Medical Specialties Commons^™

Self-Consistent Analyses For Potential Conduction Block In Nerves By An Ultrashort High-Intensity Electric Pulse, R. P. Joshi, A. Mishra, Q. Hu, K. H. Schoenbach, A. Pakhomov

Bioelectrics Publications

Simulation studies are presented that probe the possibility of using high-field (>100kV ∕ cm), short-duration (∼50ns) electrical pulses for nonthermal and reversible cessation of biological electrical signaling pathways. This would have obvious applications in neurophysiology, clinical research, neuromuscular stimulation therapies, and even nonlethal bioweapons development. The concept is based on the creation of a sufficiently high density of pores on the nerve membrane by an electric pulse. This modulates membrane conductance and presents an effective "electrical short" to an incident voltage wave traveling across a nerve. Net blocking of action potential propagation can then result. A continuum approach based …

Optimization Of Biomathematical Model Predictions For Cognitive Performance Impairment In Individuals: Accounting For Unknown Traits And Uncertain States In Homeostatic And Circadian Processes, Hans P. A. Van Dongen, Christopher G. Mott, Jen-Kuang Huang, Daniel J. Mollicone, Frederic D. Mckenzie, David F. Dinges

Mechanical & Aerospace Engineering Faculty Publications

Current biomathematical models of fatigue and performance do not accurately predict cognitive performance for individuals with a priori unknown degrees of trait vulnerability to sleep loss, do not predict performance reliably when initial conditions are uncertain, and do not yield statistically valid estimates of prediction accuracy, These limitations diminish their usefulness for predicting the performance of individuals in operational environments. To overcome these 3 limitations, a novel modeling approach was developed, based on the expansion of a statistical technique called Bayesian forecasting. The expanded Bayesian forecasting procedure was implemented in the two-process model of sleep regulation, which has been used …

Confidence Intervals For Individualized Performance Models, Hans P. A. Van Dongen, Christopher G. Mott, Jen-Kuang Huang, Daniel J. Millicone, Frederic D. Mckenzie, David F. Dinges

Mechanical & Aerospace Engineering Faculty Publications

Commentary on Reifman J; Rajaraman S; Gribok AV. Moving Towards Individualized Performance Models. Sleep 2007;30(9):1081-82.

Potential For Stimulating Host Anti-Tumor Immune Response Via Rnai-Mediated Local Foxp3 Knockdown, N. Klaiber

Chemistry & Biochemistry Faculty Publications

Neoplastic growths represent a unique challenge for the host immune system. As they are indeed derived from self, many of the same mechanisms operating to prevent autoimmunity also provide an umbrella beneath which malignant cells are free to proliferate.1 Central among these immune regulatory boundaries are an influential subset of lymphocytes known as T regs. Hypothesized to exist decades ago, yet eluding definitive characterization until relatively recently, T regs have been demonstrated to play a crucial role in the proper functioning of the immune system as a whole. They may also, however, represent one of the primary obstacles to successful …

Sir/Rsna/Cirse Joint Medical Simulation Task Force Strategic Plan: Executive Summary, Derek Gould, Aalpen Patel, Gary Becker, Buddy Conners, John Cardella, Steven Dawson, Craig Glaiberman, David Kessel, Mick Lee, Mark Scerbo

Psychology Faculty Publications

(First paragraph) The Executive Councils of the Society of Interventional Radiology (SIR), Radiological Society of North America (RSNA), and Cardiovascular and Interventional Radiological Society of Europe (CIRSE) have charged their Medical Simulation Task Forces and Work Groups to cooperate to achieve excellence and safety in interventional radiology patient care by jointly recommending and guiding implementation of a robust infrastructure and process to support Interventional Radiology (IR) simulation development, assessment, validation, application, and dissemination.

Evaluation Of Toxicity Following Electrically Mediated Interleukin-12 Gene Delivery In A B16 Mouse Melanoma Model, Loree Heller, Kathleen Merkler, Jeffrey Westover, Yolmari Cruz, Domenico Coppola, Kaaron Benson, Adil Daud, Richard Heller

Bioelectrics Publications

PURPOSE: Interleukin-12 (IL-12) has potential as an immunotherapeutic agent for the treatment of cancer but is unfortunately associated with toxicity. Delivery of a plasmid encoding IL-12 with electroporation induces an antitumor effect in the B16 mouse melanoma model without serious side effects. To translate this observation to the clinic, an evaluation of toxicity was done in the mouse model.

EXPERIMENTAL DESIGN: Weight change, tumor response, blood chemistry and hematology values, and serum IL-12 levels were evaluated. Multiple tissues were analyzed histopathologically.

RESULTS: A pronounced reduction in tumor volume, including a large percentage of complete regressions, was observed after electrically mediated …

The Effects Of Music On Art Making With Older Adults, Gertrude W. Goodwin

EVMS School of Health Professions Theses & Dissertations

It is projected that by 2030, older adults will make up 69.4 million of the population in the United States (U.S. Bureau of the Census, 2001). The basic physical, mental, and emotional needs of these older adults must be addressed to ensure an adequate quality of life. Quality of life refers to the degree needs are being met as well as the person’s perception and satisfaction with life. As the population ages there is an increased expectation for a higher quality of life because older adults are healthier, more active, and living longer. The therapeutic use of art and music …

Art Therapy And Sensory Stimulation To Decrease Agitation: A Pilot Study, Leslie Cristen Lavergne

EVMS School of Health Professions Theses & Dissertations

Dementia affects 1% of older adults in America between the ages of 65 and 74 years, and increases to 10% in those 85 years and older. The cognitive and behavioral symptoms of dementia may restrict an individuals ability to perform activities of daily living, such as self-care, memory, and language. The literature supports the premise that individuals who have dementia can benefit from a treatment approach that focuses on medication regulation, as well as mental stimulation. This study was an art therapy and sensory stimulation intervention designed to reduce agitation, a common non-cognitive symptom of dementia. This study included five …

Effect Of A Single Bout Of Prior Moderate Exercise On Cutaneous Perfusion In Type 2 Diabetes, Sheri R. Colberg, Henri K. Parson, Tanja Nunnold, D. Robb Holton, Aaron I. Vinik

Human Movement Studies & Special Education Faculty Publications

In diabetic individuals, increased shunting of circulation away from the skin may exist, contributing to their greater risk for ulcerations and poor cutaneous healing. In a prospective study (1), we previously found a lower skin perfusion during local heating in the foot dorsum of sedentary type 2 diabetic individuals compared with active people without diabetes. This defect was present despite normal increases in skin interstitial nitric oxide (NO), suggesting that NO is either ineffective or not involved (2). A prior bout of maximal exercise also lessened the impaired responsiveness to local heating of the dorsal foot in active type 2 …

The Use Of Proteomic Technologies To Identify Serum Glycoproteins For The Early Detection Of Liver And Prostate Cancers, Elizabeth Ellen Schwegler

Theses and Dissertations in Biomedical Sciences

The application of proteomic technologies to identify serum glycoproteins is an emerging technique to identify new biomarkers indicative of disease severity. Many of these newly evolving protein-profiling methodologies have evolved from previous global protein expression profiling studies such as those involving SELDI-TOF-MS technologies. Though the SELDI approach could distinguish disease from normal by utilizing protein patterns as shown herein with the HCC study of chapter II, it was unable to offer sequence information on the selected peaks, and did not have the ability to analyze the entire dynamic range of the serum/plasma proteome. To address these deficiencies, new strategies that …

Engendering Student Empathy For Disabled Clients With Urinary Incontinence Through Experiential Learning, Karen A. Karlowicz, Kay L. Palmer

Ellmer School of Nursing Faculty Publications

As part of a rehabilitation clinical course for senior baccalaureate nursing students, a disability-incontinence experiential learning activity is required. The assignment is intended to familiarize students with some of the challenges encountered by a client with mobility problems, including continence management issues using disposable undergarments. Wearing the undergarments dry and wet while being confined to a wheelchair provides insight and promotes empathy for patients with bladder control problems.

Understanding The Nature Of Surgical Excellence Using A Competency Modeling Approach, Hope S. Hanner-Bailey

Psychology Theses & Dissertations

Currently, a thorough description of the knowledge, skills, abilities, and other personal characteristics (KSAOs) that distinguish an exceptional surgeon does not exist. This knowledge is pertinent to the development of selection, training, and performance assessment methods that can be used to develop high performing surgeons. Expert surgeons from around the country were recruited to participate in an interview to discuss the KSAOs (i.e., the competencies) needed to be exceptional in the field. A smaller number of novice surgeons were also interviewed. The expert interview data were distilled into a competency model that consists of ten competencies and patterns within the …

Automatic Colonic Polyp Detection Using Multiobjective Evolutionary Techniques, Jiang Li, Adam Huang, Jianhua Yao, Ingmar Bitter, Nicholas Petrick, Ronald M. Summers, Perry J. Pickhardt, J. Richard Choi

Electrical & Computer Engineering Faculty Publications

Colonie polyps appear like elliptical protrusions on the inner wall of the colon. Curvature based features for colonie polyp detection have proved to be successful in several computer-aided diagnostic CT colonography (CTC) systems. Some simple thresholds are set for those features for creating initial polyp candidates, sophisticated classification scheme are then applied on these polyp candidates to reduce false positives. There are two objective functions, the number of missed polyps and false positive rate, that need to be minimized when setting those thresholds. These two objectives conflict and it is usually difficult to optimize them both by a gradient search. …

Teaching And Learning In Urology Nursing, Karen A. Karlowicz

Ellmer School of Nursing Faculty Publications

No abstract provided.

The Use Of The Tripartite Model Of Attitudes To Explain Ems Providers' Attitudes About The Ems Agenda For The Future, Carolyn Angela Rinaca

Health Services Research Dissertations

A dynamic and revolutionary health care system compels the Nation to develop a more cohesive, unified healthcare workforce. The Emergency Medical Services (EMS) profession has contributed to this development with the publication of the EMS Agenda for the Future. The EMS Agenda for the Future describes the future direction for emergency medical services agencies and organizations within the nation. It is a vision that integrates EMS systems with other health care professions. The EMS Agenda for the Future is designed to assist EMS professionals in realizing their full potential for proficiency and contributes to the development of the EMS profession. …

Chromosomal Localization Of The Islet Neogenesis Associated Protein (Ingap) Gene In Syrian Hamster By Tyramide Signal Amplification-Fluorescence In Situ Hybridization (Tsa-Fish), Sallie A. Smith

Biological Sciences Theses & Dissertations

Diabetes mellitus is a group of conditions characterized by hyperglycemia due to an inability to produce or properly utilize insulin. The majority of cases fall into two categories, Type I and Type 2. Type I results from the autoimmune destruction of pancreatic β-cells of the islets. The beta cells are the exclusive source of insulin and the patient becomes entirely dependent on exogenous insulin to survive. Patients with Type 2 are distinguished by insulin resistance, a condition that develops due to the inability of the body to effectively use the insulin being produced. The β-cells gradually lose their ability to …

The Antitumor Agent, Arglabin-Dma, Preferentially Induces Apoptosis In Human Colon Tumor Cells, Sung Wook Kwon

Theses and Dissertations in Biomedical Sciences

Arglabin-DMA, an analog of farnesyl pyrophosphate (FPP), reportedly inhibits farnesyltransferase (FTase) directly by competitively blocking the binding of Ras protein and its posttranslational modification, as suggested in previous studies. But, the mechanisms by which Arglabin-DMA inhibits tumor growth in vivo and in vitro are still relatively poorly characterized. To determine the mechanism by which this drug inhibits tumor growth, the effects of Arglabin-DMA in two human colon tumor cell lines (mutant K-ras HCT 116 and wild-type ras HT-29) were explored on cell proliferation, apoptosis, and cell cycle kinetics in vitro. In cell viability studies, we showed that Arglabin-DMA …

Mechanisms Of Cell Death Initiated In Herpes Simplex Virus Thymidine Kinase Expressing Colon Tumor Cells Treated With Ganciclovir And Ucn-01, Christina Elizabeth Ahn

Theses and Dissertations in Biomedical Sciences

Metastatic colon carcinoma is the second leading cause of death from malignancy in the United States, and development of more effective treatments is essential. Heterologous expression of Herpes Simplex Virus Thymidine Kinase (HSVtk) in combination with the prodrug, ganciclovir (GCV), has shown great promise for the genetic therapy of many cancers, but most patients have had only a partial or minimal response to the therapy. After screening a panel of two drug combinations, our laboratory has shown that the combination of GCV and the protein kinase inhibitor UCN-01 (7-hydroxystaurosporine) enhances tumor cell death more effectively than either drug alone. However …

Improving Clinical Practice Using Clinical Decision Support Systems: A Systematic Review Of Trials To Identify Features Critical To Success, Kensaku Kawamoto, Caitlin A. Houlihan, E. Andrew Balas, David F. Lobach

School of Medical Diagnostics & Translational Sciences Publications

Objective To identify features of clinical decision support systems critical for improving clinical practice. Design Systematic review of randomised controlled trials.
Data sources Literature searches via Medline, CINAHL, and the Cochrane Controlled Trials Register up to 2003; and searches of reference lists of included studies and relevant reviews.
Study selection Studies had to evaluate the ability of decision support systems to improve clinical practice.
Data extraction Studies were assessed for statistically and clinically significant improvement in clinical practice and for the presence of 15 decision support system features whose importance had been repeatedly suggested in the literature.
Results Seventy studies …

Simulations Of Nanopore Formation And Phosphatidylserine Externalization In Lipid Membranes Subjected To A High-Intensity, Ultrashort Electric Pulse, Q. Hu, R. P. Joshi, K. H. Schoenbach

Bioelectrics Publications

A combined MD simulator and time dependent Laplace solver are used to analyze the electrically driven phosphatidylserine externalization process in cells. Time dependent details of nanopore formation at cell membranes in response to a high-intensity (100kV∕cm), ultrashort (10ns) electric pulse are also probed. Our results show that nanosized pores could typically be formed within about 5ns. These predictions are in very good agreement with recent experimental data. It is also demonstrated that defect formation and PS externalization in membranes should begin on the anode side. Finally, the simulations confirm that PS externalization is a nanopore facilitated event, rather than the …

Enhancing The Geriatric Competence Of Urologic Nurses, Karen A. Karlowicz

Ellmer School of Nursing Faculty Publications

Editorial. Provides strategies for enhancing the geriatric competence of urologic nurses. Improvements in nursing practice and in other health care professions; Considerations in caring for older adults; Implications for nursing practice.

A Comparison Of Esomeprazole And Lansoprazole For Control Of Intragastric Ph In Patients With Symptoms Of Gastro-Oesophageal Reflux Disease, D. A. Johnson, T. Stacy, M. Ryan, T. Wootton, J. Willia, K. Hornbuckle, W. Brooks, M. Doviak

Mathematics & Statistics Faculty Publications

Background: Intragastric acid suppression is the most direct measure of the pharmacodynamic efficacy of proton pump inhibitors, which are the most effective drugs for acid-related diseases.

Aim: To compare the effectiveness of once and twice daily dosing of lansoprazole and esomeprazole in controlling intragastric acidity ( target gastric pH > 4.0) over a 24-hour period.

Methods: In an open-label, two-way crossover study, 45 Helicobacter pylori-negative patients with gastro-oesophageal reflux disease were randomized to receive one of two regimens: 30 mg lansoprazole or esomeprazole 40 mg once daily. Intragastric pH was assessed by 24-hour pH monitoring on day 5 of each regimen. …

Symptoms Of Gastro-Oesophageal Reflux Disease And The Severity Of Obstructive Sleep Apnoea Syndrome Are Not Related In Sleep Disorders Center Patients, H.-N. Kim, R. D. Vorona, M. P. Winn, M. Doviak, D. A. Johnson, J. Catesby Ware

Mathematics & Statistics Faculty Publications

Background: Studies suggest obstructive sleep apnea syndrome (OSAS) frequently manifests in patients with gastroesophageal reflux disease (GERD) and that there may be a causal relationship.

Aim: To determine the relationship between OSAS and symptoms of GERD.

Methods: Consecutive patients referred to the Sleep Disorders Center (SDC) 18 years and older with polysomnographically defined OSAS were evaluated prospectively for GERD using a validated symptoms questionnaire. The GERD and OSAS relationship was assessed by 1) determining frequency of GERD in patients with and without OSAS; 2) ascertaining the relationship between OSAS severity categories and presence of GERD; 3) examining GERD score in …

Men, Muscles, And Body Image: Comparisons Of Competitive Bodybuilders, Weight Trainers, And Athletically Active Controls, T. C. Pickett, R. J. Lewis, T. F. Cash, H. G. Pope

Psychology Faculty Publications

Objectives: To investigate body image and psychosocial adjustment among competitive bodybuilders, non-competitive weight trainers, and athletically active men.

Methods: Participants were 40 men in each of the three groups who were assessed on body composition and multiple facets of body image evaluation, investment and anxiety, eating attitudes, and social self esteem.

Results: Relative to the other two groups, competitive bodybuilders had greater body mass due to fat-free body mass. Although groups did not differ in their situational body image discomfort, competitive bodybuilders and weight trainers had a more positive global appearance evaluation and were more psychologically invested in their physical …

The Ultrastructure Of The Olfactory System In Two Species Of Short-Tailed Shrews, Blarina Brevicauda And Blarina Carolinensis, Lisa Johnson Byrum

Theses and Dissertations in Biomedical Sciences

Several studies of the fine structure of the olfactory system of rodents have been conducted, but very little research has been done on members of the Insectivora. The olfactory systems of the northern short-tailed shrew, Blarina brevicauda, and the southern short-tailed shrew, Blarina carolinensis, were examined by light and electron microscopy. These shrews were live trapped in the vicinity of Norfolk, Virginia throughout all months of the year. Olfactory tissues were processed following standard transmission and scanning electron microscopy protocols. The olfactory system structures investigated included the olfactory epitheliumlmucosa (OEM), main olfactory bulb (MOB), accessory olfactory bulb (AOB), …

Helping Older Adults Adjust To Assisted Living: An Eco-Art Therapy Approach, Lynn M. Franta

EVMS School of Health Professions Theses & Dissertations

The purpose of this exploratory study was to research the outcomes of an art therapy group using Ecopsychology principles as an aid for older adults adjusting to an assisted living facility. The group was designed to last over a 4-week period with two sessions per week. Outcomes were assessed using the Depression, Anxiety, and Stress Scales short form as well as through a structured interview format.

The study had six participants total; three men and three women, with ages ranging from 70 to 83 years. Findings were inconclusive as individual scores on the DASS varied widely. Participant report indicated overall …

Art Therapy As A Measure Of Children’S Concept Of Surgery: A Preliminary Study, Emily C. Clark

EVMS School of Health Professions Theses & Dissertations

Surgery is a strange, and often frightening experience for children. A number of programs have been studied which attempt to prepare children for the surgery experience. Art therapy may be especially suited to help prepare children for surgery because art making is an effective form of communication for children, and can allow them to express their thoughts and fears about surgery. Unfortunately, studies of art therapy preparation programs are rare, and usually take the form of case studies. This research study is the first step in designing an art therapy preparation program for preparing children for surgery.

The purpose of …

Neural Correlates Of Art Therapy As Indicated Through Electroencephalography, Kerry A. Kruk

EVMS School of Health Professions Theses & Dissertations

Quantitative electroencephalograph (QEEG) reports of 14 healthy women participants engaged in art making in response to two general art therapy directives were generated and compared at Eastern Virginia Medical School. A Cadwell Easy-II 32-channel digital EEG and Physiometrx E-net which contains placements according to the International 10-20 system were used to collect brainwave activity. This study explored the effects of clay sculpting and marker drawing conditions on neural activity in the right and left frontal and parietal cortices.

One aim of the study was to illuminate what Lusebrink (1990) suggested - that different types of media and processes elicit different …

Increased Risk For Aplastic Anemia And Myelodysplastic Syndrome In Individuals Lacking Glutathione S-Transferase Genes, Joanne F. Sutton, Michael Stacey, William G. Kearns, Thomas S. Roeg, Neal S. Young, Johnson M. Liu

Bioelectrics Publications

BACKGROUND: Aplastic anemia (AA) and myelodysplastic syndrome (MDS) are marrow failure states that may be associated with chromosomal instability. An absence of the glutathione S-transferase (GST) enzyme may genetically predispose individuals to AA or MDS. PROCEDURE AND RESULTS: To test this hypothesis, we determined the GSTM1 and GSTT1 genotypes in a total of 196 patients using multiplex PCR. The GSTT1 null genotype was found to be overrepresented in Caucasian, Asian, and Hispanic patients with either AA or MDS. We confirmed a difference in the expected frequency of the GSTM1 null genotype in Caucasian MDS patients. The double null GSTM1/GSTT1 …

Effects Of 8 Weeks Of Flexibility And Resistance Training In Older Adults With Type 2 Diabetes, Matthew T. Herriot, Sheri R. Colberg, Henri K. Parson, Tanja Nunnold, Aaron I. Vinik

Human Movement Studies & Special Education Faculty Publications

(First paragraph) Flexibility is often downplayed as unimportant to fitness. However, flexibility training is imperative to maintain full range of motion (ROM) of joints, particularly in individuals with type 2 diabetes, who may experience limited joint mobility due to glycation of joint structures (1). Maladies such as “frozen shoulder” are common complaints in type 2 diabetes (2).