Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Incidence Of Total Blindness After Central Retinal Artery Occlusion With Ocular Neovascularization, Harshvardhan Chawla, Hayley J. Redrick, Joshua T. Pannell, D. Anthony Mazzulla, Joseph D. Benevento, Sidharth Puri

School of Medicine Faculty Publications

Annual Meeting Association for Research in Vision and Ophthalmology, ARVO 2023, April 24 - 27, 2023, New Orleans, LA

Examining Benefits Of Early Intervention In Cases Of Pediatric Chronic Hypoxia, Kendra Stefan

University Honors Theses

There is a strong foundation of evidence and consensus in the literature that hypoxia has adverse impacts on brain function. Recent research has broadened the field in two directions. One is the treatment for acute hypoxic injuries, and the second is regarding the accumulative impact of intermittent or chronic hypoxia. Historically, in cases of acute hypoxia, action is taken to remedy the source of hypoxia. Physical and cognitive rehabilitation has typically been provided as needed depending on the severity of the injury. While cases of intermittent or chronic hypoxia may not demonstrate an acute urgency for treatment and rehabilitation, current …

Development Of Rp-Hplc Method For Simultaneous Determination Of Nebivolol Hydrochloride, Valsartan And Hydrochlorothiazide In Co-Administrated Antihypertensive Agents And Human Plasma, Shereen Mowaka, M. Rizk, Maha M. Abou El‐Alamin, Mariam Mohamed

Pharmacy

Reversed phase high performance liquid chromatography combined with photodiode array (HPLC-PDA) detector method was developed for simultaneous determination of two binary antihypertensive combinations; either Nebivolol (NEB) with Hydrochlorothiazide (HCZ) or with Valsartan (VAL) in pharmaceutical formulation and spiked human plasma. The method was successfully applied to separate the three drugs on one chromatogram under the same chromatographic conditions that used for two binary combinations. The separation was established on Xterra C18 column using gradient mobile phase which composed of acidified water of pH = 3.0 (adjusted with 0.1% orthophosphoric acid) and acetonitrile with flow rate of 1.0 mL/min. The drugs …

A Modified Bicanalicular Crawford Placement Method For Congenital Nasolacrimal Duct Obstruction: Reducing Need For Operative Room Removal, Ellen E. Ingram, John P. Thompson, Elizabeth M. Bozner, Armin Avdic, Charles Reeder, George S. Ellis, Austin M. Pharo

School of Medicine Faculty Publications

Annual Meeting Association for Research in Vision and Ophthalmology, ARVO 2023, April 24 - 27, 2023, New Orleans, LA

Intracept Technique At Adjacent Levels To Fusions With Pedicle Screws, David Stolzenberg, Paul Kitei, David Tran, Ryan Pfeifer

Rothman Institute Faculty Papers

No abstract provided.

Multi-Target Ligand-Guided Selection (Ligs) Against B-Cell Specific Antigens Expressed In A Single Lymphoma Cell Population, Nicole B. Williams

Dissertations, Theses, and Capstone Projects

Nucleic acid ligands called aptamers are single-stranded DNA or RNA molecules which fold into functional three-dimensional structures to facilitate their target binding with high affinity and specificity. The method used to generate aptamers is an in vitro process called Systematic Evolution of Ligands by Exponential enrichment (SELEX). A variant of SELEX, cell-SELEX has been used to select aptamers against cell-surface proteins in their native state. We recently introduced a novel method called Ligand-Guided Selection (LIGS) to identify aptamers against cell-surface markers. Herein, we expanded LIGS method into a multiplexing platform to partition multiple aptamers against B-cell-specific antigens, CD19 and CD20, …

Cervical Steroid Injections Are Not Effective For Prevention Of Surgical Treatment Of Degenerative Cervical Myelopathy., Mustfa K. Manzur, Andre M Samuel, Avani Vaishnav, Catherine Himo Gang, Evan D Sheha, Sheeraz A Qureshi

Student Papers, Posters & Projects

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: The objective of this study is to determine how often patients with degenerative cervical myelopathy (DCM) and initially treated with cervical steroid injections (CSI) and to determine whether these injections provide any benefit in delaying ultimate surgical treatment.

METHODS: All patients with a new diagnosis of DCM, without previous cervical spine surgery or steroid injections, were identified in PearlDiver, a large insurance database. Steroid injection and surgery timing was identified using Current Procedural Terminology (CPT) codes. Multivariate logistic regression identified associations with surgical treatment.

RESULTS: A total of 686 patients with DCM were identified. …

Implementing A Hearing Screening Readiness Assessment Tool For Preterm And Term Neonates In The Newborn Intensive Care Unit: A Pilot Project, Mckenzie Blatt, Adrienne Johnson, Jennifer L. Hamilton, Carly Alston, Belinda Chan

Journal of Early Hearing Detection and Intervention

Newborn intensive care unit (NICU) patients are at risk for hearing loss. Early detection mitigates consequences of speech and language delay. The Joint Committee on Infant Hearing (JCIH) recommends hearing screening (HS) on all infants by 1 month of age. Often hearing screening is performed around the time of NICU discharge, often beyond JCIH recommendations. Automated auditory brainstem response (AABR) screening can be performed once an infant reaches 32 to 34 weeks corrected gestational age (GA). Our project aimed to reduce HS delay among NICU infants. We created and implemented a HS assessment tool defining gestational age and medical stability …

Examining Dose Frameworks To Improve Aphasia Rehabilitation Research, Sam Harvey, Miranda L. Rose, Emily Brogan, John E. Pierce, Erin Godecke, Sonia L. E. Brownsett, Leonid Churilov, David Copland, Michael Walsh Dickey, Jade Dignam, Natasha A. Lannin, Lyndsey Nickels, Julie Bernhardt, Kathryn S. Hayward

Research outputs 2022 to 2026

The effect of treatment dose on recovery of post-stroke aphasia is not well understood. Inconsistent conceptualization, measurement, and reporting of the multiple dimensions of dose hinders efforts to evaluate dose-response relations in aphasia rehabilitation research. We review the state of dose conceptualization in aphasia rehabilitation and compare the applicability of 3 existing dose frameworks to aphasia rehabilitation research—the Frequency, Intensity, Time, and Type (FITT) principle, the Cumulative Intervention Intensity (CII) framework, and the Multidimensional Dose Articulation Framework (MDAF). The MDAF specifies dose in greater detail than the CII framework and the FITT principle. On this basis, we selected the MDAF …

Benefits Of Using An Upright Laboring Position As Compared To Supine In The Second Stage Of Labor And The Impact On The Use Of Assisted Devices, Chelsey Cook

Master of Science in Nursing Family Nurse Practitioner

Abstract: This paper explores the conclusion that women and their infants are at an increased risk for harm when assisted devices are used during the second stage of labor. Traditional practices involving a supine position during pushing have been associated with an elevated likelihood of assisted delivery, necessitating interventions such as forceps, vacuum extraction, or episiotomy. However, emerging evidence suggests that adopting an upright position during labor may help decrease the need for these interventions and positively impact maternal and fetal outcomes.

Although comprehensive research on this topic is limited, the available evidence supports the benefits of an upright position …

Clinical Presentation And Management Of Chromoblastomycosis: A Case Report And Review, Lacey Falgout, Deborah Hilton

School of Medicine Faculty Publications

No abstract provided.

The Role Of Alpha-2 Agonists For Attention Deficit Hyperactivity Disorder In Children: A Review, Elisa E. Neuchat, Brooke E. Bocklud, Kali Kingsley, William T. Barham, Patrick M. Luther, Shahab Ahmadzadeh, Sahar Shekoohi, Elyse M. Cornett, Alan D. Kaye

School of Medicine Faculty Publications

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders, characterized by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is marked by symptoms such as inappropriate levels of inattention, hyperactivity, and impulsivity that can affect academic, social, and personal functioning in children and adolescents. This review summarizes clinical trials demonstrating the effectiveness of Alpha-2 agonists in reducing symptoms of inattention, hyperactivity, and impulsivity in children with ADHD. Studies were identified through a systematic search of PubMed and Cochrane databases. However, these medications’ long-term safety and efficacy remain uncertain, with a lack …

Algorithmic Bias: Causes And Effects On Marginalized Communities, Katrina M. Baha

Undergraduate Honors Theses

Individuals from marginalized backgrounds face different healthcare outcomes due to algorithmic bias in the technological healthcare industry. Algorithmic biases, which are the biases that arise from the set of steps used to solve or analyze a problem, are evident when people from marginalized communities use healthcare technology. For example, many pulse oximeters, which are the medical devices used to measure oxygen saturation in the blood, are not able to accurately read people who have darker skin tones. Thus, people with darker skin tones are not able to receive proper health care due to their pulse oximetry data being inaccurate. This …

Development Of A Nurse Anesthesia Program Point-Of-Care Ultrasound Airway Examination Curriculum, Sarah Elyse Sandheinrich Butler, Colton Phillip Butler

Doctor of Nursing Practice Projects

Airway management is a critical and fundamental skill for anesthesia providers. Point-of-care ultrasound (POCUS) is an up-and-coming assessment technique that can provide critical information about a patient’s airway anatomy and may increase patient safety during anesthesia care. As a result, understanding the appropriate POCUS equipment, techniques, findings, and clinical implications for airway examination can become essential for safe and effective anesthesia practice. This project aimed to develop a clinical airway POCUS examination curriculum with detailed instructions on all aspects of appropriate examination equipment, set-up, technique, and implications for findings. The team designed the curriculum to incorporate it into the host …

Analytical Approach For Monitoring The Behavior Of Patients With Pancreatic Adenocarcinoma At Different Stages As A Function Of Time, Aditya Chakaborty Dr, Chris P. Tsokos Dr

Biology and Medicine Through Mathematics Conference

No abstract provided.

Comprehensive Analysis Of The Retinal Cell Contributions To The Human Erg, Christopher W. Tyler

MODVIS Workshop

Purpose. Standard electroretinogram (ERG) protocols are largely designed to isolate the responses of the rod and cone retinal pathways, including the use of adapting backgrounds to suppress unwanted off-pathway responses. Here, we record spectral ERGs in the low-to-high mesopic sensitivity range in the absence of any adapting background in order to assess interactions between the pathways.

Methods. We have developed a comprehensive neuroanalytic model of the component structure of the ERG driven by knowledge of the underlying retinal physiology, to enhance its power as a critical diagnostic tool for a broad range of both retinal and systemic dysfunctions. The ERG …

Artificial Intelligence In Neuroradiology: A Scoping Review Of Some Ethical Challenges, Pegah Khosravi, Mark Schweitzer

Publications and Research

Artificial intelligence (AI) has great potential to increase accuracy and efficiency in many aspects of neuroradiology. It provides substantial opportunities for insights into brain pathophysiology, developing models to determine treatment decisions, and improving current prognostication as well as diagnostic algorithms. Concurrently, the autonomous use of AI models introduces ethical challenges regarding the scope of informed consent, risks associated with data privacy and protection, potential database biases, as well as responsibility and liability that might potentially arise. In this manuscript, we will first provide a brief overview of AI methods used in neuroradiology and segue into key methodological and ethical challenges. …

Oral Changes In Hospitalized Covid-19 Patients: A Cross-Sectional Multicentric Study, Asmaa Ras, Radwa R. Hussein, Dalia M. Ghalwash, Ayman A. El-Gawish

Dentistry

Background. Coronavirus disease 2019 (COVID-19) has rapidly spread over the globe, and several oral symptoms have been documented. However, it is unclear whether these lesions are the result of coronavirus infection or are secondary symptoms of the patient’s systemic illness. The aim of this study was to collect data from various hospitals on COVID-19 patients with oral involvement in order to highlight different oral changes that may be manifested in those patients. Methods. This observational cross-sectional multicenter study used an online questionnaire covering oral signs and symptoms that were believed to be related to COVID-19 patients who were …

Botulinum Toxin For Abductor Type Spasmodic Dysphonia: A Systematic Review, Keyona Sutton

Honors Theses

A systematic review was conducted to show that BTX (Botulinum Toxin) is the most effective treatment for Abductor Spasmodic Dysphonia (ABSD). There were a total of 117 records screened for inclusion in this review. After the initial screening, there were seven successive rounds of screening for eligibility. This process produced a total of three eligible records that met the following conditions: patients presented with spastic abduction, electromyography BTX type A injection into the posterior cricoarytenoid muscle, and measurement of results with acoustic dimensions. After surveying all eligible studies, it was concluded that BTX is an effective treatment for ABSD. Every …

Isokinetic Dynamometer Leg Extensor Peak Torque Measurement: A Time-Delayed Reliability And Score Selection Analysis Study, Brennan J. Thompson, Jennifer Xu

Kinesiology and Health Science Faculty Publications

The reliability of isokinetic peak torque (PT) has been reported mostly using a short-term ( < ~10 day) inter-trial testing time frame. However, many studies and programs utilize a long-term (several weeks to months) inter-trial testing period. Additionally, the methods by which the PT value is selected and reported from a multiple rep testing scheme have not been well investigated for both reliability and PT absolute performance comparisons. The purpose of this study was to investigate the long-term reliability of isokinetic and isometric PT of the leg extensors with an emphasis on the differences among several PT score selection methods. Thirteen men and women (age = 19.5 years) underwent two testing trials separated by 28.8 (±1.8) days. Testing included maximal voluntary contractions of three sets of three reps for two isokinetic contraction conditions of 60 (Isok60) and 240 (Isok240) deg/s velocities, and three sets of one rep of isometric contractions for the leg extensors. The PT score was derived from seven different methods (see text for descriptions). Reliability as assessed from intraclass correlation coefficients (ICCs) varied widely across contraction conditions and PT score selection parameters. The Isok60 velocity overall had lower reliability (ICCs = 0.48–0.81) than Isok240 (0.77–0.87) across the conditions whereas the isometric PT variables showed moderate reliability (0.71–0.73). Overall the set 1 PT score selection parameters were generally lower (p ≤ 0.05) than those that involved sets two and three. Systematic error (p ≤ 0.05) was shown for 6 out of the 17 PT selection variables. On a subjective interpretation basis, when taking everything into account the best overall combination of time/trial efficiency, reliability, best/highest PT score parameter, and reduced risk of systematic bias appears to be the PT variable that uses the average of the highest two reps of the first two sets of three reps—i.e., averaging the highest two values of the six total reps from the first two sets.

Degree Of Uncertainty In Reporting Imaging Findings For Necrotizing Enterocolitis: A Secondary Analysis From A Pilot Randomized Diagnostic Trial, Disa Rathore, Kira Bourrett, Sherwin S. Chan, Erin Opfer, Alain Cuna

Research Days

Background: Uncertainty in reporting of imaging findings for necrotizing enterocolitis (NEC) can be challenging for clinicians and result in ambiguity, miscommunication, and potential diagnostic errors. The degree to which uncertainty complicates diagnostic imaging for NEC has not been characterized.

Objective: To determine the degree of uncertainty in diagnostic imaging for NEC.

Methods: We conducted a retrospective study using data from a previously completed pilot diagnostic randomized clinical trial (RCT). The study population comprised of preterm infants with suspected NEC who were randomized to either standard imaging with abdominal radiographs (AXR) alone or experimental imaging with AXR + add-on bowel ultrasound …

Retinoids And Their Clinical Benefits To Treating Cutaneous T-Cell Lymphoma, Baker Kendrick

Honors Theses

Cutaneous T-Cell Lymphoma (CTCL) is a deadly form on non-Hodgkin lymphoma that primarily affects the skin. Non-Hodgkin lymphoma means that the lymphoma does not have the presence of Reed-Sternberg lymphocytes. A lymphoma, also known as lymphatic cancer, affects the lymphoid tissues, which plays a major role in the immune system. Lymphoid organs include the lymph nodes, thymus, spleen, and bone marrow. Lymphatic fluid, also known as lymph, travels through the bloodstream to transport lymphocytes, a type of white blood cell, to and from lymphatic organs. Due to a high concentration of lymphocytes in the skin, lymphoma primarily affects cutaneous areas. …

Early Onset Hypertension Objective Structured Clinical Examinations, Katrina Morace

Doctoral Projects

Hypertension is known as a condition in which raised blood vessel pressure persists. On a normal day, the pressure can rise and fall causing damage to the heart. When the pressure stays at higher readings, damage can be caused to the heart and can also lead to additional health problems. Another word for high blood pressure is hypertension. The blood is carried to all body parts from the heart by the arteries. The harder the heart pumps the higher the blood pressure (Centers for Diseases Control and Prevention [CDC], 2020). When hypertension is not diagnosed and treated at an early …

Determining The Effect Of Cuff Deflation On Post-Exercise Arterial Occlusion Pressure, John Benton

Honors Theses

While it is recommended that blood flow restriction be applied relative to pre-exercise arterial occlusion pressure (AOP), no guidelines exist for an initial rest period prior to the measurement. Remeasuring AOP post-exercise can be used to estimate the cardiovascular response. When measuring post-exercise (pre-) AOP, different methods could be used. Some increase the cuff pressure from blood flow restriction exercise pressure (without deflation), or deflate the cuff prior to post-exercise (post-) AOP measurement. It is unknown if pre-AOP is affected by initial rest period, or if post- AOP is affected by cuff deflation. Thus, the purpose of this study was …

Comparison Between Honey Produced By Bees, Aphids And Wasps In Kurdistan Region - Iraq Based On Biochemical Parameters, Jian Lateif Hussein

Al-Bahir Journal for Engineering and Pure Sciences

Honey is a sweet substance that has been valued by humans for its taste and health benefits. It is produced by honey bees from the sugary secretions of plants. However, other insects, such as aphids and wasps, also produce honey-like substances. This study aimed to compare the physical and biochemical properties of honey produced by honey bees, aphids, and wasps in the Kurdistan Region of Iraq. To achieve this, samples of honey, bitter honey, honeydew, and wasp honey were collected and examined. The samples were analyzed for total sugar, sucrose, water, Hydroxymethylfurfural (HMF), acidity, total acidity, diastase activity, total phenolic …

Standardization Of Perioperative Management Of The Breastfeeding Women, Amrutha Panakkal

Doctor of Nursing Practice Projects

Mother's milk is the optimal nutrition for the term and preterm neonates. The psychological and physiological stressors in the perioperative setting can impede a lactating mother's ability to breastfeed in the postoperative setting successfully. A best-practice guideline incorporating a stoplight color-coding chart and categories such as "safe," "caution," and "consider avoidance" was used to group medications according to their safety for anesthesia providers in a large urban academic medical center in Pennsylvania. The evidence-based guideline also provided links to the hospital policy, LactMed, and Hale database to streamline resources and aid in the rapid decision-making of anesthesia providers in identifying …

Improving Imaging Practices Following Arterial Switch Operation, Mollie Walton, Nir Atlas, Sanket Shah

Research Days

Problem Statement/Question: Long-term risk in post-operative cardiac patients exists, and morbidity may be avoided with advanced imaging surveillance.

Background/Project Intent (Aim Statement): The Appropriate Use Criteria (AUC) for Multimodality Imaging During Follow-Up Care of Patients with Congenital Heart Disease (CHD) was published in 2020 by the American College of Cardiology Foundation. This includes a subsection for D-Looped Transposition of the Great Arteries (D-Loop TGA). The arterial switch operation (ASO) is the preferred method for surgical repair of D-Loop TGA. Appropriate and timely use of advanced imaging is essential in optimizing long-term postsurgical outcomes. The objective of this quality improvement (QI) …

Implementation Of A Nurse-Led Clinical Algorithm For Pressure Injury Prevention Associated With Non-Invasive Ventilation Medical Device Use, Capri Steinkuhler, Kaitlin Rogge

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Medical device related pressure injuries (PI) account for as much as 61-81% of all hospital reported wound incidents (Gefen et al., 2020) and are frequently caused by respiratory devices such as non-invasive ventilation (NIV). Use of NIV in critically ill patients dramatically increased during the pandemic. PI are one of the leading causes of injury to hospitalized patients and lengthens hospital stays (National Pressure Injury Advisory Panel [NPIAP], 2019). The NPIAP recommends routine skin assessment under devices, proper mask fit, protective barrier, moisture reduction, and interdisciplinary collaboration to prevent PIs from NIV masks. This feasibility study’s purpose …

Center Based Cardiac Rehabilitation Outcomes Associated With Covid-19 Pandemic: A Retrospective Comparative Cohort Study, Haley Williams, Kayla Woodworth

Doctor of Nursing Practice Projects: College of Nursing

Background: Traditional cardiac rehabilitation (CR) is a multidisciplinary, multifaceted program for cardiac patients. Throughout the Covid-19 pandemic, health care, including center-based CR (CBCR) programs, were closed to in-person sessions. Even with the return to CBCR participation, patient outcomes may have been affected by this disruption in care. The goal of this study was to determine if CR participation outcomes differed before and after CBCR program closure due to Covid-19.

Methods: A retrospective comparative cohort design was used to examine CR participant outcome data before and after the Covid-19 pandemic. Convenience sampling of CR participants at a large, urban …

Telehealth Integration In Primary Care, Ashley Simons

Doctor of Nursing Practice Projects

Telehealth has been proven to be a useful and integral tool in primary care settings. Carlinville Family Health Care Clinic, a rural health clinic, has the current ability to conduct Telehealth visits but is not currently doing so. They have several programs available that are equipped with Telehealth capabilities. The physicians cite lack of education on these programs and lack of a standard streamlined practice for which program to use or how to use it.

According to the physicians in this practice, along with their patients, the use of Telehealth has multiple advantages. Because visits in this clinical are usually …