Medical Specialties Commons^™

Career Regret Among Physician Assistants: A Comparative Survey Of Primary And Specialty Care Careers, Talia Sierra, Jennifer Forbes, Michael Nelson

Internet Journal of Allied Health Sciences and Practice

Purpose: This study investigated if career regret varies among physician assistants (PAs) practicing in primary and specialty care fields. This information may assist practicing and aspiring physician assistants when selecting or changing their career path.

Methods: A survey was emailed to 5,000 primary and specialty care physician assistants. Items indicating career regret were compared between primary and specialty care groups.

Results: Eight hundred and thrity-four (16.7%) completed surveys were received back. Career regret is similar between primary and specialty care physician assistants, with low reports from both groups. No statistical significance was found between primary care and specialty care groups …

Pain, Severity, And Attentional Capacity Following Acute Musculoskeletal Injury, Rebekah F. Roessler

College of Graduate Studies: Theses & Dissertations

Background: As recreational activities grow in popularity, there is a concurrent rise in musculoskeletal injury. Injury severity is determined through clinical evaluation and defined by a grading scale. Pain is included in the definition of each injury grade, despite the lack of any conclusive evidence relating injury severity and the associated pain. Additionally, previous studies report impairments in cognitive performance due to chronic and acute pain. The aim of this study is to determine the relationship between the perceived pain intensity and the clinically diagnosed severity of an acute musculoskeletal injury, and to determine if attentional capacity is influenced by …

Randomized Controlled Trial Of Influenza Vaccine In Patients With Heart Failure To Reduce Adverse Vascular Events (Ivve): Rationale And Design, Mark Loeb, Hisham Dokainish, Antonio Dans, Lia M. Palileo-Villanueva, Ambuj Roy, Ambuj Roy, Kamilu Karaye, Jun Zhu, Yan Liang, Gerald Yonga

Internal Medicine, East Africa

Background: Influenza is associated with an increase in the risk of cardiac and other vascular events. Observational data and small randomized trials suggest that influenza vaccination may reduce such adverse vascular events.

Research Design and Methods: In a randomized controlled trial patients with heart failure are randomized to receive either inactivated influenza vaccine or placebo annually for 3 years. Patients aged ≥18 years with a clinical diagnosis of heart failure and NYHA functional class II, III and IV are eligible. Five thousand patients from 10 countries where influenza vaccination is not common (Asia, the Middle East, and Africa) have been …

Dosimetric Performance And Planning/Delivery Efficiency Of A Dual-Layer Stacked And Staggered Mlc On Treating Multiple Small Targets: A Planning Study Based On Single-Isocenter Multi-Target Stereotactic Radiosurgery (Srs) To Brain Metastases., Taoran Li, Peyton Irmen, Haisong Lui, Wenyin Shi, Michelle Alonso-Basanta, Wei Zou, Boon-Keng Kevin Teo, James M. Metz, Lei Dong

Department of Radiation Oncology Faculty Papers

Purpose: To evaluate the dosimetric performance and planning/delivery efficiency of a dual-layer MLC system for treating multiple brain metastases with a single isocenter.

Materials and Methods: 10 patients each with 6-10 targets with volumes from 0.11 to 8.57 cc, and prescription doses from 15 to 24 Gy, were retrospectively studied. Halcyon has only coplanar delivery mode. Halcyon V1 MLC modulates only with the lower layer at 1 cm resolution, whereas V2 MLC modulates with both layers at an effective resolution of 0.5 cm. For each patient five plans were compared varying MLC and beam arrangements: the clinical plan using multi-aperture …

An Open-Label, Single-Dose Study To Evaluate The Safety, Tolerability, Pharmacokinetics, And Pharmacodynamics Of Cinacalcet In Pediatric Subjects Aged 28 Days To < 6 Years With Chronic Kidney Disease Receiving Dialysis., Winnie Y. Sohn, Anthony A. Portale, Isidro B. Salusky, Hao Zhang, Lucy L. Yan, Bella Ertik, Shahnaz Shahinfar, Edward Lee, Bastian Dehmel, Bradley A. Warady

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Calcimimetics, shown to control biochemical parameters of secondary hyperparathyroidism (SHPT), have well-established safety and pharmacokinetic profiles in adult end-stage renal disease subjects treated with dialysis; however, such studies are limited in pediatric subjects.

METHODS: In this study, the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of cinacalcet were evaluated in children with chronic kidney disease (CKD) and SHPT receiving dialysis. Twelve subjects received a single dose of cinacalcet (0.25 mg/kg) orally or by nasogastric or gastric tube. Subjects were randomized to one of two parathyroid hormone (PTH) and serum calcium sampling sequences: [(1) 2, 8, 48 h; or (2) …

Pediatric Dermatology Workforce In The United States., Brea Prindaville, Kimberly A. Horii, Elaine C. Siegfried, Heather Brandling-Bennett

Manuscripts, Articles, Book Chapters and Other Papers

Studies have suggested there is a shortage of pediatric dermatologists in the United States, but the workforce has not been well defined. The Society for Pediatric Dermatology (SPD) Workforce Committee sought to characterize the US pediatric dermatology workforce with a nine-question survey, sent to all 484 US SPD members in December 2016. The response rate was 30%. Most pediatric dermatologists were practicing in major metropolitan markets, seeing an average of 80 patients a week with an average 6-week wait time. These findings indicate that geographic maldistribution and long wait times for new patient appointments remain substantial hurdles for adequate access …

The Children's Oncology Group: Organizational Structure, Membership, And Institutional Characteristics., Janice S. Withycombe, Todd A. Alonzo, Michele A. Wilkins-Sanchez, Maxine Hetherington, Peter C. Adamson, Wendy Landier

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The Children's Oncology Group (COG) is the only organization within the National Cancer Institute's National Clinical Trials Network dedicated exclusively to pediatric cancer research. The purpose of this article is to provide an overview of COG's organizational structure, to characterize its institutional and individual membership, and to summarize enrollments onto COG clinical trials.

METHOD: Data from 2013 to 2015 were compiled from sources internal (Network Operations, Statistics and Data Center, Chair's Office) and external (American Hospital Association, American Nurses Credentialing Center) to COG, to present a comprehensive overview of COG's structure, individual and institutional membership, and group operations.

RESULTS: …

Genomic Prediction Of Relapse In Recipients Of Allogeneic Haematopoietic Stem Cell Transplantation., J Ritari, K Hyvärinen, S Koskela, M Itälä-Remes, R Niittyvuopio, A Nihtinen, U Salmenniemi, M Putkonen, L Volin, T Kwan, T Pastinen, J Partanen

Manuscripts, Articles, Book Chapters and Other Papers

Allogeneic haematopoietic stem cell transplantation currently represents the primary potentially curative treatment for cancers of the blood and bone marrow. While relapse occurs in approximately 30% of patients, few risk-modifying genetic variants have been identified. The present study evaluates the predictive potential of patient genetics on relapse risk in a genome-wide manner. We studied 151 graft recipients with HLA-matched sibling donors by sequencing the whole-exome, active immunoregulatory regions, and the full MHC region. To assess the predictive capability and contributions of SNPs and INDELs, we employed machine learning and a feature selection approach in a cross-validation framework to discover the …

Seroepidemiology Of Parechovirus A3 Neutralizing Antibodies, Australia, The Netherlands, And United States, Eveliina Karelehto, Lieke Brouwer, Kimberley Benschop, Jen Kok, Kerri Basile, Brendan Mcmullan, William Rawlinson, Julian Druce, Suellen Nicholson, Rangaraj Selvarangan, Christopher J. Harrison, Kamani Lankachandra, Hetty Van Eijk, Gerrit Koen, Menno De Jong, Dasja Pajkrt, Katja C. Wolthers

Manuscripts, Articles, Book Chapters and Other Papers

© 2018, Centers for Disease Control and Prevention (CDC). All rights reserved. Recent parechovirus A3 (PeV-A3) outbreaks in Australia suggest lower population immunity compared with regions that have endemic PeV-A3 circulation. A serosurvey among populations in the Netherlands, the United States, and Australia before and after the 2013 Australia outbreak showed high PeV-A3 neutralizing antibody prevalence across all regions and time periods, indicating widespread circulation.

Specificity And Transfer Of Lower-Body Strength: Influence Of Bilateral Or Unilateral Lower-Body Resistance Training, Brendyn B. Appleby, Stuart J. Cormack, Robert U. Newton

Research outputs 2014 to 2021

Appleby, BB, Cormack, SJ, and Newton, RU. Specificity and transfer of lower-body strength: Influence of bilateral or unilateral lower-body resistance training. J Strength Cond Res 33(2): 318-326, 2019-To examine the development of lower-body strength using either bilateral or unilateral resistance training. Developmental rugby players (n = 33; mean training age = 5.4 ± 2.9 years; 1 repetition maximum [1RM] 90° squat = 178 ± 27 kg) completed an 18-week randomized controlled training design (bilateral group [BIL], n = 13; unilateral group [UNI], n = 10; comparison, n = 10). The 8-week training phase involved 2 lower-body, volume-load matched resistance sessions …

Altering Brain Dynamics With Transcranial Random Noise Stimulation, Onno Van Der Groen, Jason B. Mattingley, Nicole Wenderoth

Research outputs 2014 to 2021

Random noise can enhance the detectability of weak signals in nonlinear systems, a phenomenon known as stochastic resonance (SR). This concept is not only applicable to single threshold systems but can also be applied to dynamical systems with multiple attractor states, such as observed during the phenomenon of binocular rivalry. Binocular rivalry can be characterized by marginally stable attractor states between which the brain switches in a spontaneous, stochastic manner. Here we used a computational model to predict the effect of noise on perceptual dominance durations. Subsequently we compared the model prediction to a series of experiments where we measured …

Doppler Radar-Based Non-Contact Health Monitoring For Obstructive Sleep Apnea Diagnosis: A Comprehensive Review, Vinh Phuc Tran, Adel Ali Al-Jumaily, Syed Mohammed Shamsul Islam

Research outputs 2014 to 2021

Today’s rapid growth of elderly populations and aging problems coupled with the prevalence of obstructive sleep apnea (OSA) and other health related issues have affected many aspects of society. This has led to high demands for a more robust healthcare monitoring, diagnosing and treatments facilities. In particular to Sleep Medicine, sleep has a key role to play in both physical and mental health. The quality and duration of sleep have a direct and significant impact on people’s learning, memory, metabolism, weight, safety, mood, cardio-vascular health, diseases, and immune system function. The gold-standard for OSA diagnosis is the overnight sleep monitoring …

Pathological Mechanisms And Therapeutic Outlooks For Arthrofibrosis, Kayley M. Usher, Sipin Zhu, Georgios Mavropalias, John A. Carrino, Jinmin Zhao, Jiake Xu

Research outputs 2014 to 2021

Arthrofibrosis is a fibrotic joint disorder that begins with an inflammatory reaction to insults such as injury, surgery and infection. Excessive extracellular matrix and adhesions contract pouches, bursae and tendons, cause pain and prevent a normal range of joint motion, with devastating consequences for patient quality of life. Arthrofibrosis affects people of all ages, with published rates varying. The risk factors and best management strategies are largely unknown due to a poor understanding of the pathology and lack of diagnostic biomarkers. However, current research into the pathogenesis of fibrosis in organs now informs the understanding of arthrofibrosis. The process begins …

Effect Of Ice Slushy Ingestion And Cold Water Immersion On Thermoregulatory Behavior, Hui C. Choo, Jeremiah J. Peiffer, João P. Lopes-Silva, Ricardo N. O. Mesquita, Tatsuro Amano, Narihiko Kondo, Chris R. Abbiss

Research outputs 2014 to 2021

Two studies were conducted to examine the effects of ice slushy ingestion (ICE) and cold water immersion (CWI) on thermoregulatory and sweat responses during constant (study 1) and self-paced (study 2) exercise. In study 1, 11 men cycled at 40–50% of peak aerobic power for 60 min (33.2 ± 0.3C, 45.9 ± 0.5% relative humidity, RH). In study 2, 11 men cycled for 60 min at perceived exertion (RPE) equivalent to 15 (33.9 ± 0.2C and 42.5 ± 3.9%RH). In both studies, each trial was preceded by 30 min of CWI (~22C), ICE or no cooling (CON). Rectal temperature (T …

Investigating The Relationships Between Hypothalamic Volume And Measures Of Circadian Rhythm And Habitual Sleep In Premanifest Huntington's Disease, Danielle M. Bartlett, Juan F. Domínguez D, Alvaro Reyes, Pauline Zaenker, Kirk W. Feindel, Robert U. Newton, Anthony J. Hannan, James A. Slater, Peter R. Eastwood, Alpar S. Lazar, Mel Ziman, Travis Cruickshank

Research outputs 2014 to 2021

Objective

Pathological changes within the hypothalamus have been proposed to mediate circadian rhythm and habitual sleep disturbances in individuals with Huntington’s disease (HD). However, investigations examining the relationships between hypothalamic volume and circadian rhythm and habitual sleep in individuals with HD are sparse. This study aimed to comprehensively evaluate the relationships between hypothalamic pathology and circadian rhythm and habitual sleep disturbances in individuals with premanifest HD.

Methods

Thirty-two individuals with premanifest HD and twenty-nine healthy age- and gender-matched controls participated in this dual-site, cross-sectional study. Magnetic resonance imaging scans were performed to evaluate hypothalamic volume. Circadian rhythm and habitual sleep …

Deep Learning Based Topology Guaranteed Surface And Mme Segmentation Of Multiple Sclerosis Subjects From Retinal Oct, Yufan He, Aaron Carass, Yihao Liu, Bruno Jedynak, Sharon D. Solomon, Shiv Saidha, Peter A. Calabresi, Jerry L. Prince

Mathematics and Statistics Faculty Publications and Presentations

Optical coherence tomography (OCT) is a noninvasive imaging modality that can be used to obtain depth images of the retina. Patients with multiple sclerosis (MS) have thinning retinal nerve fiber and ganglion cell layers, and approximately 5% of MS patients will develop microcystic macular edema (MME) within the retina. Segmentation of both the retinal layers and MME can provide important information to help monitor MS progression. Graph-based segmentation with machine learning preprocessing is the leading method for retinal layer segmentation, providing accurate surface delineations with the correct topological ordering. However, graph methods are time-consuming and they do not optimally incorporate …

A Time-Friendly, Feasible Measure Of Nutrition Knowledge In Type 1 Diabetes: The Electronic Nutrition And Carbohydrate Counting Quiz (Encq)., Arwen M. Marker, Amy E. Noser, Nicole Knecht, Mark A. Clements, Susana R. Patton

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Greater knowledge about nutrition and carbohydrate counting are associated with improved glycemic control and quality of life in youth with type 1 diabetes (T1D). However, limited assessments of nutrition and carbohydrate knowledge have been developed, and existing measures can be time-consuming, overly broad, or not conducive to routine clinical use. To fill this gap, we developed and examined the feasibility of administering the electronic Nutrition and Carbohydrate Counting Quiz (eNCQ).

METHOD: Ninety-two caregivers and 70 youth with T1D (mean age 12.5 years; mean time since diagnosis 5 years; English speaking) completed the 19-item eNCQ via tablet during a routine …

ผลของการฝึกออกกำลังกายที่ความหนักระดับปานกลางต่อการออกซิเดชันของไขมันในขณะพักฟื้นหลังออกกำลังกายในอุณหภูมิร้อนและเย็นของหญิงอ้วน, ปริมล แก้วผลึก

Chulalongkorn University Theses and Dissertations (Chula ETD)

การออกกำลังกายเป็นวิธีที่มีประสิทธิภาพในการลดไขมันและน้ำหนักสำหรับคนอ้วน การเพิ่มการออกซิเดชันของไขมันขณะพักฟื้นภายหลังเสร็จสิ้นการออกกำลังกายเป็นประเด็นที่น่าสนใจ และมีงานวิจัยที่ศึกษาเกี่ยวกับอุณหภูมิแวดล้อมที่ส่งผลต่อการออกซิเดชันของไขมันขณะพักฟื้นภายหลังการออกกำลังกายเพียงหนึ่งครั้งในหญิงอ้วน แต่ยังไม่มีการศึกษาในหญิงอ้วนที่มีการฝึกออกกำลังกาย งานวิจัยนี้ได้ทำการศึกษาในเพศหญิงที่มีภาวะอ้วนจำนวน 16 คน อายุ 18-50 ปี มีดัชนีมวลกาย 27.5-40 กิโลกรัมต่อเมตร2 มีประจำเดือนปกติ โดยทำการศึกษาในช่วง follicular phase ของประจำเดือนเท่านั้น ผู้เข้าร่วมวิจัยควบคุมอาหารเป็นเวลา 1 เดือน และเข้าโปรแกรมการฝึกออกกำลังกายบนลู่วิ่งสายพานที่ความหนักระดับปานกลาง (50-60% heart rate reserve (HRR) ระยะเวลา 30-60 นาที) เป็นเวลา 1 เดือน จากนั้นทำการทดสอบการออกกำลังกาย 2 ครั้ง ที่ความหนัก 60%HRR เวลา 60 นาที และพักฟื้นนาน 60 นาที ในอุณหภูมิร้อน (HT; 31-32°C) ครั้งหนึ่ง และเย็น (CT; 22-23°C) อีกครั้งหนึ่ง ตามลำดับที่สุ่มไว้ มีการประเมินการออกซิเดชันของซับสเตรท และการใช้พลังงานรวมตลอดการทดสอบ ผลการศึกษาพบว่าขณะพักฟื้นในที่เย็นมีการออกซิเดชันของไขมันสูงกว่าในที่ร้อนอย่างมีนัยสำคัญทางสถิติ (CT; 56.0 ± 24.6 mg.kg-1.h-1 vs. HT; 39.7 ± 27.5 mg.kg-1.h-1, p < 0.001) และขณะพักฟื้นในที่ร้อนมีการออกซิเดชันของคาร์โบไฮเดรทมากกว่าในที่เย็นอย่างมีนัยสำคัญทางสถิติ (HT; 104.0 ± 46.9 mg.kg-1.h-1 vs. CT; 64.6 ± 40.5 mg.kg-1.h-1, p < 0.001) ทั้งนี้ไม่พบความแตกต่างของการใช้พลังงานรวมขณะพักฟื้นในทั้งสองอุณหภูมิ (HT; 70.5 ± 19.6 kcal.h-1 vs. CT; 71.3 ± 13.7 kcal.h-1, p = 0.846) สรุปว่าปริมาณการออกซิเดชันของไขมันขณะพักฟื้นในอุณหภูมิเย็นมากกว่าในอุณหภูมิร้อน ดังนั้นการพักฟื้นในอุณหภูมิเย็นภายหลังการฝึกออกกำลังกายในระดับปานกลาง จึงควรเป็นทางเลือกที่ดีในการลดไขมันและน้ำหนักสำหรับคนอ้วน

ความหมายของชีวิตในบุคลากรทางการแพทย์ผู้ดูแลผู้ป่วยระยะสุดท้าย, สุนทร ลิ่มหลัก

Chulalongkorn University Theses and Dissertations (Chula ETD)

ที่มาและเหตุผล: การมีความหมายของชีวิตเป็นส่วนสำคัญในชีวิตมนุษย์ทุกคนและทุกช่วงวัย การค้นพบความหมายของชีวิตและส่งผลในเชิงบวกต่อสุขภาพกาย สุขภาพจิต และสุขภาวะทางจิตวิญญาณ ที่ผ่านมายังไม่มีการศึกษาความหมายของชีวิตในบุคลากรทางการแพทย์ผู้ดูแลผู้ป่วยระยะสุดท้ายซึ่งเป็นทีมสุขภาพที่ทำงานใกล้ชิดกับความเป็นความตาย การรับรู้ช่วงสุดท้ายของชีวิตผู้ป่วยอาจเป็นประโยชน์ต่อการรับรู้ความหมายของชีวิต และนำไปสู่วิถีการดำเนินชีวิตที่ดีและความอยู่ดีมีสุข วัตถุประสงค์: เพื่อศึกษาความหมายของชีวิตในบุคลากรการแพทย์ผู้ดูแลผู้ป่วยระยะสุดท้ายและปัจจัยที่มีผลต่อความหมาย และศึกษาความสัมพันธ์ระหว่างความหมายของชีวิตกับทัศนคติในการดำเนินชีวิตและการดูแลผู้ป่วย วิธีการศึกษา: การวิจัยเชิงคุณภาพในบุคลากรทางการแพทย์ผู้ดูแลผู้ป่วยระยะสุดท้ายจำนวน 12 คนโดยเก็บข้อมูลด้วยการสัมภาษณ์เชิงลึกส่วนบุคคลและแบบกึ่งโครงสร้าง จากนั้นทำการวิเคราะห์เปรียบเทียบข้อมูลและหาความสัมพันธ์ของข้อมูล และทำการสังเคราะห์ข้อมูลจนเหลือแต่คุณลักษณะที่มีความหมายร่วมกันมาประกอบกับทฤษฎี ผลการศึกษา: แนวคิด “ความหมายของชีวิต” ในบุคลากรทางการแพทย์ผู้ดูแลผู้ป่วยระยะสุดท้ายค้นพบทั้งสิ้น 5 แก่น ได้แก่ 1) การก้าวข้ามตัวตน; 2) ความรักและความผูกพัน; 3) การทำหน้าที่และทำสิ่งที่เป็นประโยชน์ให้กับโลก; 4) การชื่นชมและปีติกับความงามของชีวิต และ 5) การมีจุดมุ่งหมายในชีวิต โดยปัจจัยที่ทำให้เกิดความหมายคือประสบการณ์การดูแลผู้ป่วยระยะสุดท้ายและปัจจัยอื่นๆ เฉพาะบุคคล โดยพบว่าการมีความเข้าใจความหมายของชีวิตย่อมส่งเสริมสุขภาพจิตและพฤติกรรมในเชิงบวก ผู้ที่มีความหมายของชีวิตชัดเจนย่อมมีเป้าหมายในชีวิต รู้ความต้องการปลายทางของชีวิต ความหมายของชีวิตมีผลอย่างมากต่อมุมมองชีวิต โลกทัศน์ และวิถีชีวิต สรุปผลการศึกษา: การทำหน้าที่ดูแลผู้ป่วยในช่วงสุดท้ายของชีวิตและการมีโอกาสได้เห็นผู้ที่กำลังจะเสียชีวิต ส่งผลให้เกิดการตระหนักรู้ความหมายของชีวิต ซึ่งมีผลต่อวิถีการดำเนินชีวิต การดูแลสุขภาพกายและใจ รวมถึงมีการดูแลคนรอบข้างและผู้ป่วยที่ดีขึ้น แนวคิดความหมายของชีวิตนี้ สามารถนำไปประยุกต์ใช้ได้ในเวชปฏิบัติด้านการดูแลแบบประคับประคองในการค้นหาความหมายของชีวิตผู้ป่วย หรือด้านจิตเวชในการบำบัดรักษาทางสุขภาพจิตสำหรับผู้ที่ขาดความหมายของชีวิต เป็นกระบวนทัศน์ใหม่ในการดูแลผู้ป่วยอย่างรู้คุณค่าและมีความหมาย และสามารถนำไปใช้ส่งเสริมการมีความหมายของชีวิตในบุคลากรทางการแพทย์และสาธารณสุขกลุ่มอื่น รวมทั้งยังส่งเสริมคนในสังคมตระหนักรู้ถึงความสำคัญของความหมายแห่งการมีชีวิตอยู่ การมีเครื่องมือไว้จัดการความทุกข์ และช่วยทำให้ชีวิตมีความสุขได้ง่าย ปล่อยวางความเป็นตัวตนได้มากขึ้น และช่วยให้ชีวิตอยู่ในสมดุลและผาสุก

Measurement Of The Whole Body, Eye Lens And Extremity Occupational Exposures In Nuclear Medicine Staff At King Chulalongkorn Memorial Hospital, Siriwan Sisai

Chulalongkorn University Theses and Dissertations (Chula ETD)

Due to the epidemiology evidence of cataract and eye lens opacity, ICRP Publication 118 in 2012, recommended the new eye lens dose limit of occupational exposure at 20 mSv/year, averaged over 5-year periods, no single year exceeding 50 mSv. For the public eye lens dose limit is 15 mSv/year. After ICRP changed the eye lens dose limit, many reports on eye lens dose measurement using thermoluminescent dosimeter (TLD) from interventional radiologists and interventional cardiologists were published. Few reports on eye lens dose measurement in nuclear medicine (NM) personnel were found. The primary objective of this study is to measure whole …

A Feasibility Study Of Diffusion Weighted Imaging And Parametric Response Map Analysis For Treatment Response Prediction In Nasopharyngeal Cancer, Titiya Jirawatwanith

Chulalongkorn University Theses and Dissertations (Chula ETD)

Diffusion-weighted imaging (DWI) is an MRI technique which provides functional information of tissue by detecting microscopic motion of water molecules. The change of apparent diffusion coefficient (ADC) derived from DWI was used as an imaging biomarker for treatment response prediction in cancers. However, it was based on whole-tumor analysis which did not reflect heterogeneity within the tumor. To overcome this limitation, a new method called parametric response map (PRM) analysis was proposed to evaluate response by quantifying voxel-wise changes in ADC. Here we investigated the use of PRM analysis on ADC from DWI as an imaging biomarker for treatment response …

Dosimetric Comparison Between Single And Double Isocenters Volumetric Arc Therapy For Stereotactic Radiotherapy With Multiple Targets, Wai Lwin Lwin Kyaw

Chulalongkorn University Theses and Dissertations (Chula ETD)

The purpose of this study was to evaluate the dosimetric effects between single isocenter (SI) and double isocenters (DI) VMAT SRT of multiple brain metastases. There are two parts of study, which were experimental for energy selection, technique comparison and clinical part to use appropriate technique. As the first part, three lesions with 3 cm distance apart and 1 cm size for all lesions were created as standard plan by varying energy. Twelve VMAT SRT plans by varying energy with 6 MV, 10 MV, 6 FFF and 10 FFF were planned on simulated three lesions of CT image. 18 VMAT …

Patient-Centered Medical Homes In Community Oncology Practices: Changes In Spending And Care Quality Associated With The Come Home Experience, Teresa M. Waters, Cameron M. Kaplan, Ilana Graetz, Mary M. Price, Laura A. Stevens, Barbara L. Mcaneny

Health Management and Policy Faculty Publications

PURPOSE:

We examined whether the Community Oncology Medical Home (COME HOME) program, a medical home program implemented in seven community oncology practices, was associated with changes in spending and care quality.

PATIENTS AND METHODS:

We compared outcomes from elderly fee-for-service Medicare beneficiaries diagnosed between 2011 and 2015 with breast, lung, colorectal, thyroid, or pancreatic cancer, lymphoma, or melanoma and served by COME HOME practices before and after program implementation versus similar beneficiaries served by other geographically proximate oncologists. Difference-in-differences analysis compared changes in outcomes for COME HOME patients versus concurrent controls. Propensity score matching and regression methods were adjusted for …

Clinic-Based Delivery Of The Young Men’S Health Project (Ymhp) Targeting Hiv Risk Reduction And Substance Use Among Young Men Who Have Sex With Men: Protocol For A Type 2, Hybrid Implementation-Effectiveness Trial, Jeffrey T. Parsons, Tyrel Starks, Sitaji Gurung, Demetria Cain, Jonathan Marmo, Sylvie Naar

Publications and Research

Background: Young men who have sex with men (YMSM) are disproportionately at risk for HIV and sexually transmitted infections. Adapting and testing the effectiveness of the Young Men’s Health Project (YMHP), an efficacious intervention designed to reduce substance use and condomless anal sex (CAS) among YMSM, at clinics in Miami, Detroit, and Philadelphia has the potential to reduce HIV and STI disparities among urban YMSM.

Objective: This study (Adolescent Medicine Trials Network for HIV/AIDS Interventions [ATN] 145 YMHP) aims to adapt YMHP for clinic and remote delivery by existing clinic staff and compare their effectiveness in real-world adolescent HIV clinics. …

Value Of Dedicated Research Time For Imgs In Obtaining Surgical Residency Training Positions: A 10-Year Review Of Applicants From A Medical College In Pakistan, Mohammad Raheel Jajja, Marvi Tariq, Salila Shoaib Hashmi, Thomas F. Dodson, Rashida Ahmed

Department of Pathology and Laboratory Medicine

Objective: International Medical Graduates (IMGs) secured greater than 10% of all general surgery (GS) residency positions in the US during the past decade. The Match process remains competitive, with a significant number of IMGs performing dedicated research before residency application. The impact of such research remains largely unknown. We aimed to provide an objective analysis of the impact of dedicated research time on obtaining a categorical GS residency position.
Design: Data for National Resident Matching Program Match results from 2008-2017 was compiled from annual Match lists of the Aga Khan University, Medical College (Karachi, Pakistan). Medical graduates provided this information …

Mesenchymal Stromal Cell Therapeutic Delivery: Translational Challenges To Clinical Application, Henry Caplan, Scott D Olson, Akshita Kumar, Mitchell George, Karthik S Prabhakara, Pamela Wenzel, Supinder Bedi, Naama E Toledano-Furman, Fabio Triolo, Julian Kamhieh-Milz, Guido Moll, Charles S Cox

Faculty, Staff and Student Publications

For several decades, multipotent mesenchymal stromal cells (MSCs) have been extensively studied for their therapeutic potential across a wide range of diseases. In the preclinical setting, MSCs demonstrate consistent ability to promote tissue healing, down-regulate excessive inflammation and improve outcomes in animal models. Several proposed mechanisms of action have been posited and demonstrated across an array of in vitro models. However, translation into clinical practice has proven considerably more difficult. A number of prominent well-funded late-phase clinical trials have failed, thus calling out for new efforts to optimize product delivery in the clinical setting. In this review, we discuss novel …

Diuretic, Natriuretic, And Vasodepressor Activity Of A Lipid Fraction Enhanced In Medium Of Cultured Mouse Medullary Interstitial Cells By A Selective Faah Inhibitor, Zdravka P. Daneva

Theses and Dissertations

The relationship between the endocannabinoid system in the renal medulla and the long-term regulation of blood pressure is not well understood. To investigate the possible role of the endocannabinoid system in renomedullary interstitial cells, mouse medullary interstitial cells (MMICs) were obtained, cultured and characterized for their responses to treatment with a selective inhibitor of fatty acid amide hydrolase (FAAH), PF-3845. Treatment of MMICs with PF-3845 increased cytoplasmic lipid granules detected by Sudan Black B staining and multilamellar bodies identified by transmission electron microscopy. HPLC analyses of lipid extracts of MMIC culture medium revealed a 205nm-absorbing peak that showed responsiveness to …

The Role Of Sphingosine Kinase 2 In Alcoholic Liver Disease, Eric K. Kwong

Theses and Dissertations

Alcoholic liver disease (ALD) is one of the most common liver diseases worldwide characterized by the accumulation of lipids within the liver, inflammation and the possibility of progressing to cirrhosis and liver failure. More importantly, there are currently no effective treatments for ALD and liver transplantation remains the only therapeutic option for end-stage liver disease. Previous studies have shown that ALD is a result of a combination of endoplasmic reticulum (ER) stress, lipid metabolism dysregulation and inflammation. It has been previously reported that alcohol disrupts gut microbiota homeostasis and causes increased endotoxins that contribute to the pathology of ALD. However, …

Perceived Impact Of Ambient Operating Room Noise By Certified Registered Nurse Anesthetists, Marianne S. Cosgrove

Theses and Dissertations

It is widely acknowledged that elevated levels of noise are commonplace in the healthcare environment, particularly in high acuity areas such as the operating room (OR). Excessive ambient noise may pose a threat to patient safety by adversely impacting provider performance and interfering with communication among perioperative care team members. With respect to the certified registered nurse anesthetist (CRNA), increased ambient OR noise may engender distractibility, diminish situation awareness and cause untoward health effects, thereby increasing the possibility for the occurrence of error and patient injury.

This research project analytically examines the perceived impact of ambient noise in the operating …

Motivational Interviewing In A Team-Based Wellness Clinic: Perceptions And Fidelity, Jodi M. Winship

Theses and Dissertations

INTRODUCTION: Motivational Interviewing (MI) is an evidenced based counseling style to elicit health behavior change. Team-based student clinics are an ideal climate for students to learn and practice team-based care, yet little is understood as to how client-centered communication styles such as MI are implemented in a team setting.

PURPOSE: The purpose of this dissertation was to conduct an exploratory study using mixed methods to better understand how an MI training translates to team-based communication with clients, the factors impacting team-based implementation of MI, and how team-based MI impacts clients’ perceived autonomy at a student-led, interprofessional, team-based wellness clinic for …