice in Athletic Training

Nonoperative measures have been shown to have positive effects on thumb ulnar collateral ligament (UCL) sprains considered less than complete. This case presents evidence supporting Graston Technique® (GT) plus therapeutic exercise in order to decrease pain and stiffness in a collegiate football athlete who sustained a grade III UCL sprain. The results showed that there was a reduction in pain level above the minimal clinically importance difference, and ROM improved throughout the three-week intervention. The findings of this case study provide minimal support for an alternative treatment to reduce pain and stiffness in a grade III UCL sprain, with further …

Monitoring The Systemic Immune System To Understand And Improve The Efficacy Of Immunotherapy For Metastatic Osteosarcoma, Justin Edward Markel

Graduate Theses, Dissertations, and Problem Reports (ETD)

Osteosarcoma (OS) is a complex tumor with no effective targeted therapies due to its genomic heterogeneity and pleomorphism. The immune response it creates, particularly against metastatic lesions, is considerable; however, various suppressive mechanisms induced by the tumor prohibit its effectiveness. The presence of infiltrating lymphocytes suggests that therapeutic disinhibition through checkpoint blockade could increase antitumor immunity, though none have been successful in clinical trials. The complexities of the immune response to OS tumors have yet to be unraveled; however, there is evidence to suggest that cell-mediated immunity (CMI, specifically T cells, Natural Killer [NK] cells, and myeloid-lineage cells [MLCs]) plays …

Safety Of Blood Flow Restriction Training For Musculoskeletal Disorders: An Evidence-To-Practice Review, Breanna Ferguson, Erica Schulman, Matthew Zimmerman, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Blood flow restriction training (BFRT) is low-level resistance training while partially occluding proximal blood flow. It is well documented that this style of training leads to increased muscle size as well as strength. It is theorized that these size and strength gains are due in part to the decreased oxygen environment. This results in increased muscular stress without the need for increased external load making this style of resistance training ideal for individuals who have restrictions due to musculoskeletal disorders. The guiding systematic review examined the safety of BFRT when used as a therapeutic intervention for patients with a variety …

Anisocoria As The Sole Initial Symptom Of Concussion In A Collegiate Volleyball Player: A Case Report, I Hopper, B J. Warner, M Mckenney, R M. Galbraith, C Cox, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old female collegiate volleyball player reported to the athletic training staff after a competition upon noticing that her pupils were unequal. The patient stated that she was not experiencing any other signs or symptoms that would indicate a concussion, but did recall striking her head on the court during pre-competition warmups. The patient reported no previous history of concussion or eye injury. Further evaluation did not reveal any issues with the patient’s reflexes, balance, or memory. At this time, the decision was made to preemptively withhold the patient from participating in athletic activities so she could be monitored …

Conservative Care Of A Patient With Initial Anterior Shoulder Dislocation Participating In An Intercollegiate Basketball: A Disablement Model Case Study, Lucas Bianco

Clinical Practice in Athletic Training

A 23-year-old male patient participating in intercollegiate basketball, suffered an acute shoulder dislocation. The patient was diagnosed with an anterior glenohumeral labral tear and was treated with an indirect approach to increase range of motion (ROM) and function while decreasing pain. Patient-related outcome (PRO) measures were used along with clinician related outcome (CRO) measures to discharge the patient. The immediate changes in ROM and pain along with follow-up assessments of the Disabilities of the Arm, Shoulder, Hand (DASH) Scale achieved Minimal Clinically Importance Difference (MCID) levels. As rehabilitation specialists, athletic trainers have the opportunity to provide quality care to patients …

Comparison Of The Closed Shoulder Reduction Techniques: An Evidence-To-Practice Review, Kaitlin Sznajder, Dylan Arango, Zachary K. Winkelmann

Clinical Practice in Athletic Training

The shoulder joint is one of the most dislocated joints in the body. It does not have substantial bony support which allows for a large range of motion. Shoulder joints most commonly dislocate anteriorly, and less often dislocate posteriorly and inferiorly. There is a myriad of ways to reduce a shoulder dislocation including closed and open techniques. The purpose of this evidence-to-practice review is to summarize which closed shoulder reduction techniques are most effective and apply those results to an athletic training setting. The authors of this guiding systematic review studied multiple articles that compared different closed shoulder reduction techniques …

Validity Of Selective Tissue Tests For Knee Pathologies: An Evidence-To-Practice Review, Stephanie P. Ulshafer, Samara D. Johnson, Kevin N. Schoell, Zachary K. Winkelmann

Clinical Practice in Athletic Training

The knee is the most commonly injured joint in sport, inherently meaning the knee is also the joint most frequently evaluated by healthcare providers. Clinicians evaluate and treat the knee as efficiently as possible to prevent long-term disability of the patient. Clinicians rely on physical examination tests such as McMurray’s Test, Apley’s Test, Joint Line Tenderness, Lachman Test, Anterior Drawer, Pivot Shift Test, and the Ottawa Knee Rules for initial diagnosis and initiation of care. These physical examination tests have varying levels of diagnostic accuracy and validity. Clinicians should know how definite they can be about a diagnosis from physical …

Body Tempering And Its Effect On Ankle Dorsiflexion And Power, Neal Ori, Justin Goins, Jay Patel, Robbie Ingle

Clinical Practice in Athletic Training

Body Tempering (BT) is a newer myofascial release (MFR) technique that is used by athletes and healthcare professionals. The effects of BT are stated to be similar to foam rolling (FR) and other MFR techniques, but there is minimal research assessing the effects of BT on power and range of motion (ROM). The purpose of this study was to determine the effect of BT on ankle dorsiflexion ROM and power, as well as to compare the effects of BT to traditional FR. Twenty college-aged participants (10 males-10 females) were tested before and after intervention on three measurements of the broad …

Herpes Zoster As An Incidental Finding During Treatment For Thoracic Back Pain In A Collegiate Baseball Player, L E. Trail, B J. Warner, R L. Peebles, R M. Galbraith, C Cox, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old male collegiate baseball pitcher reported to the athletic training staff complaining of thoracic back pain when throwing during the non-traditional season. The patient did not recall a specific mechanism of injury, and noted that his pain had gradually increased over time. The patient reported no previous history of thoracic or lumbar spine injury. Further evaluation revealed multiple myofascial adhesions that did not resolve with conservative treatments. After the failure of conservative treatment, the patient was referred to the team physician for further evaluation.. Differential Diagnosis: Myofascial adhesions, Rib subluxation, Thoracic Disc Herniation Treatment: Upon referral, the team …

Using The Mulligan Mobilization With Movement And Fibular Repositioning To Treat High School Patients With A Grade One Lateral Ankle Sprain, Alexander Zettlemoyer, Rich Patterson, Russell Baker, Alan Nasypany

Clinical Practice in Athletic Training

Ankle injuries are common among high school athletics with the highest incidence rates in boys and girls basketball and boys football. Novel treatment paradigms like the Mulligan Mobilization with Movement (MWM) in conjunction with fibular repositioning tape have shown promising results in reducing pain, disability, and time lost due to lateral ankle sprains (LAS). However, research focusing on Mulligan treatment strategies and ankle swelling following a LAS is limited. Therefore, the purpose of this case series was to evaluate the combined effects of the MWM and fibular repositioning taping on swelling, function, and pain in high school patients with an …

Improving Ankle Range Of Motion With The Use Of Instrument Assisted Soft Tissue Mobilization: A Validation Case Study, Sarah Jakubek, Elena Robinson, Annette D. Monk

Clinical Practice in Athletic Training

The purpose of this case validation study was to examine the effects of Instrument-Assisted Soft Tissue Mobilization (IASTM) on the ankle. The patient population consisted of nine participants (2 females, 7 males, age = 16± 2 years) from a suburban high school in Illinois. Each patient completed an IASTM treatment program, incorporating the Graston Technique (GT). The program was completed over a three-week period with 2 sessions occurring each week, for a total of 6 sessions. Data collection of ankle dorsiflexion range of motion (DFROM) occurred after the completion of the GT. This was assessed by performing the weight-bearing lunge …

Concussion Profiles: Moving Beyond The Graded Symptom Scale, Tamara Valovich Mcleod, Brian Vesci

Clinical Practice in Athletic Training

No abstract provided.

Plan Quality And Isotoxic Dose Escalation Investigation Using A 0.35t Mr-Linac System In Ablative 5-Fraction Stereotactic Magnetic Resonance-Guided Radiation Therapy (Mrgrt) For Primary Pancreatic Cancer, Robert Eric Hawranko

Theses and Dissertations

This study investigates plan quality generated by an MR-Linac (MRL) treatment planning system (TPS) for 5-fraction stereotactic body radiation therapy (SBRT) of primary pancreatic cancer (PCa). In addition, an isotoxic dose escalation was investigated with the MRL TPS based on the stereotactic MR-guided adaptive radiation therapy (SMART) trial constraints. A clinical workflow was developed for adaptive and non-adaptive treatments with the MRL, on which a time-driven activity-based costing (TDABC) analysis was performed to quantify clinical efficacy. Fifteen Pca patients previously treated with a conventional Linac were retrospectively re-planned for this study. Three plans were generated for each patient: using the …

Modeling Of Patient-Specific Periaortic Mechanics And Pulmonary Artery Hemodynamics Based On Phase-Contrast Magnetic Resonance Imaging Sequences., Johane H. Bracamonte

Theses and Dissertations

Inverse modeling in cardiovascular medicine is a collection of methodologies that can provide non-invasive patient-specific estimations of clinical risk factors using medical imaging as inputs. Its incorporation into clinical practice has the potential to improve diagnosis and treatment planning with low associated risks and costs.

Herein, three different phase contrast magnetic resonance imaging (MRI) modalities were implemented as input data, displacement encoding with stimulated echoes (DENSE MRI) applied, and time-resolved velocity encoding phase-contrast MRI, in 1D and 3D, applied to pulmonary artery (PA) hemodynamics.

A model to account for the effect of periaortic interactions due to static and dynamic structures …

Refinement Of Alphafold2 Models Against Experimental And Hybrid Cryo-Em Density Maps, Maytha Alshammari, Willy Wriggers, Jiangwen Sun, Jing He

Computer Science Faculty Publications

Recent breakthroughs in deep learning-based protein structure prediction show that it is possible to obtain highly accurate models for a wide range of difficult protein targets for which only the amino acid sequence is known. The availability of accurately predicted models from sequences can potentially revolutionise many modelling approaches in structural biology, including the interpretation of cryo-EM density maps. Although atomic structures can be readily solved from cryo-EM maps of better than 4 Å resolution, it is still challenging to determine accurate models from lower-resolution density maps. Here, we report on the benefits of models predicted by AlphaFold2 (the best-performing …

A Novel Computational Network Methodology For Discovery Of Biomarkers And Therapeutic Targets, Qing Ye

Graduate Theses, Dissertations, and Problem Reports (ETD)

Lung cancer has the second highest cancer incidence rate and the top cancer-related mortality worldwide. An estimate from the American Cancer Society shows that, in 2022, there will be about 236,740 lung cancer cases (117,910 men and 118,830 women) in the US. To date, there are no prognostic/predictive biomarkers to select chemotherapy, immunotherapy, and radiotherapy in individual non-small cell lung cancer (NSCLC) patients. There is an unmet clinical need to identify patients with early-stage NSCLC who are likely to develop recurrence and to predict their therapeutic responses. This dissertation developed a novel computational methodology for modeling molecular gene association networks …

Quantitative Raman Analysis Of Carotenoid Protein Complexes In Aqueous Solution, Joy Udensi, Ekaterina Loskutova, James Loughman, Hugh Byrne

Datasets

Carotenoids are naturally abundant fat-soluble pigmented compounds, with dietary, antioxidant and vision protection advantages. The dietary carotenoids, Beta Carotene, Lutein and Zeaxanthin, complexed with in bovine serum albumin (BSA) in aqueous solution, were explored using Raman spectroscopy to differentiate and quantify their spectral signatures. UV visible absorption spectroscopy was employed to confirm the linearity of responses over the concentration range employed (0.05-1mg/ml) and, of the 4 source wavelengths, 785nm, 660nm, 532nm, 473nm, 532nm was chosen to provide the optimal response. After preprocessing to remove water and BSA contributions, and correct for self-absorption, a partial least squares model with R^{2 …}

Biologic Tnf-Α Inhibitors Reduce Microgliosis, Neuronal Loss, And Tau Phosphorylation In A Transgenic Mouse Model Of Tauopathy, Weijun Ou, Joshua Yang, Juste Simanauskaite, Matthew Choi, Demi M. Castellanos, Rudy Chang, Jiahong Sun, Nataraj Jagadeesan, Karen D. Parfitt, David H. Cribbs, Rachita K. Sumbria

Pharmacy Faculty Articles and Research

Background

Tumor necrosis factor-α (TNF-α) plays a central role in Alzheimer’s disease (AD) pathology, making biologic TNF-α inhibitors (TNFIs), including etanercept, viable therapeutics for AD. The protective effects of biologic TNFIs on AD hallmark pathology (Aβ deposition and tau pathology) have been demonstrated. However, the effects of biologic TNFIs on Aβ-independent tau pathology have not been reported. Existing biologic TNFIs do not cross the blood–brain barrier (BBB), therefore we engineered a BBB-penetrating biologic TNFI by fusing the extracellular domain of the type-II human TNF-α receptor (TNFR) to a transferrin receptor antibody (TfRMAb) that ferries the TNFR into the brain via …

Pulsed Chronopotentiometry With Polymer-Based Potassium-Selective Electrodes, Roland A. Long, Kebede L. Gemene Dr.

Posters-at-the-Capitol

This research aimed to develop ion-selective electrodes selective to potassium for use in measuring potassium concentration in blood. Potassium is an important electrolyte within the body, orchestrating nerve excitation, muscular function, and heart rate. Excessive or insufficient potassium levels can cause breakdowns in these systems difficult to differentiate from other potential causes. Isolating potassium concentration as the sole cause necessitates selective measurement. Pulsed Chronopotentiometry with polymer-based membrane electrodes offered a versatile route of interrogation: membrane composition and magnitude of applied current can be altered to assess selectivity in a fast and controlled manner. All potential measurements recorded corresponded to known …

Preventing Bleeding Complications Of Paracentesis Using Point-Of-Care Ultrasound: An N-Of-1 Case Study, Adam Karevoll, Willie Talbert, Christopher J. Smith

Graduate Medical Education Research Journal

Abdominal paracentesis is a common bedside procedure, and the advent of point-of-care ultrasound has provided an opportunity to reduce the associated risks. Multiple society guidelines now recommend both site and vascular marking to avoid potential complications. This case illustrates the importance of vascular marking specifically to avoid damage to adjacent blood vessels.

Increasing Continuous Positive Airway Pressure Compliance With Various Telemedicine Interventions: An Integrated Literature Review, Tracy Partington

Doctor of Nursing Practice (DNP) Projects

Aims and Objectives. This literature review's objective was to synthesize evidence from previously published literature on telemedicine interventions' effectiveness on CPAP (Continuous Positive Airway Pressure) therapy compliance.

Background. It is estimated that 22 million Americans suffer from a form of Sleep Apnea (SA), and those up to 80 percent of the cases of moderate to severe Obstructive Sleep Apnea (OSA) are undiagnosed (Sleep Apnea, n,d). The first-line therapy for OSA is CPAP. However, CPAP therapy is associated with low compliance rates.

Design. Systematic review.

Method. A multi-database literature search was conducted to identify published literature between 2009 and 2020. …

Are Polypills A Viable Option To Improve Health Outcomes In Those With Cardiovascular Disease?, Alexander Voytovich, Cara Mckee

Physician Assistant Capstones, 2020-current

Objective: Does the use of polypill therapy improve systolic blood pressure and low-density lipoprotein cholesterol (LDL-C) levels more than usual care in adults with established cardiovascular disease (CVD) or with 10-year atherosclerotic cardiovascular disease risk >10%. Design: Systematic literature review. Methods: Searches were performed in PubMed and UpToDate using the following search terms polypill and cardiovascular. Other limits included: randomized control trials, adults, published in the last 10 years, LDL-C and systolic blood pressure. Results: Analysis of articles to ensure similar design, intervention and fit with the other inclusion/exclusion criteria yielded three studies: Labefer et al, Muñoz et al, and …

Ketamine As A Treatment Modality For Treatment-Resistant Depression, Tracy Wulff, Shen Cao

Physician Assistant Capstones, 2020-current

Many recent studies have demonstrated the ability of ketamine, an NMDA receptor antagonist, to produce antidepressant effects that may be effective in helping reduce treatment-resistant major depression. In particular, three double-blinded randomized control trials have been conducted to assess the viability and effectiveness of this medication for treatment. This systematic literature review will analyze these studies and determine if the overall research indicates that ketamine is useful in improving depression as measured by the Montgomery–Asberg Depression Rating Scale (MADRS)¹.

Objective: Assess the effectiveness of IV Ketamine in reducing treatment-resistant major depressive disorder as measured by the Montgomery–Asberg …

Enhanced Recovery After Surgery: Necessity Of Real Time Tracking In Quality Measures And Outcomes, Emily Owens

Master's Projects and Capstones

Abstract

A High Reliability Organization (HRO), such as this Northern California Medical Center, holds itself to high standards of performance in the areas of recognition, ranking, and accreditation. The commonality between these high-scored and valuable acknowledgements is the pillars of Quality Outcomes. As benchmarking and reporting allow this facility to measure outcomes against self and other plans, it greatly strengthens the internal focus for continual improvement and goal setting in direct patient care and outcomes. A deeper layer of the Quality Department includes the bundle “ERAS – Enhanced Recovery After Surgery”, which is compiled of principles aiming to minimize opioid …

Deep Learning Approach To Improved Image Quality For Medical Diagnostics, Olivia Loesch, Katie Leyba, Halyley Chan, Craig Goergen

Discovery Undergraduate Interdisciplinary Research Internship

The United Nation’s health-related Sustainable Development Goals are difficult to achieve in low- and middle-income countries due to workforce shortages and inadequate health surveillance systems. However, with the growth of artificial intelligence (AI) and computer algorithms, it is possible to apply AI to healthcare technologies to improve progress towards these UN standards. This project aims at using and improving computer algorithms and deep learning to aid in the extraction of important structural and functional information from murine carotid artery ultrasound and photoacoustic images. First, we created a large database of simulated photoacoustic images to optimize the algorithms. These images were …

Deep Convolutional Neural Networks For Accurate Diagnosis Of Covid-19 Patients Using Chest X-Ray Image Databases From Italy, Canada, And The Usa, Amgad A. Salama, Samy H. Darwish, Samir M. Abdel-Mageed, Radwa A. Meshref, Ehab I. Mohamed

The University of Louisville Journal of Respiratory Infections

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), famously known as COVID-19, has quickly become a global pandemic. Chest X-ray (CXR) imaging has proven reliable, fast, and cost-effective for identifying COVID-19 infections, which proceeds to display atypical unilateral patchy infiltration in the lungs like typical pneumonia. We employed the deep convolutional neural network (DCNN) ResNet-34 to detect and classify CXR images from patients with COVID-19 and Viral Pneumonia and Normal Controls.

Methods: We created a single database containing 781 source CXR images from four different international sub-databases: the Società Italiana di Radiologia Medica e Interventistica (SIRM), the GitHub Database, the …

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Clinical Diagnosis Support With Convolutional Neural Network By Transfer Learning, Spencer Fogleman, Jeremy Otsap, Sangrae Cho

SMU Data Science Review

Breast cancer is prevalent among women in the United States. Breast cancer screening is standard but requires a radiologist to review screening images to make a diagnosis. Diagnosis through the traditional screening method of mammography currently has an accuracy of about 78% for women of all ages and demographics. A more recent and precise technique called Digital Breast Tomosynthesis (DBT) has shown to be more promising but is less well studied. A machine learning model trained on DBT images has the potential to increase the success of identifying breast cancer and reduce the time it takes to diagnose a patient, …

Machine Learning Approach To Distinguish Ulcerative Colitis And Crohn’S Disease Using Smote (Synthetic Minority Oversampling Technique) Methods, Kris Ghimire, Walter Lai, Yasser Omar, Thad Schwebke, Jamie Vo

SMU Data Science Review

Irritable Bowel Disease (IBD) affects a sizable portion of the US population, causing symptoms such as vomiting, abdominal pain, and diarrhea. Despite the disease’s prevalence, the precise cause is not fully understood. This study consists of endoscopic and histological data from patients diagnosed with IBD and a control population for reference. The machine learning models' focus is to classify patients into IBD types. Several models were analyzed, including decision trees, logistic regression, and k-nearest neighbors. In addition, various methods of SMOTE were applied to determine the most effective transformation and ensuring that the dataset is balanced. The best model with …