Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Reliability Of Bod Pod Measurements Remain High Following A Short Duration Low-Carbohydrate Diet, Beau K. Greer, Kathleen M. Edsall (Alumna), Anna E. Greer

All PTHMS Faculty Publications

The purpose of the present study was to determine whether expected changes in body weight via a three day low-carbohydrate (CHO) diet will disrupt the reliability of air displacement plethysmography measurements via BOD POD. Twenty-four subjects recorded their typical diets for three days prior to BOD POD and seven-site skinfold analyses. Subjects were matched for lean body mass and divided into low-CHO (LC) and control (CON) groups. The LC group was given instruction intended to prevent over 50 grams/day of carbohydrate consumption for three consecutive days, while the CON group replicated their previously recorded diet. Body composition measurements were repeated …

Speckle-Tracking Echocardiographic Measures Of Right Ventricular Function Correlate With Improvement In Exercise Function After Percutaneous Pulmonary Valve Implantation., Shahryar M. Chowdhury, Ziyad M. Hijazi, John T. Fahey, John F. Rhodes, Saibal Kar, Raj Makkar, Michael Mullen, Qi-Ling Cao, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Speckle-tracking echocardiographic (STE) measures of right ventricular (RV) function appear to improve after transcatheter pulmonary valve implantation (TPVI). Measures of exercise function, such as ventilatory efficiency (the minute ventilation [VE]/carbon dioxide production [VCO2] slope), have been shown to be prognostic of mortality in patients who may require TPVI. The aim of this study was to evaluate the correlation between STE measures of RV function and changes in VE/VCO2 after TPVI.

METHODS: Speckle-tracking echocardiography and cardiopulmonary exercise testing were performed at baseline and 6 months after TPVI in 24 patients from four centers. Conventional echocardiographic measures of RV function were …

Track Extubation In Pediatric Congenital Heart Disease Open Heart Surgical Patients In Pakistan, Mohammad Irfan Akhtar

Department of Anaesthesia

No abstract provided.

Clinical Outcomes After Drug-Eluting Stents Versus Coronary Artery Bypass Surgery In High Surgical Risk Patients With Left Main Or Three-Vessel Coronary Artery Disease, Tonga Nfor, Kambiz Shetabi, Wael Hassan, Quinta Nfor, Jayant Khitha, Anjan Gupta, Tanvir Bajwa, Suhail Allaqaband

Journal of Patient-Centered Research and Reviews

Purpose

Previous studies comparing percutaneous coronary intervention (PCI) with coronary artery bypass graft surgery (CABG) in patients with unprotected left main or three-vessel coronary artery disease (LM-3VD) have excluded patients at high surgical risk. We compared clinical outcomes after PCI with drug-eluting stents to CABG in high surgical risk patients with LM-3VD.

Methods

Patients with symptomatic LM-3VD who had Society of Thoracic Surgeons (STS)-predicted operative mortality >5% and were undergoing either PCI with drug-eluting stents or CABG at a tertiary care center from January 2009 to December 2010 were enrolled in this nonrandomized prospective study.

Results

Mean STS score was …

Overview Of The Role Of Duplex Ultrasound For Treatment And Surveillance Of Peripheral Arterial Disease, John H. Fish Iii, Peter Klein-Weigel, Gustav Fraedrich

Journal of Patient-Centered Research and Reviews

Imaging strategies for preinterventional planning in symptomatic peripheral artery disease have employed various modalities ranging from duplex ultrasound to noninvasive angiography with computed tomography (CT) or magnetic resonance (MRA). These methods have classically been compared to the gold standard of digital subtraction angiography and are reviewed here in detail through the work of relevant published studies and meta-analyses between 1996 and 2014. In particular, we focus on the diagnostic performance, reproducibility and cost-effectiveness of these aforementioned modalities with respect to mapping the lower extremity arterial tree for planning vascular intervention and surveillance. The data presented suggests comparable sensitivity and specificity …

Use Of Coronary Techniques In Celiac And Hepatic Artery Stenting In Post-Hepatic Transplant Patients, Harpreet Parmar, Ryan Beard, Mark W. Mewissen, Armaan Shaikh, Tanvir Bajwa

Journal of Patient-Centered Research and Reviews

Hepatic artery stenosis (HAS) remains a rare but serious complication after liver transplantation. While invasive surgical techniques were needed for HAS treatment in the past, recently endovascular techniques, including hepatic artery stenting, have been proven to be a safe and effective treatment. The present work focused on a review of the recent literature regarding HAS as well as recent cases demonstrating the various presentations of HAS and the variety of approaches to endovascular intervention. Our single-center experience has shown endovascular treatment of HAS to be safe and effective, including the two specific cases discussed here. While further research is needed, …

Investigation In To The Effect Of Spin Locking On Contrast Agent Relaxivity, Julian Saunders Haigh

Dissertations and Theses

The current trend in magnetic resonance imaging (MRI) is towards higher external magnetic field strengths (B₀) to take advantage of increased sensitivity and signal to noise ratio (SNR). Unfortunately, as (B₀) increases the effectiveness (relaxivity) of clinical gadolinium (Gd³⁺⁾-based contrast agents (CAs) administered to enhance image contrast is significantly reduced. Excellent soft tissue contrast can be generated with current agents despite their non-optimum relaxivities but necessitates large doses. The limits of detection of a CA at high B₀ fields can be lowered by recovering the lost relaxivity and is a pre-requisite to the …

A Non-Invasive Method Of Measuring Respiration While Providing Wireless Power For Rodents With Implantable Devices, Jynx O. Boyne, Daniel J. Pederson, Zhi Wang, Pedro Irazoqui Dr.

The Summer Undergraduate Research Fellowship (SURF) Symposium

Respiratory measurements can be used as diagnostic and research tools. Spirometry is the gold standard for gaining these measurements, but is difficult to use in rodents as it requires an invasive procedure. Total Body Plethysmograpy (TBP) is a non-invasive way to measure respiration rates that does not cause stress to the rodent. In this system, the subject is encased in a solid, constant volume chamber with measurements determining the subject’s respiration. When using TBP in medical or research settings, challenges occur in powering devices within the TBP chamber as wires and other recording equipment compromise the airtightness of the chamber. …

Quantification Of Analyte Concentration From A Paper-Based Lateral Flow Assay Device Using Reflective Sensors, Megan Z. Chiu, Jacqueline Linnes

The Summer Undergraduate Research Fellowship (SURF) Symposium

Paper-based point-of-care (POC) diagnostics is a growing field in global health due to the extreme portability, accuracy, affordability, and ease of use of these tests. Advancements in recent years have led to more accurate detection and improved functionality using multistep molecular diagnostics. Many such assays utilize lateral flow detection strips for visualization of diagnostic results by eye, which limits the results to qualitative Yes/No readouts. This project focused on combining recent developments in paper-based POC diagnostics to develop and optimize an in-house built quantitative paper-based diagnostic reader for lateral flow detection in low-resource settings. Initially different sensors, including photocell sensors, …

Impact Of Standardized Oral Health Assessment On Preventing Ventilator-Associated Events, Juana Ambriz De Williams

Evidence-Based Practice Project Reports

Ventilator-associated pneumonia (VAP) is a common but preventable health-care associated infection that affects up to 20% of mechanically ventilated adult patients, resulting in estimated mortality rates ranging from 13% to 55% (Chahoud, Semaan, Almoosa, 2015; Melsen et al., 2013). In an effort to reduce morbidity, mortality and related costs, the Centers for Disease Control and Prevention (CDC) and the National Healthcare Safety Network (NHSN), proposed ventilator-associated pneumonia prevention as a national patient safety goal. In 2014, amid growing concerns that the subjectivity of existing definitions had led to inconsistent reporting, thereby impeding efforts to reduce VAP, the CDC refocused surveillance …

The Effectiveness Of Implementing Standard Of Care Best Practices Including Use Of Daily Incentive Spirometry To Improve Dyspnea And Quality Of Life In Adults With Chronic Obstructive Pulmonary Disease (Copd), Christine Gallagher

Doctor of Nursing Practice (DNP) Program

Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterized by symptoms of dyspnea, cough, and wheezing. Many patients with COPD are on daily medications for their symptoms yet these symptoms continue to persist, impairing their quality of life. Patients with COPD experience respiratory muscle weakness that contributes to dyspnea and an inability to participate in daily activities. GOLD (2014) guidelines state that the goal of therapy in these patients is to reduce symptoms, increase participation in activities, and restore the highest level of independent functioning. The guidelines recommend the use of inspiratory muscle training (IMT) in …

Kinematic And Kinetic Effects Of Alterations In Lumbar Lordosis In People With Tight Hamstrings, Dema Assaf

Theses and Dissertations (ETD)

The etiology of nonspecific low back pain is sparsely understood. To better understand the contributing factors to nonspecific low back pain, there are often common concurrent pathologies that are investigated to determine their functional relationship to low back pain. One such pathology, investigated further in this thesis, is tight hamstrings. Specifically, the effect of hamstring length on pelvic position during gait and activities of daily living under normal and altered spinal position were investigated as part of this study in a motion analysis lab.

First, a marker validation study was conducted to ensure the accuracy of sagittal spinal measures of …

Review Of Biomedical Čerenkov Luminescence Imaging Applications, Kaveh Tanha, Ali Mahmoud Pashazadeh, Brian W. Pogue

Dartmouth Scholarship

Čerenkov radiation is a fascinating optical signal, which has been exploited for unique diagnostic biological sensing and imaging, with significantly expanded use just in the last half decade. Čerenkov Luminescence Imaging (CLI) has desirable capabilities for niche applications, using specially designed measurement systems that report on radiation distributions, radiotracer and nanoparticle concentrations, and are directly applied to procedures such as medicine assessment, endoscopy, surgery, quality assurance and dosimetry. When compared to the other imaging tools such as PET and SPECT, CLI can have the key advantage of lower cost, higher throughput and lower imaging time. CLI can also provide imaging …

Assessment Of Uncertainty In Planning And Dose Delivery Of Proton Therapy In An Iroc- Houston Qa Phantom Due To Variable Ct Technique And Proton Energy, Mattie M. Mcinnis

Dissertations and Theses (Open Access)

As proton therapy increases in popularity, so does the need for effective quality assurance. Proton therapy institutions participating in NCI funded clinical trials rely heavily on the credentialing and auditing services of IROC-H and therefore the process must be well understood. The purpose of this project is to understand the uncertainties in proton therapy treatment planning for the IROC-H proton phantom QA program due to variations in CT technique and proton energy. It was hypothesized that variations in CT technique and proton energy will alter the delivered dose distributions of typical proton treatments by reducing the percent of passing pixels …

Adverse Effects Of Asparaginase In Pediatric Patients With Acute Lymphoblastic Leukemia, Chengcheng Liu

Theses and Dissertations (ETD)

Acute lymphoblastic leukemia (ALL) is the most common type of childhood cancer. Asparaginase is a critical treatment component for ALL. However, its use is complicated by adverse effects, such as hypersensitivity, osteonecrosis and pancreatitis.

Hypersensitivity to asparaginase typically requires discontinuation of current formulation and substitution with other formulations, but the differential diagnosis can be challenging, and the diagnostic utility of antibody tests is unclear. We comprehensively analyzed anti-Elspar (native E.coli asparaginase) IgG antibodies in 410 pediatric patients treated on an asparaginaseintensive front-line clinical trial. Of 169 patients (41.2%) who exhibited clinical allergy, 147 (87.0%) were positive for anti-Elspar antibody. Of …

Quantifying Measurement Error In Digital Instruments, William B. Laing Iii, Sean Bryant

Faculty Works

A first lab experiment clearly illustrates that a glucose meter is actually an excellent source of both random and systematic error, much to the surprise to students and physicians alike. A histogram is constructed and the utility of the standard deviation and standard error to quantify the uncertainty in each measurement and in the mean value, respectively, is demonstrated. From the first lab on, students are challenged to express and interpret confidence intervals in order to form quantitative conclusions. Assessments reveal that many students find this to be surprisingly challenging.

College Student Understanding Of Informed Consent Terminology, Kishore Garapati

Master's Theses and Doctoral Dissertations

A good, understandable informed consent form (ICF) is key to ethical medical research, and the ICF is necessary according to United States federal regulation. Since they may be written in complex technical language, ICFs are often difficult for subjects to understand. The purpose of this research was to evaluate students' understanding of terminology commonly used in the ICF. An online research survey was sent to active students of Eastern Michigan University (EMU) during the winter 2015 semester. Questions were asked to evaluate the students' understanding of the correct meaning of the terms used in medical research. The majority of students …

Characteristics Of A Novel Treatment System For Linear Accelerator–Based Stereotactic Radiosurgery, Ning Wen, Haisen Li, Kwang Song, Karen Chin-Snyder, Yujiao Qin, Jinkoo Kim, Maria Bellon, Misbah Gulam, Stephen Gardner, Anthony Doemer, Suneetha Devpura, James Gordon, Indrin Cherry, Farzan Siddiqui, Munther Ajlouni, Robert Pompa, Zane Hammoud, Michael Simoff, Steven Kalkanis, Benjamin Movsas, M. Salim Siddiqui

Internal Medicine Faculty Publications

The purpose of this study is to characterize the dosimetric properties and accuracy of a novel treatment platform (Edge radiosurgery system) for localizing and treating patients with frameless, image-guided stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). Initial measurements of various components of the system, such as a comprehensive assessment of the dosimetric properties of the flattening filter-free (FFF) beams for both high definition (HD120) MLC and conical cone-based treatment, positioning accuracy and beam attenuation of a six degree of freedom (6DoF) couch, treatment head leakage test, and integrated end-to-end accuracy tests, have been performed. The end-to-end test of the …

Increased Resting-State Functional Connectivity Of Visual- And Cognitive-Control Brain Networks After Training In Children With Reading Difficulties, Tzipi Horowitz-Kraus, Mark Difrancesco, Benjamin Kay, Yingying Wang, Scott K. Holland

Center for Brain, Biology, and Behavior: Faculty Publications

The Reading Acceleration Program, a computerized reading-training program, increases activation in neural circuits related to reading.We examined the effect of the training on the functional connectivity between independent components related to visual processing, executive functions, attention, memory, and language during rest after the training. Children 8–12 years old with reading difficulties and typical readers participated in the study. Behavioral testing and functional magnetic resonance imaging were performed before and after the training. Imaging data were analyzed using an independent component analysis approach. After training, both reading groups showed increased single-word contextual reading and reading comprehension scores. Greater positive correlations between …

Wirelessly Connected Sensor Acquisition System For Remote Nursing Applications, Yuhua Hu

Dissertations, Theses and Capstone Projects (Full IR Collection)

Taking advantage of the equipment used in the "Remote Nursing" project, nurses can watch patients' status remotely. The equipment, which is installed in the patient's ward or home, can monitor them and their environment. This project demonstrates this using a microcontroller system that interfaces to a video camera and temperature and humidity sensors in the room. Also a servomotor is installed to control the position of the camera. The microcontroller communicates wirelessly with a PC.

This project is focused on hardware rather than software. It is to test the video camera and sensors being used over the microcontroller through the …

Test-Retest Reliability Of The Sway Balance Mobile Application, Ryan Z. Amick, Alex Chaparro, Jeremy A. Patterson, Michael J. Jorgensen

Publications

The SWAY Balance Mobile Application is an FDA-cleared balance testing system which uses the built-in tri-axial accelerometers of a mobile electronic device to objectively assess postural movement. The system was designed to provide a means of quantitative balance assessment in clinical and on-field environments. The purpose of this study was to determine the intrasession and intersession reliability, as well as the minimum difference to be considered real, of the SWAY Balance Mobile Application.

Effects Of Pringle Maneuver And Partial Hepatectomy On The Pharmacokinetics And Blood–Brain Barrier Permeability Of Sodium Fluorescein In Rats, Mohammad K. Miah, Imam H. Shaik, Ulrich Bickel, Reza Mehvar

Pharmacy Faculty Articles and Research

Liver diseases are known to affect the function of remote organs. The aim of the present study was to investigate the effects of Pringle maneuver, which results in hepatic ischemia–reperfusion (IR) injury, and partial hepatectomy (Hx) on the pharmacokinetics and brain distribution of sodium fluorescein (FL), which is a widely used marker of blood–brain barrier (BBB) permeability. Rats were subjected to Pringle maneuver (total hepatic ischemia) for 20 min with (HxIR) or without (IR) 70% hepatectomy. Sham-operated animals underwent laparotomy only. After 15 min or 8 h of reperfusion, a single 25-mg/kg dose of FL was injected intravenously and serial …

Anesthesia For Deep Brain Stimulation In Traumatic Brain Injury-Induced Hemidystonia., Jill M Jani, Chima O Oluigbo, Srijaya K Reddy

Anesthesiology and Critical Care Medicine Faculty Publications

Deep brain stimulation in an awake patient presents several unique challenges to the anesthesiologist. It is important to understand the various stages of the procedure and the complexities of anesthetic management in order to have a successful surgical outcome and provide a safe environment for the patient.

Anisotropic Smoothing Improves Dt-Mri-Based Muscle Fiber Tractography, Amanda K W Buck, Zhaohua Ding, Christopher P. Elder, Theodore F. Towse, Bruce M. Damon

Peer Reviewed Articles

Purpose

To assess the effect of anisotropic smoothing on fiber tracking measures, including pennation angle, fiber tract length, and fiber tract number in the medial gastrocnemius (MG) muscle in healthy subjects using diffusion-weighted magnetic resonance imaging (DW-MRI).

Materials and Methods

3T DW-MRI data were used for muscle fiber tractography in the MG of healthy subjects. Anisotropic smoothing was applied at three levels (5%, 10%, 15%), and pennation angle, tract length, fiber tract number, fractional anisotropy, and principal eigenvector orientation were quantified for each smoothing level.

Results

Fiber tract length increased with pre-fiber tracking smoothing, and local heterogeneities in fiber direction …

Insole Antenna For On-Body Telemetry, Domenico Gaetano, Patrick Mcevoy, Max Ammann, Matthias John, Colm Brannigan, Louise Keating, Frances Horgan

Articles

A 433 MHz antenna is proposed for integration with the insole of footwear for a body area network. The folded dipole design with an asymmetric groundplane radiates from its edges and considers the close proximity of the human foot and ground surfaces. It functions for different ground conductivity conditions and an on-body communication link with an Inverted F Antenna in the upper body area was evaluated on a static and dynamic human subject. The antenna solution was compliant with Specific Absorption Rate requirements, remains matched and links with upper-body nodes regardless of the body posture and node location.

Functional Analysis Of The Molluscum Contagiosum Virus Mc160 Death Effector Domain-Containing Protein Rxdl Motif, Sarah Weber

Seton Hall University Dissertations and Theses (ETDs)

The Molluscum contagiosum virus (MCV) is a member of the Poxviridae family that causes benign skin lesions. MCV lesions persist on average for 8-12 months in otherwise healthy individuals. MCV lesions are characterized by reduced inflammation. The persistence and reduction of inflammation at the site of MCV lesions have been attributed to MCV immune evasion genes. MCV encodes two death effector domain (DED) containing proteins, MC159 and MC160. DEDs are found in cellular proteins such as FADD and procaspase-8. These cellular proteins are involved in several innate immune responses such as apoptosis and activation of interferon (IFN). Presumably, MC159 and …

A Study To Evaluate The Maximal Dose Administration At Two Different Locations In Two Different Vdr4 High Frequency Percussive Ventilator (Hpfv) Circuits, Jeff L. Heltborg, Bethany S. Kobza, Ace Nilson

Student Research Symposium

The purpose of this study was to determine if the positioning of a nebulizer at two different locations in the VDR4, a specialty ventilator, would result in differing dose administrations of a bronchodilator, Albuterol Sulfate. We hypothesized that placement near the endotracheal tube will provide greater dose deposition. The ventilator was set up to mimic the normal adult patient. Administration was done through the nebulizer placed in the ventilator circuit either before the humidifier or between the endotracheal tube and the VDR 4’s Phasitron. Three trials were performed using a standard dose of Albuterol for each trial. The mass of …

A Novel Caspase 8 Selective Small Molecule Potentiates Trail-Induced Cell Death, Octavian Bucur, Gabriel Gaidos, Achani Yatawara, Bodvael Pennarun, Chamila Rupasinghe, Jérémie Roux, Stefan Andrei, Bingqian Guo, Alexandra Panaitiu, Maria Pellegrini, Dale Mierke, Roya Khosravi-Far

Dartmouth Scholarship

Recombinant soluble TRAIL and agonistic antibodies against TRAIL receptors (DR4 and DR5) are currently being created for clinical cancer therapy, due to their selective killing of cancer cells and high safety characteristics. However, resistance to TRAIL and other targeted therapies is an important issue facing current cancer research field. An attractive strategy to sensitize resistant malignancies to TRAIL-induced cell death is the design of small molecules that target and promote caspase 8 activation. For the first time, we describe the discovery and characterization of a small molecule that directly binds caspase 8 and enhances its activation when combined with TRAIL, …

Physical Feature Encoding And Word Recognition Abilities Are Altered In Children With Intractable Epilepsy: Preliminary Neuromagnetic Evidence, Maria Pardos, Milena Korostenskaja, Jing Xiang, Hisako Fujiwara, Ki H. Lee, Paul S. Horn, Anna Byars, Jennifer Vannest, Yingying Wang, Nat Hemasilpin, Douglas F. Rose

Center for Brain, Biology, and Behavior: Faculty Publications

Objective evaluation of language function is critical for children with intractable epilepsy under consideration for epilepsy surgery. The purpose of this preliminary study was to evaluate word recognition in children with intractable epilepsy by using magnetoencephalography (MEG). Ten children with intractable epilepsy (M/F 6/4, mean ± SD 13.4 ± 2.2 years) were matched on age and sex to healthy controls. Common nouns were presented simultaneously from visual and auditory sensory inputs in “match” and “mismatch” conditions. Neuromagnetic responses M1, M2, M3, M4, and M5 with latencies of ∼100ms, ∼150ms, ∼250ms, ∼350ms, and ∼450ms, respectively, elicited during the “match” condition were …

Using Education And A Prevention Protocol Tool To Decrease The Incidence Of Pressure Ulcers In A Nursing Home, Kristina L. Scalzitti

Evidence-Based Practice Project Reports

Over 1.3 million persons are residents in nursing homes (NHs); one in ten have pressure ulcers. The purpose of this evidence based practice project was to determine if implementation of a pressure ulcer prevention tool, along with staff education, decreases the incidence of pressure ulcers within the NH. Florence Nightingale’s Environmental Model and the Stetler Model were used to guide this project. The setting was a NH in northwest Indiana. Eleven nurses attended a 15 minute educational session on pressure ulcer prevention and implementation of the Pressure Ulcer Prevention Protocol Intervention (PUPPI) tool. PowerPoint slides were distributed and flyers about …