Medical Specialties Commons^™

การศึกษาเปรียบเทียบผลของการออกกำลังกายที่ความหนักระดับสูงสลับเบาและความหนักระดับปานกลางต่อการตอบสนองของระบบหายใจในผู้ที่มีภาวะอ้วน, อรนรี เชาว์นะรัง

Chulalongkorn University Theses and Dissertations (Chula ETD)

เพื่อศึกษาการตอบสนองของระบบหายใจต่อการออกกำลังกายที่ความหนักระดับสูงสลับเบา (HIIE) และความหนักระดับปานกลาง (MICE) ในผู้ที่มีภาวะอ้วน โดยอาสาสมัครจะได้รับการทดสอบออกกำลังกายทั้งสองรูปแบบข้างต้น คือปั่นจักรยานที่ความหนักสูง 90% peak power output (PPO) 1 นาทีสลับกับความหนักเบา 15% PPO 1 นาที เป็นระยะเวลา 20 นาที (HIIE) และปั่นจักรยานที่ความหนักปานกลาง 50% PPO เป็นระยะเวลา 20 นาที (MICE) วัดความแข็งแรงของกล้ามเนื้อหายใจก่อนและหลังออกกำลังกายและวัดการตอบสนองของระบบหายใจขณะออกกำลังกาย ผลการศึกษาในอาสาสมัคร 27 ราย พบว่าค่าความแข็งแรงกล้ามเนื้อหายใจเข้า (MIP) และออก (MEP) มีค่าลดลงหลังออกกำลังกาย (p < 0.05) แต่ไม่พบความแตกต่างระหว่างกลุ่ม ค่า VO2 ของ HIIE ช่วง high intensity มีค่ามากกว่า MICE (p<0.01) ค่า VCO2 ของ HIIE ตลอดการออกกำลังกาย 20 นาทีมีค่ามากกว่า MICE อย่างมีนัยสำคัญ (p<0.05) ค่า VE มีแนวโน้มสูงขึ้นขณะออกกำลังกายทั้งสองรูปแบบ โดยใน HIIE มีค่ามากกว่า MICE (p<0.001) และมีความแตกต่างกันหลังเสร็จสิ้นการ cool down (p<0.05) ไม่พบความแตกต่างกันของค่า IC ขณะพักและหลังเสร็จสิ้นการ cool down ในการออกกำลังกายทั้งสองรูปแบบ แต่เมื่อเทียบภายในกลุ่มพบว่าค่า IC หลังเสร็จสิ้นการ cool down มีค่าสูงกว่าค่าขณะพักอย่างมีนัยสำคัญ สรุปได้ว่าการออกกำลังกายทั้งสองแบบส่งผลต่อความแข็งแรงของกล้ามเนื้อหายใจ ทำให้ความแข็งแรงกล้ามเนื้อหายใจลดลงหลังออกกำลังกาย และการออกกำลังกายแบบ HIIE มี respiratory demand มากกว่าการออกกำลังกายแบบ MICE

Development Of End-To-End Test Phantom For Stereotactic Radiosurgery Using Alanine Dosimeter, Aungsumalin Intang

Chulalongkorn University Theses and Dissertations (Chula ETD)

Alanine dosimeters are generally used in high-dose dosimetry, while accurate and precise dose delivery verification procedures are important in stereotactic radiosurgery (SRS). Hence, an end-to-end test is required. In addition, no end-to-end SRS test employing an alanine dosimeter has been established in Thailand. The objective of this study was to determine the dose accuracy of SRS VMAT plans in end-to-end test phantom using alanine dosimeter. The electron paramagnetic resonance (EPR) parameters were optimized in the 1-2000 cGy dose range. Following that, suitable parameters were used to investigate the alanine characteristics and estimate the uncertainty in radiation therapy dose range. The …

Catheter-Directed Embolectomy For Massive Pulmonary Embolism In A Pediatric Patient, Shin Mei Chan, Fabian M Laage Gaupp, Jessica M Lee, Jeffrey S Pollak, Akhil Khosla

Faculty, Staff and Student Publications

Pulmonary embolisms can affect 0.9 in 100,000 children and carry high risk for mortality. However, management of pediatric pulmonary embolism is largely derived from adult studies and treatment often includes local or systemic thrombolytics or anticoagulation, which may pose unique bleeding risks in children and adolescents compared with adults. This report describes a case in which catheter-directed embolectomy was used to successfully manage a pediatric patient with high-risk/massive pulmonary embolism. This case suggests that catheter-directed embolectomy is an effective therapy in patients outside the adult population and more research is required to expand inclusion criteria for current catheter-directed embolectomy treatment …

Healing Through Mother Earth, Taylor A. Russell

Dance (MFA) Theses

This thesis deals with mental health, with a focus on Black women. Historically, Black women are often so compromised, being constant caregivers and helping everyone else, that they forget to help themselves, not having the time and financial means to do so. If we go back in the time of slavery, many Black women were taking care of slave owners' children and suckling the white women’s babies instead of their own. By the time they got home and after diligently caring for other people’s children they were focused on their own children, who they had been away from for hours …

Association Of Health Literacy And Provider Education With Knowledge Of Breast And Cervical Cancer Screening In An Underserved Female Population, Mallory Gandy, Karly A. Meyer, Jennifer Liu, Jenenne Geske

EMET Projects

No abstract provided.

Factors Influencing Nurses’ Willingness To Recommend Reiki For Their Oncology Patients’ Pain, Amy Nezzer

Walden Dissertations and Doctoral Studies

Hospitalized, adult, oncology patients experience intractable pain that does not always respond to pharmacological therapies. Reiki is a complementary and alternative method used to reduce pain and increase the effectiveness of pharmacological treatments, but nurses may not possess knowledge about Reiki or have the self-efficacy to educate patients about Reiki. The purpose of this study, guided by Bandura’s social cognitive theory, was to identify the relationship between nurses’ knowledge, level of self-efficacy in educating their patients, beliefs about Reiki’s effectiveness, years practicing as a nurse, and willingness to recommend Reiki for their oncology patients’ pain. The Knowledge of Nurses’ Questionnaire …

Digest Of The Philadelphia College Of Osteopathic Medicine (2022 No. 1), Philadelphia College Of Osteopathic Medicine

PCOM Digest 2020s

The 2022 Vol 1 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Updates
• Advancing Alumni
• PCOM Board of Trustees Elects New Chairman Thomas J. Gravina
• Past PCOM Chairman John P. Kearney’s Legacy
• 125 Years Through 125 Stories: Six Reflections of Legendary PCOM Professors
• Edna K. Williams DO 1926: The Diminutive Osteopath with Mighty Hands and Spirit
• A Humble Genius: David A. Festinger, PhD
• Class Notes

Self- Vs Provider-Referral Differences For Coronary Artery Calcium Testing, Rebekah Lantz, Steve Young, Janet Lubov, Anas Ahmed, Ronald J. Markert, Srikanth Sadhu

Internal Medicine Faculty Publications

Study objectives: The objectives of this study were to identify independent predictors for moderate/accentuated coronary artery calcium (CAC) score and compare patients who self-referred for CAC Computed Tomography (CT) testing to those who were provider-referred. Design: Patients underwent CAC between January to July 2019. The analysis was divided into self-referred patients influenced by a CAC community campaign who identified themselves as having cardiovascular risk factors compared to provider-referred intermediate-risk patients who were asymptomatic. SAS version 9.4 (SAS Institute, Inc., Cary, NC) was used for all analyses. Setting: Seven southwest Ohio hospitals from a single network. Participants: 2124 adult patients who …

A Study To Compare Baseline Functional Residual Capacity And Forced Vital Capacity As A Predictor Of Mortality And Hospitalization In A Cohort Of Mild To Moderate Interstitial Lung Disease, O R. Gomez Rojas, E Naeem, F Ionescu, E Castillo, G B. Nair

Conference Presentation Abstracts

Background Forced Vital Capacity (FVC) is a common parameter used to assess disease progression in patients with Interstitial lung disease (ILD) and acts as a surrogate for mortality. Previous studies suggest Functional Residual Capacity (FRC) may be an earlier predictor of disease progression in ILD. In this study, we compared ability of baseline FRC to FVC to predict one-year-mortality and respiratory related hospitalization in patients with mild to moderate ILD. Methods We retrospectively analyzed a prospective cohort of ILD patients attending a multidisciplinary ILD program from Jan 2017 to Oct 2021 at a large Health care system. Patients who had …

Qualitative Study Exploring The Feasibility, Usability And Acceptability Of Neonatal Continuous Monitoring Technologies At A Public Tertiary Hospital In Nairobi, Keny, Mai-Lei Woo Kinshella, Violet Naanyu, Dorothy Chomba, Mary Waiyego, Jessica Rigg, Jesse Coleman, Bella Hwang, J. Mark Ansermino, William Macharia, Amy Sarah Ginsburg

Paediatrics and Child Health, East Africa

Objective: To assess the feasibility, usability and acceptability of two non-invasive, multiparameter, continuous physiological monitoring (MCPM) technologies for use in neonates within a resource-constrained healthcare setting in sub-Saharan Africa.

Design: A qualitative study using in-depth interviews and direct observations to describe healthcare professional and caregiver perspectives and experiences with investigational MCPM technologies from EarlySense and Sibel compared with selected reference technologies.

Setting: Pumwani Maternity Hospital is a public, high-volume, tertiary hospital in Nairobi, Kenya.

Participants: In-depth interviews were conducted with five healthcare administrators, 12 healthcare providers and 10 caregivers. Direct observations were made of healthcare providers using the technologies on …

The Intertwined Relationship Of Stress And Sleep Quality Of Undergraduate Students During The Covid-19 Pandemic, Jordan Nguyen

Honors Undergraduate Theses

This study aims to examine the relationship between stress and sleep of undergraduate students during the course of the COVID-19 pandemic. The possibly correlational relationship between these two parameters was determined with respect to how this population was faring during recent times, two years into the pandemic. The study also served to examine how this relationship changed over time based on three time frames: before the pandemic, during the advent of the lockdown (March 2020-May 2020), and during recent times. A survey was developed to collect data from the undergraduate participants for correlation and regression analysis to determine the relationship …

An Examination Of Lung Cancer Treatment Characteristics On Lung Cancer Patients With Co-Existing Heart Disease, Elias Rhanime

Honors Undergraduate Theses

With the rising rates of heart disease incidents in the United States and the increase in lung cancer deaths as well, many individuals suffer and get their treatments compromised due to these diseases. Especially considering that many lung cancer and heart disease patients are over 70 years of age, treatment options and success rates drop significantly. Due to this, a great concern is raised for patients with co-existing heart disease and lung cancer. This was a case-control study that assessed lung cancer treatment options and success rates for patients with co-existing heart disease. We used research papers that discussed lung …

Reporter Chondrocyte Optimization Of Bioinks For Zonal 3d Bioprinting Of Cartilage, Kari Martyniak

Electronic Theses and Dissertations, 2020-2023

Osteoarthritis (OA) is the most common form of arthritis, often thought of as a disease of the elderly, but post traumatic OA predominantly impacts younger individuals. Articular cartilage is the tissue that coats the end of your bones in synovial joints. Since cartilage has limited healing capacity, defects, or injuries to it progressively erodes down to the subchondral bone. Unfortunately, current treatment options all have limitations, particularly for younger patients. Cartilage has a specific zonal architecture that is distinguished by the different cell morphologies and arrangements, biochemical composition, and mechanical properties. 3D bioprinting is a tissue engineering technique that involves …

A Pathway For Inclusive Innovation In Pediatric Mental Health: Prevention And Intervention Using Technology, Kate Corinne Bennett

DSW Capstone Projects

It is no secret that access to quality healthcare is difficult for citizens to achieve in the United States. Racism, discrimination, and oppression further exist at the root of compounding social problems, including limits in minority access to mental health services. The COVID-19 pandemic has also exacerbated mental health problems for young children, especially those who are already underserved and at risk. For these reasons, it is imperative that the social work profession emphasizes innovative approaches to equitable treatment access, including a focus on early intervention and the use of technology. Product one of this capstone engages a systematic review …

Evaluating The Data Of Patient Scales (Phq-9, Bdi, Gad-7) From The Lehigh Valley Health Network Transcranial Magnetic Stimulation (Tms) Program, Courtney Chellew, Eugene Kim, Brett Williamson Msw, Mba

Department of Psychiatry

No abstract provided.

Strategies For Improving Customer Retention For Medical Imaging Devices, Guillermo Sander

Walden Dissertations and Doctoral Studies

Some sales managers of medical imaging devices lack strategies to improve long-term customer retention. Increasing retention can save these sales managers up to 50% of their customer acquisition costs. Grounded in the service profit chain theory, the purpose of this qualitative multiple case study was to explore strategies sales managers of medical imaging devices use to improve long-term customer retention. The participants comprised seven sales managers of medical imaging devices from three companies who successfully achieved long-term customer retention. Data were collected using semistructured interviews and public documents. Thematic analysis was used to analyze the data. Three themes emerged: value-added …

Apoe Genotype And Sex Modulate Ketogenic Diet Enhancements To Metabolism And Gut Microbiome In Young Mice, Andrew T. Yackzan

Theses and Dissertations--Medical Sciences

The apolipoprotein ε (APOE) allele in humans has been associated with risk for development of Alzheimer’s disease (AD). There are predominately three variations of the allele – ε2 (E2), ε3 (E3), and ε4 (E4) – with E4 contributing the greatest risk of AD development. Recent research has unveiled evidence of neurometabolic and neurovascular deficits in E4 carriers present decades before the onset of dementia; it is believed these chronic defects play a major role in the development of AD, thus making them a potential target for preventative intervention. The purpose of this study was to examine the effect of a …

Novel Mechanism Of Endogenous Pancreatic Cancer Cell Expression Of Immune Checkpoint Programmed Cell-Death 1 Protein (Pd-1) Inducing Epithelial-To-Mesenchymal Transition (Emt) Through The Met Pathway And Promoting Cancer Progression In An Immune-Independent Process, Megan M. Harper

Theses and Dissertations--Clinical and Translational Science

Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest cancers with few treatment options, necessitating an urgent need for novel therapeutics. Immuno-oncologic (IO) therapies have revolutionized anti-cancer regimens in the past decade but typically involve reactivation of adaptive immune responses. In particular, immune checkpoint PD-1 is traditionally expressed only on immune cells while PD-L1 (PD-1 ligand) is overexpressed on cancer cells. When tumor-endogenous PD-L1 binds the PD-1 receptor on T-cells, the immune cells undergo anergy resulting in self-tolerance and cancer cell immune evasion. However, contrary to standard dogma, we previously demonstrated tumor-endogenous PD-1 expression in PDAC. Our data indicated that …

Progressive Endoscopic Approach To Balloon Dilation For Benign Esophageal Strictures, Chad J. Cooper

Theses and Dissertations--Clinical and Translational Science

Benign esophageal strictures are a frequently encountered problem in clinical practice. The management of benign esophageal strictures have slowly evolved over the decades based on “expert opinion.” Despite vast amounts of data about the efficacy and safety of dilation, unfortunately there is no consensus on a systematic and safe approach that is efficient, limits complications and provides long lasting improvement of dysphagia. Our group designed a progressive approach to endoscopic balloon dilation based on tailoring certain technical aspects of the dilation process.

Most studies in the literature concluded that endoscopic dilation is safe and effective in relieving dysphagia caused by …

Investigating The Uncertainties In Ct Non-Small Cell Lung Cancer Radiomics, Gary Ge

Theses and Dissertations--Radiation Medicine

Radiomics is a technique that extracts quantitative features, termed radiomic features, from medical images using data-characterization algorithms. These radiomic features can be used to identify tissue characteristics and radiologic phenotyping that are not observable by clinicians in a non-invasive, low-cost manner, potentially generating image biomarkers for clinical decision. To date, there are still many uncertainties involved in radiomics which limit its clinical implementation. Herein, we propose to explore the impact of each component in the radiomics pipeline on predicting clinical outcomes. In Chapter II, we conduct a thorough review of CT lung cancer radiomics studies to examine the typical feature …

Impact Of Difelikefalin On 5d-Itch Domains In Patients With Ckd-Associated Pruritus, Anjay Rastogi, Joel M. Topf, Thilo Schaufler, Isabelle Morin, Frederique Menzaghi, Warren Wen, Kieran Mccafferty

Conference Presentation Abstracts

Background: Chronic kidney disease-associated pruritus (CKD-aP) is common in hemodialysis (HD) patients, impacting quality of life (QoL). In the Phase 3 KALM studies, difelikefalin (DFK), a selective kappa opioid receptor agonist approved in the United States and Europe for the treatment of moderate–severe pruritus in adults undergoing HD, improved itch intensity and QoL. The impact of DFK treatment on the subdomains of the 5D-itch scale (a multidimensional questionnaire validated in patients with chronic pruritus) were explored.

Methods: In this pooled KALM-1 and KALM-2 analysis (n=712), HD patients with moderate–severe CKD-aP were randomized 1:1 to receive intravenous DFK 0.5 µg/kg or …

#Askrenal: Use Of An Automated Twitter Account To Crowdsource Nephrology Queries, Jade M. Teakell, Alicja Rosolowska, Swapnil Hiremath, Matthew A. Sparks, Edgar V. Lerma, Joel M. Topf, Nikhil A. Shah

Conference Presentation Abstracts

Background: Social media platforms are used in contemporary crowdsourcing, and Twitter is apt for reaching a large number of people with a common interest. Users, especially those with a small follower count may find it challenging to reach a large audience. #AskRenal was developed as a Twitter crowdsourcing tool to help users get answers to nephrology questions. We hypothesized that the #AskRenal hashtag could be used by anyone to receive helpful and timely responses to simple or complex nephrology questions posed on the social media platform. Methods: A Twitter account @AskRenal, and an online Twitter bot that automatically retweeted any …

Radiation Of Meningioma Dural Tail May Not Improve Tumor Control Rates., Keenan Piper, Siyuan Yu, Mohammad Taghvaei, Christian Fernandez, Nikolaos Mouchtouris, Rupert D Smit, Clifford Yudkoff, Sarah Collopy, Maikerly Reyes, Pascal Lavergne, Michael Karsy, Giyarpuram Prashant, Wenyin Shi, James J. Evans

Student Papers, Posters & Projects

Introduction: Dural tails are thickened contrast-enhancing portions of dura associated with some meningiomas. Prior studies have demonstrated the presence of tumor cells within the dural tail, however their inclusion in radiation treatment fields remains controversial. We evaluated the role of including the dural tail when treating a meningioma with stereotactic radiation and the impact on tumor recurrence.

Methods: This is a retrospective, single-institution, cohort study of patients with intracranial World Health Organization (WHO) grade 1 meningioma and identified dural tail who were treated with stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) from January 2012 to December 2018. SRS and …

The Lived Experiences Of Sports Retirement Among Elite, Action Sports Athletes, Gracie Struthers

Antioch University Dissertations & Theses

This study explored the lived experiences of sports retirement among elite, action sport athletes. This study examined participants’ retirement experiences, their well-being post-retirement, and recommendations participants had for current athletes about retirement. Interviews were conducted remotely with four participants. Participants identified as Caucasian, in the 25–38 age range, had been involved with their sport competitively for 17.75 years, and had been retired for 3.37 years. Data was collected and analyzed utilizing Interpretive Phenomenological Analysis (IPA). Participants’ experiences during retirement illustrated a significant disruption in their lives and the way they lived. This disruption was characterized by significant grief and distress, …

Re: Safety, Tolerability, And Efficacy Of Liris 400 Mg In Women With Interstitial Cystitis/Bladder Pain Syndrome With Or Without Hunner Lesions, R Evans, A Kohan, R Moldwin, D Radecki, T Geib, K M. Peters

Articles

Editorial Comment: The lidocaine-releasing intravesical system (LiRIS) is a passive, nonresorbable intravesical system inserted cystoscopically and designed to provide continuous, controlled release of lidocaine into the bladder over a 2-week period, after which it is removed. There was a positive anticipation that this treatment system might provide symptomatic relief for at least a segment of patients with interstitial cystitis/bladder pain syndrome (IC/BPS), based on the logic of the rationale and from results in 2 small studies, 1 of which was presented at the American Urological Association annual meeting in 2016,1 showing positive results in patients with Hunner lesions (HL). This …

Transformed Waldenström Macroglobulinemia Responsive To Tafasitamab Plus Lenalidomide: A Case Report, Syed Alishan Nasir, Deep Pandya, Steven Wojkiewicz, Bhavna Khandpur, Elizabeth Downes, Pradip Pathare, Richard Frank

Physician Associate Studies Faculty Publications

The histologic transformation (HT) of Waldenström macroglobulinemia (WM) into diffuse large-cell lymphoma is an uncommon but poor-prognostic event for which there is no standard therapy. Knowledge of this entity is mainly derived from largely retrospective studies, which report abysmal average survival rates even with the utilization of first-line chemoimmunotherapy and especially in patients who meet the high-risk criteria based on prognostic indices used for WM. We present the case of a 75-year-old man with high-risk, transformed WM who was ineligible for standard chemoimmunotherapy (due to pancytopenia and multiple comorbidities) and was consequently treated with tafasitabmab, an anti-CD19 monoclonal antibody plus …

Increasing Awareness Of Personal Harm Reduction Interventions In The Clinical Setting: A Quality Improvement Project, Shawn Theberge

DNP Scholarly Projects

Abstract

The ever-rising concern for safety in the healthcare setting has become increasingly prevalent and levels of hostility and violence more publicly visible. Over the last decade both patients and clinicians have been targeted in healthcare facilities at record levels. These incidents have created an environment of not only risk but increased anxiety and feelings of uncertainty for most clinical personnel. The study will initially measure clinician’s viewpoint of the clinical setting that they work in; and over the span of the project, track and evaluate the effects of the interventions on clinicians’ overall feelings and perceptions. The expected outcome …

Increasing Rates Of Urine Albumin Creatinine Ratio Ordering By Providers In Diabetics In Adult Primary Care: A Quality Improvement Initiative, James Ehrlich

DNP Scholarly Projects

Background: The rising incidence of diabetes within the United States and worldwide has led to increased diabetes related morbidity and mortality. As the leading cause of end stage renal disease (ESRD), more attention needs to be placed on increasing rates of diabetic nephropathy screening. The vast majority of diabetics are treated in primary care, positioning primary care as a center focus for diabetes related screening and treatment.

Local problem: Low rates of diabetic nephropathy screening were noted at an academic medical center affiliated primary care clinic. A quality improvement initiative was elicited to increase the number of urine microalbumin creatine …

Delivery Room St Segment Analysis To Predict Short Term Outcomes In Near-Term And Term Newborns, Jorgen Linde, Anne Lee Solevag, Joar Eilevstjonn, Ladislaus Blacy, Hussein Kidanto, Hege Ersadal, Claus Klingenberg

Obstetrics and Gynaecology, East Africa

Background: ST-segment changes to the fetal electrocardiogram (ECG) may indicate fetal acidosis. No large-scale characterization of ECG morphology immediately after birth has been performed, but ECG is used for heart rate (HR) assessment. We aimed to investigate ECG morphology immediately after birth in asphyxiated infants, using one-lead dry-electrode ECG developed for HR measurement.

Methods: Observational study in Tanzania, between 2013–2018. Near-term and term infants that received bag-mask ventilation (BMV), and healthy controls, were monitored with one-lead dry-electrode ECG with a non-diagnostic bandwidth. ECGs were classified as normal, with ST-elevations or other ST-segment abnormalities including a biphasic ST-segment. We analyzed ECG …

Ret Signaling Pathway And Ret Inhibitors In Human Cancer, Angelina T Regua, Mariana Najjar, Hui-Wen Lo

Faculty, Staff and Student Publications

Rearranged during transfection (RET) receptor tyrosine kinase was first identified over thirty years ago as a novel transforming gene. Since its discovery and subsequent pathway characterization, RET alterations have been identified in numerous cancer types and are most prevalent in thyroid carcinomas and non-small cell lung cancer (NSCLC). In other tumor types such as breast cancer and salivary gland carcinomas, RET alterations can be found at lower frequencies. Aberrant RET activity is associated with poor prognosis of thyroid and lung carcinoma patients, and is strongly correlated with increased risk of distant metastases. RET aberrations encompass a variety of genomic or …