Medical Specialties Commons^™

Updates On The Diagnosis And Management Of Hepatocellular Carcinoma, Aimun Raees, Muhammad Kamran, Hasan Özkan, Wasim Jafri

Section of Gastroenterology

Introduction: Globally, the incidence, as well as mortality, related to hepatocellular carcinoma (HCC) is on the rise, owing to relatively few curative options. Underlying cirrhosis is the most common etiology leading to HCC, but risk factors of cirrhosis show great regional variability. Over the years, there has been a steady development in the diagnostic and therapeutic modalities of HCC, including the availability of a wide range of systemic chemotherapeutic agents. We aim to review the recent advancements in the diagnostic and therapeutic strategies for HCC.
Methodology: The literature search was done using databases PubMed, Cochrane, and Science Direct, and the …

Disordered Eating, Food Insecurity, And Weight Status Among Transgender And Gender Nonbinary Youth And Young Adults: A Cross-Sectional Study Using A Nutrition Screening Protocol, Whitney R. Linsenmeyer, Ian M. Katz, Jaime L. Reed, Andrea M. Giedinghagen, Christopher B. Lewis, Sarah K. Garwood

Psychology Faculty Publications

Purpose: The purpose of this study was to describe the prevalence of and relationships among disordered eating, food insecurity, and weight status among transgender and gender nonbinary youth and young adults.

Methods: This cross-sectional study involved a screening protocol to assess disordered eating and food insecurity risk from September to December of 2019 at a gender clinic using five validated measures: (1) previous eating disorder diagnosis (yes/no); (2) Sick, Control, One Stone, Fat, Food Questionnaire (SCOFF); (3) Adolescent Binge Eating Disorder Questionnaire (ADO-BED); (4) Nine-Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS); and (5) Hunger Vital Sign. Age, assigned sex at …

Does Team Leader Gender Matter? A Bayesian Reconciliation Of Leadership And Patient Care During Trauma Resuscitations, Elizabeth D. Rosenman, Anthony Misisco, Jeffrey Olenick, Sarah M. Brolliar, Anne K. Chipman, Marie C. Vrablik, Georgia T. Chao, Steve W.J. Kozlowski, James A. Grand, Rosemarie Fernandez

Psychology Faculty Publications

OBJECTIVE: Team leadership facilitates teamwork and is important to patient care. It is unknown whether physician gender-based differences in team leadership exist. The objective of this study was to assess and compare team leadership and patient care in trauma resuscitations led by male and female physicians.

METHODS: We performed a secondary analysis of data from a larger randomized controlled trial using video recordings of emergency department trauma resuscitations at a Level 1 trauma center from April 2016 to December 2017. Subjects included emergency medicine and surgery residents functioning as trauma team leaders. Eligible resuscitations included adult patients meeting institutional trauma …

Laypeople Perception And Interpretation Of Simulated Life-Threatening Bleeding: A Controlled Experimental Study, Erik Prytz, Rachel Phillips, Susanna Lönnqvist, Marc Friberg, Carl-Oscar Jonson

Psychology Faculty Publications

Introduction

First aid performed by immediate responders can be the difference between life and death in the case of trauma with massive bleeding. To develop effective training programs to teach bleeding control to laypersons, it is important to be aware of beliefs and misconceptions people hold on bleeding and severity of bleeding situations.

Method

A controlled study was conducted in which 175 American college students viewed 78 video clips of simulated bleeding injuries. The volume of blood present (between 0 and 1900 ml), rate of blood flow, and victim gender were systematically varied within participants. Participants were asked to rate …

Nonsuicidal Self-Injury, Suicide Planning, And Suicide Attempt Among High-Risk Adolescents Prior To Psychiatric Hospitalization, Christina M. Sellers, Antonia Díaz-Valdés, Andrew C. Porter, Catherine R. Glenn, Adam Bryant Miller, Adeline Wyman Battalen, Kimberly H. Mcmanama O'Brien

Psychology Faculty Publications

The purpose of this study was to understand the trajectories of nonsuicidal self-injury (NSSI) and suicide plans (SP) in the 90 days prior to inpatient hospitalization, understand the role of NSSI and SP in predicting suicide attempts (SA) on a given day, and to test the interaction between NSSI and SP in predicting same-day SA. Participants included 69 adolescents (77% female, 65% white, 77% Non-Hispanic/Latinx, Mage = 15.77 SDage = 1.00) from an inpatient psychiatric unit. Past 90 day NSSI, SP, and SA were measured using the Columbia Suicide Severity Rating Scale and Timeline Follow Back. First, mixed effect models …

Dilemmas In Anticoagulation And Use Of Inferior Vena Cava Filters In Venous Thromboembolism; A Survey Of Respiratory Physicians, Haematologists And Medical Oncologists And A Review Of The Literature, Philip Craven, Ciara Daly, Nisha Sikotra, Tim Clay, Eli Gabbay

Research outputs 2014 to 2021

© The Author(s) 2021. Twenty percent of patients with Cancer Associated Thrombosis receive an inferior vena cava filter annually. Insertion is guided by practice guidelines, which do not specify or discuss the use of inferior vena cava filters in malignancy. Adherence to these guidelines is known to be variable. We aimed to see if there was consistent management of venous thromboembolism among Medical Oncologists/Haematologists and Respiratory Physicians, with respect to inferior vena cava filter use in the setting of suspected and confirmed malignancy. Medical Oncologists, Haematologists and Respiratory Physicians were surveyed with four theoretical cases. Case 1 concerns a patient …

Sleep Characteristics And Mood Of Professional Esports Athletes: A Multi-National Study, Sangha Lee, Daniel Bonnar, Brandy Roane, Michael Gradisar, Ian C. Dunican, Michele Lastella, Gemma Maisey, Sooyeon Suh

Research outputs 2014 to 2021

© 2021 by the authors. Licensee MDPI, Basel, Switzerland. Esports is becoming increasingly professionalized, yet research on performance management is remarkably lacking. The present study aimed to investigate the sleep and mood of professional esports athletes. Participants were 17 professional esports athletes from South Korea (N = 8), Australia (N = 4), and the United States (N = 5) who played first person shooter games (mean age 20 ± 3.5 years, 100% male). All participants wore a wrist-activity monitor for 7–14 days and completed subjective sleep and mood questionnaires. Participants had a median total sleep time of 6.8 h and …

Associations Between Fruit Intake And Risk Of Diabetes In The Ausdiab Cohort, Nicola P. Bondonno, Raymond J. Davey, Kevin Murray, Simone Radavelli-Bagatini, Catherine P. Bondonno, Lauren C. Blekkenhorst, Marc Sim, Dianna J. Magliano, Robin M. Daly, Jonathan E. Shaw, Joshua R. Lewis, Jonathan M. Hodgson

Research outputs 2014 to 2021

Context

Fruit, but not fruit juice, intake is inversely associated with type 2 diabetes mellitus (T2DM). However, questions remain about the mechanisms by which fruits may confer protection. Objective The aims of this work were to examine associations between intake of fruit types and 1) measures of glucose tolerance and insulin sensitivity and 2) diabetes at follow-up.

Methods

Among participants of the Australian Diabetes, Obesity and Lifestyle Study, fruit and fruit juice intake was assessed by food frequency questionnaire at baseline. Associations between fruit and fruit juice intake and 1) fasting plasma glucose, 2-hour postload plasma glucose, updated homeostasis model …

Thymectomy, Bryan Bennett, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Excerpt

Thymectomy is the resection of the thymus gland. This anterior mediastinal organ can enlarge as in myasthenia gravis and thymoma and harbor malignant cells such as in thymic carcinoma or neuroendocrine tumors. The first thymectomies were performed incidentally in conjunction with thyroidectomies for Grave disease by Garre and Sauerbruch, but it was not until Blalock and colleagues that multiple series were performed with adequate results.

This also included patients with myasthenia gravis but without thymomas. The gold standard approach for thymectomy is a median sternotomy or transsternal approach, but this has evolved to less invasive techniques such as upper …

Posterior Urethral Valve, George Bingham, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Posterior urethral valves are one of the most common causes of urinary tract obstruction in the pediatric population. They are obstructing membranous folds in the lumen of the posterior part of the urethra and are exclusive to male patients. Posterior urethral valves were first described by Morgagni in 1717 and then by Langenbeck in 1802, who reported valve-like folds in dissected cadavers. Posterior urethral valves can lead to a spectrum of pathology both inside and outside the urinary system. This includes acute retention, chronic kidney disease, and in severe cases, pulmonary hypoplasia secondary to low amniotic fluid levels.

Posterior urethral …

Simulation Training And Skill Assessment In Obstetrics And Gynecology, Thomas G. Weiss, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Simulation is a valuable teaching tool that increases skill and knowledge acquisition in obstetric and gynecologic clinical scenarios. There are increasing options for simulation from animal and human cadaver, low-fidelity (inanimate simulator), and virtual reality simulation. The role of obstetric and gynecologic simulation also plays a key role in both outcomes-based as well as competency-based medical education.

Simulators were initially created for flight training for pilots in the 1920s, and the ability to reproduce clinical situations has been utilized in obstetric and gynecologic education. Simulations used in medical training were used in the 1960s with standardized patients and mannequins. Simulation …

Temporary Abdominal Closure Techniques, Laura R. Brown, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Critically ill patients with underlying intraabdominal hypertension due to sepsis or injury are often managed with a damage control laparotomy (DCL), which involves the minimum intervention necessary to save the patient’s life. In order to save time, the abdomen may be left open to facilitate a second look to confirm the control of bleeding or sepsis before fascial closure. In the interim, some patients will develop bowel and abdominal wall edema with a high-volume resuscitation, especially if the crystalloid fluid is used primarily.

The many causes and management of intraabdominal hypertension as well as the indications for a damage control …

Study Design And Baseline Characteristics Of The Cardinal Trial: A Phase 3 Study Of Bardoxolone Methyl In Patients With Alport Syndrome., Glenn M. Chertow, Gerald B. Appel, Sharon Andreoli, Sripal Bangalore, Geoffrey A. Block, Arlene B. Chapman, Melanie P. Chin, Keisha L. Gibson, Angie Goldsberry, Kazumoto Iijima, Lesley A. Inker, Bertrand Knebelmann, Laura H. Mariani, Colin J. Meyer, Kandai Nozu, Megan O'Grady, Arnold L. Silva, Peter Stenvinkel, Roser Torra, Bradley A. Warady, Pablo E. Pergola

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Alport syndrome is a rare genetic disorder that affects as many as 60,000 persons in the USA and a total of 103,000 persons (10,000) in the European Union [1, 2]. It is the second most common inherited cause of kidney failure and is characterized by progressive loss of kidney function that often leads to end-stage kidney disease. Currently, there are no approved disease-specific agents for therapeutic use. We designed a phase 3 study (CARDINAL; NCT03019185) to evaluate the safety, tolerability, and efficacy of bardoxolone methyl in patients with Alport syndrome.

METHODS: The CARDINAL phase 3 study is an international, …

Thyrotoxic Periodic Paralysis In An Adolescent Male: A Case Report And Literature Review., Luke He, Veronica Lawrence, Wayne V. Moore, Yun Yan

Manuscripts, Articles, Book Chapters and Other Papers

Thyrotoxic periodic paralysis (TPP) is rarely seen in children and adolescents. Clinical manifestations in children and adolescents may vary. It is important for clinicians to be aware of this rare and life-threatening condition.

Retrospective Review Of Pharmacogenetic Testing At An Academic Children's Hospital., Timothy A. Roberts, Jennifer A. Wagner, Tracy L. Sandritter, Benjamin T. Black, Andrea Gaedigk, Stephani L. Stancil

Manuscripts, Articles, Book Chapters and Other Papers

There is limited evidence to support pharmacogenetic (PGx) testing in children. We conducted a retrospective review of PGx testing among 452 patients at an academic children's hospital to determine the potential utility of PGx in diseases of childhood and to identify targets for future pediatric pharmacogenetic research. An actionable gene-drug pair associated with the 28 genes tested (Clinical Pharmacogenetics Implementation Consortium (CPIC) level A or B, Pharmacogenomics Knowledge Base (PharmGKB) level 1A or B, or US Food and Drug Administration (FDA) recommendation and a PharmGKB level) was present in 98.7% of patients. We identified 203 actionable gene-drug-diagnosis groups based on …

Cardiac Resynchronization Therapy In Continuous Flow Left Ventricular Assist Device Recipients: A Systematic Review And Meta-Analysis From Electram Investigators, Kuldeep Shah, Vallabh Karpe, Mohit Turagam, Mahek Shah, Andrea Natale, Rakesh Gopinathannair, Dhanunjaya Lakkireddy, Jalaj Garg

Division of Cardiology Faculty Papers

Introduction: Whether cardiac resynchronization therapy (CRT) continues to augment left ventricular remodeling in patients with the continuous-flow left ventricular assist device (cf-LVAD) remains unclear. Methods: We performed a systematic review and meta-analysis of all clinical studies examining the role of continued CRT in end-stage heart failure patients with cf-LVAD reporting all-cause mortality, ventricular arrhythmias, and ICD shocks. Mantel-Haenszel risk ratio (RR) random-effects model was used to summarize data. Results: Eight studies (7 retrospective and 1 randomized) with a total of 1,208 unique patients met inclusion criteria. There was no difference in all-cause mortality (RR 1.08, 95% CI 0.86-1.35, p = …

Physician Knowledge, Attitudes, And Behaviors Towards Registered Dietitian Nutritionists, Amy Motley Jones

UNF Graduate Theses and Dissertations

Diet is increasingly linked with overall quality of life, and a healthy diet is now being considered one of the cornerstones of preventative care. Physicians rely on Registered Dietitian Nutritionists (RDNs) as most doctors lack the nutrition knowledge to properly treat their patients, especially during their residency. Little published information exists on the specific collaboration of RDNs and resident physicians. This study aimed to determine whether mentoring with an RDN increased physician nutrition knowledge, increased consults to RDNs, and whether physician attitudes improved regarding their understanding of the role of the RDN in healthcare. Knowledge or attitude alone are not …

A Model For Inhalation Of Infectious Aerosol Contaminants In An Aircraft Passenger Cabin, Bert A. Silich

International Journal of Aviation, Aeronautics, and Aerospace

Aerosol contamination of an aircraft cabin by infectious passengers is a concern of passengers, aircrew and the aviation industry. This may be especially important during a pandemic, such as COVID-19, where the full extent of aerosol transmission is not well understood. A statistical method to determine the number of infectious passengers on board along with a mathematical model estimating the contaminant concentration of aerosols in the cabin and the number of inhaled infectious particles by passengers is presented. An example is used to demonstrated how the results can be estimated during normal operations and emergency conditions with malfunctions of the …

How Duty Rosters And Stress Relate To Sleep Problems And Fatigue Of International Pilots, Marion Venus, Martin Grosse Holtforth

International Journal of Aviation, Aeronautics, and Aerospace

While previous research focused on pilots’ fatigue, rosters, potential performance-impairment and aviation-safety, this research investigates, how pilots’ work-related and psychosocial stress and rosters can affect their sleep and fatigue. A cross-sectional online survey was completed by 192 pilots flying for European operators, 180 Australian pilots and 34 pilots from UAE, Turkey and Asia Pacific. Pilots reported their actual duty- and flight-hours, flown sectors, standby, rest, vacation days, number of early starts, night-flights and sports-hours for the last two months. Schedule-related data, way to work, age, flight-hours on the present type of aircraft, subjective job-security and psychosocial stress were used as …

Gene Selection For Cancer Classification: A New Hybrid Filter-C5.0 Approach For Breast Cancer Risk Prediction, Mohammed Hamim, Ismail El Moudden, Hicham Moutachaouik, Mustapha Hain

Department of Medicine Faculty Publications

Despite the significant progress made in data mining technologies in recent years, breast cancer risk prediction and diagnosis at an early stage using DNA microarray technology still a real challenging task. This challenge comes especially from the high-dimensionality in gene expression data, i.e., an enormous number of genes versus a few tens of subjects (samples). To overcome this problem of data imbalance, a gene selection phase becomes a crucial step for gene expression data analysis. This study proposes a new Decision Tree model-based attributes (genes) selection strategy, which incorporates two stages: fisher-score-based filter technique and the gene selection ability of …

In Silico Investigation Of Cardiac Arrhythmia Susceptibility In Long Qt Phenotype, Anthony Owusu-Mensah, Victoria Lam, Bright Tsevi, Michel Audette, Makarand Deo

Electrical & Computer Engineering Faculty Publications

Long QT Syndrome (LQTS) is associated with cardiac arrhythmia and sudden cardiac death. The Long QT Type 2 (LQT2) phenotype, which accounts for 35–40 % of all LQTS patients, is caused by mutations in HERG gene. The mechanisms of arrhythmia in presence of LQT2 conditions are not fully understood. We utilized anatomically and electrophysiologically realistic numerical simulations to elucidate the mechanisms of arrhythmia initiation in presence of blockade in rapid component of delayed rectifier potassium current, I_Kr. We utilized a 3D finite element model of rabbit ventricles integrated with His-purkinje network to simulate whole heart response to LQT2 …

Evaluation Of Spinal Anatomy Segmentation Methods Using Synthetic Computed Tomography Volumes, Austin Tapp, Michel Audette

Electrical & Computer Engineering Faculty Publications

Severe adolescent idiopathic scoliosis (AIS) is corrected by surgical procedures that necessitate ligament releases. To determine appropriate release allotments, soft tissues must be localized on a patient-specific basis, However, routine computer tomography (CT) imaging precludes traditional, voxel-based soft tissue localization. Fortunately, recent studies have proposed top-down segmentation methods, which elucidate soft tissues using pre-operative CT volumes. While the accuracy of vertebral segmentations obtained from these methods has not been determined, the accuracy of soft tissue segmentations has not. To ensure the soft tissue segmentation methods are clinically applicable, soft tissue validation must occur. This study presents an evaluation measure for …

Modeling And Simulation Of Electromagnetic Fields To Maintain Bone Density During Prolonged Low Gravity Exposure, Austin Tapp, Michael Francis, Michel A. Audette

Electrical & Computer Engineering Faculty Publications

Astronauts in a long term, low-gravity environments experience bone density loss at 10 times the rate of those diagnosed with osteoporosis. One treatment effective at maintaining bone density in osteoporotic individuals is electromagnetic field (EMF) therapy. Tools that induce EMFs are becoming increasingly prevalent, but to amplify osteogenesis and encourage superior bone density retention for astronauts, ideal EMF therapy parameters must be determined on patient-specific bases. Therefore, this study explores simulation environments that elucidate highly favorable EMF factors. Pulsed electromagnetic field and combined magnetic field generating devices are variably introduced near partient-specific, finite element (FE) models of the femur, spine, …

Joint Modeling Of Rnaseq And Radiomics Data For Glioma Molecular Characterization And Prediction, Zeina A. Shboul, Norou Diawara, Arastoo Vossough, James Y. Chen, Khan M. Iftekharuddin

Electrical & Computer Engineering Faculty Publications

RNA sequencing (RNAseq) is a recent technology that profiles gene expression by measuring the relative frequency of the RNAseq reads. RNAseq read counts data is increasingly used in oncologic care and while radiology features (radiomics) have also been gaining utility in radiology practice such as disease diagnosis, monitoring, and treatment planning. However, contemporary literature lacks appropriate RNA-radiomics (henceforth, radiogenomics) joint modeling where RNAseq distribution is adaptive and also preserves the nature of RNAseq read counts data for glioma grading and prediction. The Negative Binomial (NB) distribution may be useful to model RNAseq read counts data that addresses potential shortcomings. …

Dosimetric Comparison Of Rapidplan And Manually Optimized Plans For Hippocampus Avoidance Whole Brain Radiation Therapy, Laksamon Phimolasawakun

Chulalongkorn University Theses and Dissertations (Chula ETD)

Nowadays, whole-brain radiation therapy (WBRT) is a good method to cure brain metastases. However, it has been noted that whole-brain radiation therapy could be a cause to neurological toxicity which could damage the hippocampus that is an important part of forming long-term memories. The HA-WBRT is a complicated plan depending on planner skills, the researcher would like to simplify this problem using knowledge-based planning called RapidPlan. The objective of this study was to compare the dosimetric difference of RapidPlan and manually optimized plans for the treatment of HA-WBRT. The RapidPlan model was created for HA-WBRT. The PTV and OARs constraints …

Hepatic Lesion Detectability On Dual Energy Computed Tomography Imaging : Phantom Study, Hataipat Jantawong

Chulalongkorn University Theses and Dissertations (Chula ETD)

The purpose of this study is to determine the hepatic lesion detectability in abdomen from various phantom sizes by dual-energy computed tomography (DECT) imaging and to investigate the factors affecting the detectability of hepatic lesion in abdomen by dual-energy CT in phantom study. The anthropomorphic liver with nodule inserted phantom with extension rings simulating the small, medium, and large patients were scanned under DECT acquisitions by varying three kVp combinations (80/-,90/-, and 100/Sn150-kVp). The series of 40-,50-,60-, and 70-keV VMI were generated from DECT data set. All images were used to assess the task-based image quality; task transfer function (TTF), …

Determination Of Field Output Correction Factors In Elongated Small Field Photon Beams, Mananchaya Vimolnoch

Chulalongkorn University Theses and Dissertations (Chula ETD)

IAEA along with AAPM have published a code of practice TRS 483 for small field dosimetry. The field correction output factors of various detectors were introduced to correct detector response changes in relative dosimetry. However, the publication of TRS 483 has focused on symmetry field sizes, the correction factors for elongated small fields are not included in the protocol. The overall objective of this work is to determine the field output correction factor in elongated small field. The correction factors of IBA CC01, Sun nuclear EDGE, and Exradin W2 PSD for 6 MV photon beam were determined using Monte Carlo …

Evaluation Of Integral Depth-Dose Curves In Proton Pencil Beam Scanning Using Plane-Parallel Ionization Chambers, Phatthraporn Thasasi

Chulalongkorn University Theses and Dissertations (Chula ETD)

Proton therapy is an advanced form of radiation therapy treatment that can potentially decrease side effects and increase tumor control probability. The integral depth-dose curve is an essential parameter that has to be determined and introduced into the proton treatment planning system for the dose calculation. Besides the halo, the integral depth-dose curve measurements should be performed with a large-diameter plane-parallel ionization chamber. The purpose of this research is to determine the integral depth-dose curves and assess the geometrical collection efficiency at intermediate depths of different detector diameters in proton pencil beam scanning. The integral depth-dose curves with a proton …

Baselines Of Daily Quality Assurance For Proton Pencil Beam Scanning Using The Sphinx Compact, Tanapat Tiajaroen

Chulalongkorn University Theses and Dissertations (Chula ETD)

Quality assurance (QA) is a systematic process used to determine whether the product meets specified requirements. The American Association of Physicists in Medicine (AAPM) published a comprehensive proton therapy machine QA in TG-224 to provide confidence in use. King Chulalongkorn Memorial Hospital (KCMH) recently operated the first proton therapy center in Thailand, and the data of daily QA are not available or established. This study aims to apply the control chart for establishing the baselines of daily QA for the proton pencil beam scanning system using the Sphinx Compact detector. The Sphinx Compact was used to perform the proton daily …

Moderated Neutron Detector For Accumulated Ambient Dose Equivalent In Proton Therapy, Tanawat Tawonwong

Chulalongkorn University Theses and Dissertations (Chula ETD)

The Varian ProBeam compact was installed at Her Royal Highness Princess Maha Chakri Sirindhorn Proton Center. Since 2017, the project has started at the King Chulalongkorn Memorial Hospital and after 4 years, during Covid19 pandemic, the 1st patient treatment received proton therapy on August, 2021. The radiation safety of the center was accomplished through firstly, the shielding calculation and secondary, the radiation survey at the milestone points such as cyclotron installation and 1st Beam ON at the treatment room. The only one WENDI-II dosimeter was used in radiation survey. The main purpose of this study is to validate the in-house …