Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Whose Preferences Matter? A Patient-Centered Approach For Eliciting Treatment Goals, Nananda F. Col, Andrew J. Solomon, Vicky Springman, Calvin P. Garbin, Carolina Ionete, Lori Pbert, Enrique Alvarez, Brenda Tierman, Ashli Hopson, Christen Kutz, Idanis Berrios Morales, Carolyn Griffin, Glenn Phillips, Long H. Ngo

Department of Psychology: Faculty Publications

Background. Patients facing a high-stakes clinical decision are often confronted with an overwhelming array of options. High-quality decisions about treatment should reflect patients’ preferences as well as their clinical characteristics. Preference-assessment instruments typically focus on pre-selected clinical outcomes and attributes chosen by the investigator. Objective. We sought to develop a patient-centered approach to elicit and compare the treatment goals of patients with multiple sclerosis (MS) and healthcare providers (HCPs). Methods. We conducted five nominal group technique (NGT) meetings to elicit and prioritize treatment goals from patients and HCPs. Five to nine participants in each group responded silently to one question …

Development Of Cellular Assays To Monitor Enzymatic And Biological Activity Of Cd73: A Key Modulator Of Anti-Tumor Immune Response, Alexandra Fanuka

Graduate School of Biomedical Sciences Theses and Dissertations

Ecto-5’-nucleotidase, known as CD73, is an extracellular enzyme that converts adenosine monophosphate (AMP) to adenosine and has recently been identified as a potential drug target for cancer immunotherapy. Its immunosuppressive effects, mediated by the activity of adenosine, are associated with higher rates of tumor invasion and metastasis, as well as poorer prognoses overall in many cancer types. CD73 is often co-expressed with ectonucleoside triphosphate diphosphohydrolase-1 (CD39), which catalyzes the conversion of adenosine triphosphate (ATP) to adenosine diphosphate (ADP), and ADP to AMP on the surface of tumor cells. Dual expression further propagates immunosuppressive effects of adenosine in the tumor microenvironment. …

The Neuropsychology Of Sport And Performance, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

Neuropsychological theory has been a mainstay for understanding pathology within the brain-behavior context. However, our theories for predicting superior behavior are not as well developed. Sport neuropsychology was developed on the presumption that athletes represent a population in a relatively well-controlled environment for studying brain pathology due to injury. This study of pathology within a high-performance environment has been responsible for identifying the effects of mild traumatic brain injury (mTBI) on individual functioning. Far less attention has been paid to the other end of the performance continuum, and yet, viable brain-behavior hypotheses should hold true across the spectrum of function …

Validity And Reliability Of Baseline Testing In A Standardized Environment, Kathryn L. Higgins, Todd Caze, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

Objective — The Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) is a computerized neuropsychological test battery commonly used to determine cognitive recovery from concussion based on comparing post-injury scores to baseline scores. This model is based on the premise that ImPACT baseline test scores are a valid and reliable measure of optimal cognitive function at baseline. Growing evidence suggests that this premise may not be accurate and a large contributor to invalid and unreliable baseline test scores may be the protocol and environment in which baseline tests are administered. This study examined the effects of a standardized environment and administration …

Measurement Of Cortisol In Saliva: A Comparison Of Measurement Error Within And Between International Academic‑Research Laboratories, Jessica L. Calvi, Frances R. Chen, Victoria Brann Benson, Eleanor Brindle, Matt Bristow, Alpana De, Sonja Entringer, Helen Findlay, Christine Heim, Eric A. Hodges, Heiko Klawitter, Sonia Lupien, Holly M. Rus, Jitske Tiemensma, Silvanna Verlezza, Claire-Dominique Walker, Douglas A. Granger

Center for Brain, Biology, and Behavior: Faculty Publications

Objective: Hundreds of scientific publications are produced annually that involve the measurement of cortisol in saliva. Intra- and inter-laboratory variation in salivary cortisol results has the potential to contribute to crossstudy inconsistencies in findings, and the perception that salivary cortisol results are unreliable. This study rigorously estimates sources of measurement variability in the assay of salivary cortisol within and between established international academic-based laboratories that specialize in saliva analyses. One hundred young adults (Mean age: 23.10 years; 62 females) donated 2 mL of whole saliva by passive drool. Each sample was split into multiple- 100 μL aliquots and …

Patterns Of Referral In High School Concussion Management Programs: A Pilot Study Of Consultants From Different Disciplines, Jonathan Lichtenstein, Kate S. Linnea, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

School-based concussion management programs cover thousands of young athletes, yet there is little in the way of research to assess program processes or outcomes. This study examined the referral patterns of consultants working with ten high school concussion management programs. In addition to the number of referrals made to specialists, other potential outcome variables were explored. The sample included over 5,000 athlete-seasons and 298 concussions managed directly by certified athletic trainers. All programs used computerized neuropsychological testing (both baseline and post injury). Two groups were compared: five programs used a clinical neuropsychologist (NP) as the testing consultant and five used …

Attention Is Associated With Postural Control In Those With Chronic Ankle Instability, Adam B. Rosen, Nicholas T. Than, William Z. Smith, Jennifer M. Yentes, Melanie L. Mcgrath, Mukul Mukherjee, Sarah A. Myers, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

Chronic ankle instability (CAI) is often debilitating and may be affected by a number of intrinsic and environmental factors. Alterations in neurocognitive function and attention may contribute to repetitive injury in those with CAI and influence postural control strategies. Thus, the purpose of this study was to determine if there was a difference in attentional functioning and static postural control among groups of Comparison, Coper and CAI participants and assess the relationship between them within each of the groups. Recruited participants performed single-limb balance trials and completed the CNS Vital Signs (CNSVS) computer-based assessment to assess their attentional function. Center …

Sandbagging On The Immediate Post-Concussion Assessment And Cognitive Testing (Impact) In A High School Athlete Population, Kathryn L. Higgins, Robert L. Denny, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a computerized neuropsychological test battery commonly used to assess cognitive functioning after a concussion. It is recommended that application of ImPACT utilizes a baseline administration so athletes have an individualized baseline with which to compare post-injury results should they sustain a concussion. It has been suggested that athletes may provide suboptimal effort, called “sandbagging,” in order to return to their baseline cognitive scores, and thus to play, more quickly. This research examines ImPACT baseline scores when high school athletes were asked to attempt to “sandbag,” and compares those scores with scores …

Psychological And Neural Contributions To Appetite Self-Regulation, Luke E. Stoeckel, Leann L. Birch, Todd Heatherton, Traci Mann, Christine Hunter, Susan Czajkowski, Lisa Onken, Paige K. Berger, Cary R. Savage

Center for Brain, Biology, and Behavior: Faculty Publications

Objective: This paper reviews the state of the science on psychological and neural contributions to appetite self-regulation in the context of obesity. Methods: Three content areas (neural systems and cognitive functions; parenting and early childhood development; and goal setting and goal striving) served to illustrate different perspectives on the psychological and neural factors that contribute to appetite dysregulation in the context of obesity. Talks were initially delivered at an NIH workshop consisting of experts in these three content areas, and then content areas were further developed through a review of the literature. Results: Self-regulation of appetite involves a complex interaction …

Pilot Study Of Endurance Runners And Brain Responses Associated With Delay Discounting, Laura E. Martin, Jason-Flor V. Sisante, David R. Wilson, Angela A. Moody, Cary R. Savage, Sandra A. Billinger

Center for Brain, Biology, and Behavior: Faculty Publications

High levels of endurance training have been associated with potentially negative health outcomes and addictive-like symptoms such as exercise in the presence of injury and higher levels of impulsivity. This pilot study examined the relationships among self-report measures of addictive symptoms related to exercise and behavioral and neural measures of impulsivity in endurance runners. We hypothesized endurance runners would have increased preference for immediate rewards and greater activation of cognitive control regions when making decisions involving delayed rewards. Twenty endurance runners (at least 20 miles/week) were recruited to undergo measures of self-report exercise addiction symptoms, impulsive decision-making (delay discounting) and …

Lateral Hypothalamic Activity Indicates Hunger And Satiety States In Humans, Omid Talakoub, Raquel R. Paiva, Matija Milosevic, Marcelo Q. Hoexter, Ruth Franco, Eduardo Alho, Jessie Navarro, Jose F. Pereira Jr., Milos R. Popovic, Cary Savage, Antonio C. Lopes, Pedro Alvarenga, Durval Damiani, Manoel J. Teixeira, Euripides C. Miguel, Erich T. Fonoff, Marcelo C. Batistuzzo, Clement Hamani

Center for Brain, Biology, and Behavior: Faculty Publications

Lateral hypothalamic area (LHA) local field potentials (LFPs) were recorded in a Prader–Willi patient undergoing deep brain stimulation (DBS) for obesity. During hunger, exposure to food-related cues induced an increase in beta/ low-gamma activity. In contrast, recordings during satiety were marked by prominent alpha rhythms. Based on these findings, we have delivered alphafrequency DBS prior to and during food intake. Despite reporting an early sensation of fullness, the patient continued to crave food. This suggests that the pattern of activity in LHA may indicate hunger/satiety states in humans but attest to the complexity of conducting neuromodulation studies in obesity.

Is It Time To Start Using Mitochondrial Dna Copy Number As An Indicator Of Health And Diseases?, Vasudeva G. Kamath

Touro College of Osteopathic Medicine (Middletown) Publications and Research

The author discusses whether the medical community should seriously investigate the numerical relation of mitochondrial DNA copy number as a health indicator.

Patient Characteristics Associated With False Arrhythmia Alarms In Intensive Care, Patricia R.E. Harris, Jessica K. Zègre-Hemsey, Daniel Schindler, Yong Bai, Michelle M. Pelter, Xiao Hu

Collected Faculty Scholarship

Introduction

A high rate of false arrhythmia alarms in the intensive care unit (ICU) leads to alarm fatigue, the condition of desensitization and potentially inappropriate silencing of alarms due to frequent invalid and nonactionable alarms, often referred to as false alarms.

Objective

The aim of this study was to identify patient characteristics, such as gender, age, body mass index, and diagnosis associated with frequent false arrhythmia alarms in the ICU.

Methods

This descriptive, observational study prospectively enrolled patients who were consecutively admitted to one of five adult ICUs (77 beds) at an urban medical center over a period of 31 …

Stress: Effects And Management, Breanna Buscher

Nebraska College Preparatory Academy: Senior Capstone Projects

Stress is how the body reacts to any change in a person's life, as well as how it reacts in life or death situations. It is important everyone knows how to manage stress and what will happen if they do not. While there are an abundance of terrifying things that can happen when stress goes unmanaged, there are also plenty of easy ways everyone can keep their stress in check.

Stress can feel overwhelming and often cause health problems if gone unmanaged but luckily there are a plethora of ways to manage it.

Future Research: I would like to research …

Assessment With Children Who Need Augmentative And Alternative Communication (Aac): Clinical Decisions Of Aac Specialists, Shelley Lund, Wendy Quach, Kristy S. E. Weissling, Miechelle L. Mckelvey, Aimee R. Dietz

Department of Special Education and Communication Disorders: Faculty Publications

Purpose

The purpose of this study was to explore how speech-language pathologists (SLPs) who are augmentative and alternative communication (AAC) specialists approach the assessment process for 2 case studies, 1 child with cerebral palsy and 1 with autism spectrum disorder. The aim of the study was to answer the following questions: (a) How do clinicians with expertise approach the AAC assessment process for children with developmental disabilities? (b) Can any initial hypothesis be drawn about how SLPs approach the assessment of children with motor versus social interactive deficits?

Method

This study used a phenomenological qualitative design. The researchers conducted 2 …

Relationship Of Common Vascular Anatomy To Cannulated Catheters., Paul Gagne, Karun Sharma

Pediatrics Faculty Publications

Superficial veins of the upper extremity are the primary location for placement of peripheral IV catheters (PIVC). It is believed that a significant portion of PIVCs placed may cross or abut valves and branching veins or occlude a significant portion of the vein, limiting the ability to aspirate blood from the PIVC. Two separate clinical investigations using ultrasound were performed to understand the potential interaction between PIVCs and the vein lumen and the venous valves and branches of the superficial veins of the upper extremity. One study with 35 adult volunteers interrogated 210 vein segments where a PIV would likely …

Development Of A Compact Broadband Optical Parametric Oscillator For Ultra-Sensitive Molecular Detection, Sean O. Crystal

Honors Undergraduate Theses

Every gas molecule has a unique absorption spectrum that can be captured using optical spectroscopy to identify an unknown sample's composition. Frequency combs systems can provide an extremely broad mid-infrared spectrum that is very useful for molecular detection. A degenerate optical parametric oscillator (OPO) was built to generate the down-converted and shifted frequency comb spectrum. This system utilizes an ultra-short pulse 1.56µm pump laser and a never before used orientation patterned gallium-phosphide crystal. Periodically polled lithium niobate (PPLN), Gallium Arsenide (GaAs) and Gallium Phosphide are all crystals used to accomplish this task. GaP, in comparison to PPLN, has (i) a …

Dancing Through Life: Dance As Physical Therapy To Prevent Falls, Salon Gegel

Honors Projects

The basis of this project was to create a series of dance-based exercise activities to be used as part of an exercise class for elderly people who are classified as fall risks. The idea was to approach exercise through a medium that was convenient and versatile for the class leader, while being comfortable and fun for participants. The activities were developed and presented over the course of the six-week P.L.A.C.E. Program, held at the Montessori School of Bowling Green. Participants met four times to take part in a guided exercise class, and enjoy other activities. At these sessions, participants were …

Actionable Patient Safety Solution (Apss) #3c: Improve Prevention Of Severe Hypoglycemia, Jerika Lam, Steven Barker, Michael Ramsay, Ariana Longley, Joe Kiani

Pharmacy Faculty Articles and Research

This report presents a plan of action for introducing a "program to reduce errors in the recognition and treatment of [severe hypoglycemia]".

A Randomized Study Comparing Digital Imaging To Traditional Glass Slide Microscopy For Breast Biopsy And Cancer Diagnosis., Joann G Elmore, Gary M Longton, Margaret S Pepe, Patricia A Carney, Heidi D Nelson, Kimberly H Allison, Berta M Geller, Tracy Onega, Anna N A Tosteson, Ezgi Mercan, Linda G Shapiro, Tad T Brunyé, Thomas R Morgan, Donald L Weaver

Articles, Abstracts, and Reports

BACKGROUND: Digital whole slide imaging may be useful for obtaining second opinions and is used in many countries. However, the U.S. Food and Drug Administration requires verification studies.

METHODS: Pathologists were randomized to interpret one of four sets of breast biopsy cases during two phases, separated by ≥9 months, using glass slides or digital format (sixty cases per set, one slide per case,

RESULTS: Sixty-five percent of responding pathologists were eligible, and 252 consented to randomization; 208 completed Phase I (115 glass, 93 digital); and 172 completed Phase II (86 glass, 86 digital). Accuracy was slightly higher using glass compared …

Associations Between Modifiable Health-Risk Behaviors And Personality Types, Jon C. Schommer, Paul D. Tieger, Anthony W. Olson, Lawrence M. Brown

Pharmacy Faculty Articles and Research

Objectives: The first objective for this study was to explore if characteristics of personality type (using the Preferred Communication Style Questionnaire) are associated with the following modifiable health-risk behaviors: smoking, exercise, alcohol consumption, nutrition, sleep, depression-related stress, anxiety-related stress, healthcare professional usage, and self-discipline. The second objective for this study was to explore if characteristics of personality type are associated with (1) the quality of patient-physician relationships, (2) patient-physician communication, and (3) preferred method for receiving information.

Methods: Data were collected from 10,500 adult individuals residing in the United States via an on-line, self-administered survey coordinated by Qualtrics …

An Expanded Role For Nurses In Laboratory Utilization, Marilyn S. Hamilton, Rangaraj Selvarangan, Michele Fix, Lynn E. Shriver

Posters

Introduction: The majority of laboratory testing errors occur in the pre-analytical stage, including specimen collection. Children provide special challenges including small blood volumes, small veins, and an inability to cooperate. We describe collaboration between laboratorians and nursing staff to improve specimen collection and the reliability of test results.

Methods: We identified three areas for improvement: 1) Volume of blood for culture, 2) Urine collection, and 3) Appropriate blood collection through a line. Base line data was established. Guidelines for specimen collection were updated. Nurse members of the Laboratory Utilization Committee developed educational tools.

Results: Nursing education was effective at improving …

Validity And Reliability Of The Balance Tracking System™ During Static Stance, Cody L. Grotewold

College of Graduate Studies: Theses & Dissertations

Introduction: The Balance Tracking System™ (BTrackS™) is a balance board designed to quickly analyze postural control through center of pressure (COP) analysis.

Purpose: Examine concurrent validity and test-retest reliability of the BTrackS™ during static stance.

Methods: A convenience sample of 51 healthy collegiate students between 18 - 25 years old (21.8 ± 3.1 years) completed four, 20 second (s) trials of feet together static stance during both eyes open and closed trials. Data was simultaneously collected on the BTrackS™ and a laboratory force plate to establish concurrent validity. A second testing session was administered 48 - 72 …

Enhanced Breast Cancer Classification With Automatic Thresholding Using Support Vector Machine And Harris Corner Detection, Mohammad Taheri

Electronic Theses and Dissertations

Image classification and extracting the characteristics of a tumor are the powerful tools in medical science. In case of breast cancer medical treatment, the breast cancer classification methods can be used to classify input images as benign and malignant classes for better diagnoses and earlier detection with breast tumors. However, classification process can be challenging because of the existence of noise in the images, and complicated structures of the image. Manual classification of the images is timeconsuming, and need to be done only by medical experts. Hence using an automated medical image classification tool is useful and necessary. In addition, …

Effect Of Exercise Position On Percent Changes In Serratus Anterior Muscle Thickness, Joseph M. Day

Physical Therapy Faculty Publications

Objective: A reliable method for measuring SA thickness with ultrasound imaging has been reported, yet the ability to detect differences in levels of contractility has yet to be established. The purpose of this study was to determine if there are differences in the percent change in thickness of the SA during four different exercise positions performed by healthy individuals.

Design: Observational study

Setting: Laboratory

Participants: Twenty-eight healthy participants, mean age 26 (SD 4, 57% female, 100% right handed)

Methods: Volunteers were positioned in a standardized sitting posture and anatomical landmarks were marked for ultrasound probe positioning. Two resting and two …

Thyroid Hormone As A Method Of Reducing Damage To Donor Hearts After Circulatory Arrest, William P. Adams

Theses and Dissertations

There is a chronic lack of donor hearts to meet the need for heart transplant both in the US and worldwide. Further, the use of available hearts is limited by the short period between collection and implantation during which the heart can be safely preserved ex vivo. Using mid-thermic Langendorff machine perfusion, we have been able to preserve the metabolic function of a healthy heart for up to 8 hours, twice the limit for current static cold storage. We have also been able to preserve the metabolic function of a damaged DCD Heart collected 30 minutes after cardiac arrest …

Evaluating Medical Students’ Proficiency With A Handheld Ophthalmoscope: A Pilot Study, Gregory Gilmour, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Introduction: Historically, testing medical students’ skills using a handheld ophthalmoscope has been difficult to do objectively. Many programs train students using plastic models of the eye which are a very limited fidelity simulator of a real human eye. This makes it difficult to be sure that actual proficiency is attained given the differences between the various models and actual patients. The purpose of this article is to introduce a method of testing where a medical student must match a patient with his/her fundus photo, ensuring objective evaluation as well as developing skills on real patients which are more likely to …

Radiation Therapy Medical Physics Review – Delivery, Interactions, Safety, Feasibility, And Head To Head Comparisons Of The Leading Radiation Therapy Techniques, Cielle Collins

Honors Theses and Capstones

Radiation therapy uses high energy radiation to kill cancer cells. Radiation therapy for cancer treatment can take the form of photon therapy (using x-rays and gamma rays), or charged particle therapy including proton therapy and electron therapy. Within these categories, numerous methods of delivery have been developed. For example, a certain type of radiation can be administered by a machine outside of the body, called external-beam radiation therapy, or by a “seed” placed inside of the body near cancer cells, called internal radiation therapy or brachytherapy. Approximately half of all cancer patients receive radiation therapy, and the form of radiation …

Utility Of Ultrasound/Photoacoustic Imaging For Accurate Catheter Tracking And Temperature Monitoring During Endovenous Laser Ablation, Ayushi Jharia, Keerthana Palani, Yan Yan

Research Opportunities for Engineering Undergraduates (ROEU) Program 2016-17

Laser ablation is a treatment method that uses light energy through a catheter inserted into a vein to induce localized heat to close the diseased blood vessels. Ultrasound (US) imaging has been used for catheter visualization and tracking. US has limitations for tracking the accurate location of the fiber tip inside small perforating veins such as angular dependency and comet tail artifacts. We propose a robust and accurate method for fiber tip tracking using combined US and Photoacoustic (PA) imaging to overcome the existing limitations.

Are Contact Lenses An Effective Vehicle For Ocular-Disease Drug Delivery?, Chana Haimowitz

The Science Journal of the Lander College of Arts and Sciences

Due to numerous drawbacks with current modes of treatment for various ocular diseases, researchers are synthesizing drug dispensing contact lenses. The lenses will contribute to greater bioavailability of the drug, the minimization of negative side effects, and increased patient compliance. As treatment for glaucoma, in vivo studies have been conducted with latanoprost, timolol maleate, and brimonidine tartrate-eluting lenses, and have succeeded in reducing intraocular pressure to desired values (Ciolino et al., 2016), (Schultz and Mint, 2002). As treatment for fungal keratitis, in vitro studies prove that econazole and natamycin-eluting contact lenses have been successful in killing 100% of fungi for …