Equipment and Supplies Commons^™

Utilizing The System Engineering Trade Study Analysis Method To Analyze Patient Aeromedical Evacuation, Sara Shaghaghi, Jeremy M. Slagley, Michael E. Miller, Gaiven Varshney

Faculty Publications

The US Air Force has gone through many aeromedical patient isolation transport system designs. The first designs were developed in response to the Ebola outbreak in 2014 and, more recently, the COVID-19 pandemic. The trade study analysis part of the system engineering design method was used to analyze the historic and current aeromedical patient contamination control transport systems. A trade study is a process that evaluates alternatives based upon various “-ilities”, such as reconfigurability, flexibility, durability, cost, and more, and performs a systematic analysis to aid designers in producing a ‘good’ design alternative given the large set of possible solutions. …

Digital 3d Brain Mri Arterial Territories Atlas, Chin-Fu Liu, Johnny Hsu, Xin Xu, Ganghyun Kim, Shannon M. Sheppard, Erin L. Meier, Michael I. Miller, Argye E. Hillis, Andreia V. Faria

Communication Sciences and Disorders Faculty Articles and Research

The locus and extent of brain damage in the event of vascular insult can be quantitatively established quickly and easily with vascular atlases. Although highly anticipated by clinicians and clinical researchers, no digital MRI arterial atlas is readily available for automated data analyses. We created a digital arterial territory atlas based on lesion distributions in 1,298 patients with acute stroke. The lesions were manually traced in the diffusion-weighted MRIs, binary stroke masks were mapped to a common space, probability maps of lesions were generated and the boundaries for each arterial territory was defined based on the ratio between probabilistic maps. …

It’S A Mesh In These Bowels: Delayed Case Of Decade Long Mesh Eroding Into A Small Bowel Causing Obstruction And Intraperitoneal Sepsis, Margaret Rose, Jamie Pham, Adina Mcnair, Saptarshi Biswas

South Atlantic Division GME Research Day 2023

No abstract provided.

Bundle Up To Improve Cauti, Jennifer Anderson, Valorie Dearmon

DNP Manuscripts

Catheter Associated Urinary Tract Infections (CAUTIs) are a leading cause of healthcare acquired infections. Strong evidence for CAUTI best practices exists, however, the struggle to translate best practice evidence into everyday practice remains a challenge. Catheter associated urinary tract infection rates continue to be a problem despite organizational efforts to implement best practice guidelines; the challenge is to effectively translate and embed best practices into everyday practice. The Centers for Medicare and Medicaid Services (CMS) will no longer reimburse hospitals for expenses associated with hospital acquired CAUTI; moreover, hospitals are subject to penalties for high rates of hospital acquired CAUTIs. …

Factors Contributing To Ventilator Dependent Days In Covid-19, Isaac Ginsberg, Samantha Eteve, Bryan Lunt, Kenneth Krell

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

Combining Novel Direction Modulated Brachytherapy Tandem-And-Ovoids Applicators For Treatment Planning Of Multi-Institutional Cervical Cancer Cases: Removing Needles In Intracavitary-Interstitial Techniques, Sharmin Alam

Theses and Dissertations

Lack of standard guidelines for optimal needle insertion during high-dose-rate (HDR) intracavitary-interstitial (IC-IS) brachytherapy of the cervix means a sophisticated and technical skillset of inserting needles next to IC applicators must be developed to enhance plan quality. This study sought to evaluate the performance of two separate direction modulated brachytherapy (DMBT) tandem applicators used in conjunction with one set of novel DMBT ovoids, to effectively obviate the need for IS needles.

A cohort of 32 retrospective clinical HDR brachytherapy plans was re-planned with Varian’s BrachyVision^® treatment planning system, using VEGO^® inverse optimization algorithm, with dose heterogeneity accounted for …

The Impact Of Bracing On Kinesiophobia And Recovery In Acl Reconstruction Patients: A Case Study, N Valdecanas, K Neelon, K Braunreiter

Clinical Practice in Athletic Training

Introduction: With 100,000 to 200,000 cases reported in the U.S. yearly, the anterior cruciate ligament (ACL) is a commonly torn structure in the knee among contact and non-contact sports. As medical research on ACL injuries grows, ACL reconstruction (ACLR) continues to be the preferred surgical intervention. Due to extensive rehabilitation timeline requirements, ACLR patients may face physical and psychosocial circumstances affecting their overall recovery. At any point in rehabilitation the patient may experience kinesiophobia, or an irrational fear relating to further injury from participation in physical movement, especially with return to running, jumping, and sports-specific programs. Functional bracing has been …

One In Every Twenty-Six, Rey'na Riggans

Capstone Showcase

There is a disorder that is rather common within the world and yet is not well known. It is a something that affects one in every twenty-six individuals. It is called epilepsy. Epilepsy is a neurological disorder in which a person to experience bursts of random electrical activity within their brains, these bursts being called "seizures." This article discusses this disorder and goes into detail about the forms of it, procedures that are done to try and help those living with epilepsy, and artwork that is inspired by this disorder.

Injuries In Manual And Mechanical Cpr, Macon Spruill, Malik Bangura

Physician Assistant Capstones, 2020-current

Objective: To compare the rate of injuries during cardiopulmonary resuscitation (CPR) using manual versus mechanical chest compressions with the Lund University Cardiopulmonary Assist System (LUCAS™).

Design: Systematic literature review

Methods: We investigated the use of 2 different CPR methods, manual and mechanical, in order to determine if one was more likely to cause injury in individuals during a cardiac arrest. PubMed searches were conducted using the terms “cardiopulmonary resuscitation,” “adverse effect,” “classification,” “method,” “mortality,” “statistical and numerical data,” “trends,” “complication,” “epidemiology,” and “etiology.” Studies were excluded if they took place before the year 2000, included individuals under 18 …

Training In The Use Of Interpretive Services For Patients With Limited English Proficiency, Kristina Wooten

Symposium of Student Scholars

In clinical settings, there is a disconnect between health care professionals (HCPs) and patients with limited English proficiency (LEP). HCPs rely on ad hoc interpreters to communicate with patients with LEP (e.g. nurses using untrained friends and family or nursing students to interpret care information). Refusing to use or misusing professional interpreters and other interpretive services may lead patients with LEP to avoid seeking necessary care, misunderstand their diagnoses and treatment regimens, and fail to return for follow-up care. This increases the already existing health care disparity between patients who speak English and patients with LEP. Studies show that if …

Practical Mouse Model To Investigate Therapeutics For Staphylococcus Aureus Contaminated Surgical Mesh Implants, Madison M. Collins, Brent Race, Ronald J. Messer, Chase Baune, Scott D. Kobayashi, Dan Long, Katie Williams, Aaron M. Hasenkrug, Kim Hasenkrug, Natalia Malachowa

School of Medicine Faculty Publications

Introduction: The use of prosthetic mesh in hernia repair provides a powerful tool to increase repair longevity, decrease recurrence rates, and facilitate complex abdominal wall reconstruction. Overall infection rates with mesh are low, but for those affected there is high morbidity and economic cost. The availability of a practicable small animal model would be advantageous for the preclinical testing of prophylactics, therapeutics, and new biomaterials. To this end, we have developed a novel mouse model for implantation of methicillin-resistant Staphylococcus aureus–infected surgical mesh and provide results from antibiotic and immunotherapeutic testing. Materials and Methods: Implantation of surgical mesh between fascial …

Three-Dimensional Motion Analysis For Occupational Therapy Upper Extremity Assessment And Rehabilitation: A Scoping Review, Stephen W. Hill, Samantha Mong, Quyen Vo

The Open Journal of Occupational Therapy

Background: Three-dimensional (3D) human motion analysis provides objective, quantitative, and reliable kinematic data that are valuable in rehabilitation. Clinicians, including occupational therapists and other specialists, can apply this technology to quantify patients’ upper extremity (UE) motion during functional tasks. A better comprehension of altered body mechanics serves to guide clinical reasoning, develop evidence-based interventions, and monitor patients’ progress through follow-up. However, the scientific literature has yet to emphasize the practicality of using 3D motion analysis as a clinical measurement tool.

Method: This scoping review appraised 20 articles that used 3D motion analysis to quantify UE movements for individuals …

Inpatient Physical Activity Across A Large University City Hospital: A Behavioral Mapping Study, Karin Valkenet, Prue Mcrae, Elja Reijneveld, Marielle Jans, Petra Bor, Lotte Van Delft, Daniel L. Young, Cindy Veenhof

Physical Therapy Faculty Research

Background: Physical inactivity is common during hospitalization. Physical activity has been described in different inpatient populations but never across a hospital. Purpose: To describe inpatient movement behavior and associated factors throughout a single university hospital. Methods: A prospective observational study was performed. Patients admitted to clinical wards were included. Behavioral mapping was undertaken for each participant between 9AM and 4PM. The location, physical activity, daily activity, and company of participants were described. Barriers to physical activity were examined using linear regression analyses. Results: In total, 345 participants from 19 different wards were included. The mean (SD) age was 61 (16) …

Artificial Intelligence In The Radiomic Analysis Of Glioblastomas: A Review, Taxonomy, And Perspective, Ming Zhu, Sijia Li, Yu Kuang, Virigina B. Hill, Amy B. Heimberger, Lijie Zhai, Shenjie Zhai

Electrical & Computer Engineering Faculty Research

Radiological imaging techniques, including magnetic resonance imaging (MRI) and positron emission tomography (PET), are the standard-of-care non-invasive diagnostic approaches widely applied in neuro-oncology. Unfortunately, accurate interpretation of radiological imaging data is constantly challenged by the indistinguishable radiological image features shared by different pathological changes associated with tumor progression and/or various therapeutic interventions. In recent years, machine learning (ML)-based artificial intelligence (AI) technology has been widely applied in medical image processing and bioinformatics due to its advantages in implicit image feature extraction and integrative data analysis. Despite its recent rapid development, ML technology still faces many hurdles for its broader applications …

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

Graduate Medical Education Research Journal

Introduction

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

Methods

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

Results

In all three cases marked improvement was the …

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

Doctor of Nursing Practice Projects

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

Purpose: This …

Implementing Nurse Extracorporeal Membrane Oxygenation Specialists To Maintain A Sustainable Program, David L. Boyd

DNP Qualifying Manuscripts

Extracorporeal membrane oxygenation (ECMO) offers hope for patients with acute respiratory distress syndrome when other treatment methods fail. However, ECMO requires continuous hourly management leading to extremely high operating costs. With the onset of the COVID-19 pandemic, the high number of patients on ECMO led to a significant increase in the costs when using perfusionists to manage ECMO. Switching to a nurse-driven model resulted in a 52% decrease in costs related to the hourly management. Changing to a nurse-driven program provided increased nursing support and sustainability, and with determination and support, other ECMO centers can change to nurse-driven programs too.

Counting Every Drop: Preventing Maternal Mortality With Quantifying Blood Loss Through Triton Scale, Summer Le

Master's Projects and Capstones

Postpartum (PP) hemorrhage is one of the leading causes of maternal mortality (AWHONN, 2021). In each of the past three years, the percentage of PP hemorrhage has increased at Hospital X. The PP unit at Hospital X performs around 4,500 total deliveries each year. While the standard of care for PP blood loss is to specifically measure blood in milliliters as Quantifying Blood Loss (QBL) for Labor and Delivery (L&D), it is not yet the standard of care in the 24 hours postpartum after delivery (ACOG, 2019). This quality improvement project involved educating nurses about measuring blood loss – specifically …

The Development Of A Brain Penetrating Erythropoietin For The Treatment Of Alzheimer’S Disease, Joshua Yang

KGI Theses and Dissertations

The development of a neurotherapeutic for the treatment of Alzheimer’s Disease (AD) is challenging due to limited endpoint efficacy. Erythropoietin (EPO), a hematopoietic neurotrophin, is a potential therapeutic for AD but has limited blood-brain barrier (BBB) permeability. A chimeric fusion protein of EPO bound to the transferrin receptor monoclonal antibody (cTfRMAb) can act as a molecular trojan horse for brain drug delivery, shuttling EPO into the brain via the transvascular route. However, cTfRMAbs have Fc-effector function adverse effects, and removal of the Fc N-linked glycosylation site by substituting Asn with Gly (cTfRMAb-N292G-EPO) reduces this Fc effector function. Hence, developing this …

Rate Of Intraoperative Proximal Femoral Fractures With Automated Broaching, Tyler Radack, Hope Skibicki, Julian Zangrilli, Ruchir Nanavati, Cole Kleinman, Michael Harrer

Rowan-Virtua Research Day

Intraoperative proximal femur fractures (PFF) occur in 3.7% of total hip arthroplasties (THA) using the standard mallet broaching technique and increase a patient’s risk of revision surgery from 3.4% to 10%. The Depuy KINCISE automatic broaching system is designed to attenuate the risk of these fractures by applying consistent co-linear force to the broach. The aim of this study is to determine if the KINCISE system decreases the rate of intraoperative PFF fracture during THA compared to the standard mallet technique.

Alternate Site Pacing And The Impact On Intracellular Calcium Handling During The Post-Extrasystolic Cardiac Cycle, Kent Ozcan, Lawrence Mulligan

Rowan-Virtua Research Day

Objective: Previous work has shown that alternate site (RV apex) results in myocardial dysfunction. With the development of tools to place endocardial pacing leads in locations that create physiological pacing activation, we sought to evaluate how ventricular trans-septal or left ventricular apical placement pacing differs from right atrial pacing. We will evaluate how these chronic pacing modes impact the PR and RF at baseline, 0, and 16 weeks in the canine heart.

Methods: Quantitative analysis will be performed on previously generated data. The data set includes pacing of 15 dogs total (8 with trans-septal leads & 7 with left ventricular …

To Flash Or Not To Flash, Christy Overly

The Eleanor Mann School of Nursing DNP Capstone Projects

In 2015, healthcare-associated infection (HAI) prevalence survey found that there were an estimated 110,800 surgical site infections (SSIs) associated with inpatient surgeries in 2015. Consequently, instruments and implants sterilized by immediate use steam sterilization (IUSS) have been found to increase the patient’s risk for an SSIs. Due to these risks, the Joint Commission (TJC) determined that organizations should implement evidenced-based protocols to reduce IUSS use. A needs assessment revealed a gap in care in that the increasing SSI rates appeared to be correlated with the misuse of IUSS at the physician owned surgical hospital in Tulsa, Oklahoma. This Doctor of …

Analyzing The Survival Rate Of Clinically Pathogenic Bacteria On Occupational Therapy Devices Used During Full Hip Replacement Rehabilitation, Meredith Rippy

Honors Theses

An increasing concern of the healthcare system has been that of Healthcare-Associated Infections (HAIs). HAIs currently account for approximately 1.7 million infections and 99,000 deaths per year in United States hospitals. HAI’s (formerly called nosocomial infections) are defined as infections that develop in patients who have been in residence in a healthcare facility (i.e., in-patient clinics) for 48 hours or longer and who previously had no evidence of infection prior to admission. Consequences of HAIs include increased length of hospital stay, exposure to high frequency antibiotics, sepsis, and in unfortunate cases, death. In out-patient environments where patients are receiving rehabilitative …

Point Of Care Devices, Oluwatomilola Taiwo, Leena Pattarkine

Harrisburg University Research Symposium: Highlighting Research, Innovation, & Creativity

A point of care device is a portable and/or compact device that allows for patient testing by the area of patient care (e.g., bedside) or generally within the proximity of the patient; this allows for decision making that can lead to an improvement of patient health outcomes. (Class Project)

Electrocardiogram-Based Machine Learning Emulator Model For Predicting Novel Echocardiography-Derived Phenogroups For Cardiac Risk-Stratification: A Prospective Multicenter Cohort Study, Heenaben B. Patel, Naveena Yanamala, Brijesh Patel, Sameer Raina, Peter D. Farjo, Srinidhi Sunkara, Márton Tokodi, Nobuyuki Kagiyama, Grace Casaclang-Verzosa, Partho P. Sengupta

Journal of Patient-Centered Research and Reviews

Purpose: Electrocardiography (ECG)-derived machine learning models can predict echocardiography (echo)-derived indices of systolic or diastolic function. However, systolic and diastolic dysfunction frequently coexists, which necessitates an integrated assessment for optimal risk-stratification. We explored an ECG-derived model that emulates an echo-derived model that combines multiple parameters for identifying patient phenogroups at risk for major adverse cardiac events (MACE).

Methods: In this substudy of a prospective, multicenter study, patients from 3 institutions (n = 727) formed an internal cohort, and the fourth institution was reserved as an external test set (n = 518). A previously validated patient similarity analysis model was used …

A Better Way To Non-Invasively Measure Bilirubin Levels To Protect Infant Health, Kristen Mackeil

Symposium of Student Scholars

Background: Jaundice screening using transcutaneous bilirubin(TcB) monitors often produce inaccurately low results for lighter skin tone newborns and inaccurately high results for darker skin tone newborns. While high jaundice levels for lighter skin tone newborns risk going undetected, darker skin tone newborns receive unnecessary follow up heel sticks for serum bilirubin determination. This is a problem because dangerous jaundice levels may be under or over reported. Additionally, unnecessary heel sticks for darker skin tone newborns increase the risk of complications from puncture and increase newborn discomfort. Performing the heel stick and processing the blood sample also cost nurses and …

Reducing Pediatric Procedural Pain Using Virtual Reality, Emily Davis, Carmen Bandy

Scholars Week

Above all else, children require stability in their lives in order to develop a healthy perspective of the world. Feelings of instability can come from something as small as a change in schools. In the practice of pediatric medicine it is especially important to avoid these feelings of instability, which can lead children to develop healthcare-anxiety. Healthcare settings can be exceptionally emotionally taxing to children, because the children have a complete lack of control over their environment. This lack of control combined with fear and potentially pain can be incredibly distressing. While it is easy to disregard a child’s anxiety …

Temporary Epicardial Pacing Wires In Isolated Coronary Artery Bypass Graft: Necessity Or Force Of Habit?, Mian Mustafa Kamal, Abdul Ahad Sohail, Majid Osman, Shiraz Hashmi, Muhammad Mehdi, Asma Altaf Hussain Merchant, Hasanat Sharif

Section of Cardiothoracic Surgery

Objective: To determine the frequency of Temporary epicardial pacing wires usage and its predictors in the immediate postoperative period in isolated coronary artery bypass graft surgery.
Methods: The longitudinal study was conducted at the Aga Khan University Hospital, Karachi, from September 2019 to August 2020, and comprised adult patients of either gender who underwent isolated coronary artery bypass graft in the Department of Cardiothoracic Surgery. Demographic, peri-operative and post-operative Temporary Epicardial Pacing Wires use data was extracted from patient's files and the institutional electronic database. Logistic regression models were built to explore predictors of Temporary epicardial pacing wires usage. Data …

Surgical Research: Exploring Our History - Navigating The Future, Nadeem Ahmed Siddiqui, Muhammad Shahzad Shamim, Syed Ather Enam

Department of Surgery Docs

No abstract provided.

Monitoring And Evaluation Of Patient Engagement In Health Product Research And Development: Co-Creating A Framework For Community Advisory Boards, Sevgi E. Fruytier, Lidewij Eva Vat, Rob Camp, François Houÿez, Hilde De Keyser, Denise Dunne, Davide Marchi, Laura Mckeaveney, Richard H. Pitt, Carina A.C.M. Pittens, Meagan F. Vaughn, Elena Zhuravleva, Tjerk Jan Schuitmaker-Warnaar

Journal of Patient-Centered Research and Reviews

Purpose: While patient engagement is becoming more customary in developing health products, its monitoring and evaluation to understand processes and enhance impact are challenging. This article describes a patient engagement monitoring and evaluation (PEME) framework, co-created and tailored to the context of community advisory boards (CABs) for rare diseases in Europe. It can be used to stimulate learning and evaluate impacts of engagement activities.

Methods: A participatory approach was used in which data collection and analysis were iterative. The process was based on the principles of interactive learning and action and guided by the PEME framework. Data were collected via …