Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Computer Aided Diagnosis System For Breast Cancer Using Deep Learning., Asma Baccouche

Electronic Theses and Dissertations

The recent rise of big data technology surrounding the electronic systems and developed toolkits gave birth to new promises for Artificial Intelligence (AI). With the continuous use of data-centric systems and machines in our lives, such as social media, surveys, emails, reports, etc., there is no doubt that data has gained the center of attention by scientists and motivated them to provide more decision-making and operational support systems across multiple domains. With the recent breakthroughs in artificial intelligence, the use of machine learning and deep learning models have achieved remarkable advances in computer vision, ecommerce, cybersecurity, and healthcare. Particularly, numerous …

Ribonucleotide Reductase Subunit Switching In Hepatoblastoma Drug Response And Relapse, Anthony Brown

Theses and Dissertations (ETD)

Hepatoblastoma is the most common primary liver cancer in infants and young children. Despite being a very rare cancer that accounts for only 0.5-2% if all childhood cancer cases, HB has the largest increase in incidence among childhood cancers in the United States and worldwide. The five-year survival rate of children with the aggressive forms of HB, including those that have developed metastatic or recurrent diseases, is less than 40% due to the lack of effective treatment. We aim to identify targetable mechanisms underlying the progression and drug resistance of high-risk HB. Our recent work on HB mouse and organoid …

Monte Carlo Simulation Of Thallium-Bromide Semiconductor Detector For Range Verification Of A Carbon Ion Radiotherapy Beam Through Prompt Gamma-Ray Detection, Peter Dimpfl

UNLV Theses, Dissertations, Professional Papers, and Capstones

Thallium-Bromide is a semiconductor material which is well suited for photon detection. Composed of high atomic number elements and a high mass density of 7.56 g/cm3, TlBr has superb photon stopping power. External beam radiation therapy is an ever-changing environment with technology rapidly improving. With proton therapy facilities becoming more widely available, and carbon ion facilities showcasing the benefits of carbon ion radiation therapy, there is an industry need toprovide accurate dosimetric treatment plans to verify patients are receiving proper care. Current clinical practices apply safety margins to clinical target volumes to safe treatment. Through research to improve detection techniques, …

Cell-Free Dna Sequencing In Multiple Myeloma, Russell Irwin

Dissertations and Theses (Open Access)

Multiple myeloma (MM) is an incurable plasma cell dyscrasia. Recent advances in MM therapy, including CAR-T therapy, have increased survival and shown the value of assessing treatment response with great sensitivity, both in acute and long-term settings. Cell-free DNA, DNA fragments which are released into circulation as a part of normal cellular turnover, is a useful and dynamic biomarker in cancer patients due to the presence of circulating tumor DNA (ctDNA), which is readily identified using next generation sequencing. Here we report the analytical sensitivity, applicability, consistency, and prognostic ability of M5Seq, a novel hybrid capture panel designed for MM …

Development Of Advanced Mr-Guided Adaptive Radiation Therapy Methods For Head & Neck Cancers On The 1.5t Mr-Linac, Brigid Mcdonald

Dissertations and Theses (Open Access)

The 1.5T hybrid MRI/linear accelerator (MR-linac) has recently been introduced into clinical practice and used for the treatment of head and neck cancers (HNC). This device enables on-line adaptive radiation therapy (ART) based on anatomical changes throughout treatment and variations in patient position. This novel technology also has the potential for advanced ART strategies such as dose-optimized ART, in which the treatment plan is optimized based on the accumulated dose over previous fractions, or biological image-guided ART, in which the plan is adapted based on individual tumor response as measured through quantitative imaging techniques such as diffusion-weighted imaging (DWI). The …

Roles Of Oxidative Stress And Dna Methylation In Cigarette Smoking-Induced Accelerated Acute Myeloid Leukemia Progression, Mary Figueroa

Dissertations and Theses (Open Access)

Acute myeloid leukemia (AML) is a commonly diagnosed cancer in smokers. When current or former smokers have AML, they have worse survival compared to never smoking patients. This has been observed clinically for decades, but then it is unknown how smoking leads to worsened AML survival. Smoking causes oxidative stress and altered DNA methylation that persists for decades in peripheral blood mononuclear cells, but these changes from smoking have not been evaluated in the context of AML. We hypothesize that smoking-induced molecular changes, including altered DNA methylation associated with poor AML prognosis, promote AML. We developed a novel model to …

How Valuable Are Clinical Neuropsychological Assessments? A Meta-Analysis Of Neuropsychological Tests With Comparison To Common Medical Tests And Treatments, Murphy N. Harrell

Graduate Theses and Dissertations (2019 - present)

There has been a general decrease in neuropsychological assessments at a time when medical diagnostic technology and treatments have expanded, leading to a faulty assumption that medical tests and healthcare treatments provide more reliable or valid data than psychological assessments. A landmark report from the American Psychological Association’s (APA) Psychological Assessment Work Group (PAWG) found that validity coefficients for many psychological tests were indistinguishable from those of medical tests (Meyer et al., 2001). An updated systematic review of the advancement in neuropsychological testing is essential to the continued advancement of the value of neuropsychological assessment in healthcare. This meta-analysis sought …

Neuropsychology Of Primary Headache Disorders: A Meta-Analysis, Jasmin H. Pizer

Graduate Theses and Dissertations (2019 - present)

Objective: A meta-analysis was conducted comparing cognition on clinical measures between individuals with a primary headache disorder (PHD) and healthy controls (HC). Data Selection: The University of South Alabama Libraries’ OneSearch and PubMed, with a uniform search-strategy, were used to locate original research comparing cognition between PHD and HC samples. Analyses were modeled under random effects. Hedge’s g was used as a bias-corrected estimate of effect size. Between-study heterogeneity was assessed using Cochran’s Q and I2. Data Synthesis: The initial search interval spanned inception–May 2021 and yielded 6692 results. Fifty-seven studies were analyzed. Meta-analysis showed a significant combined effect size …

Radioluminescence Based Biochemical Sensing And Imaging Strategies To Measure Local Drug Release And Ph, Gretchen B. Schober

All Dissertations

In this dissertation we describe methods for measuring infection relevant biochemical analytes using radioluminescent and ultrasound luminescent materials. Films and nanoparticles fabricated with europium doped gadolinium oxysulfide (Gd₂O₂S:Eu³⁺) are used to quantitatively measure radiolabeled pharmaceutical concentration, specifically tritium labeled vancomycin (³H-vancomycin). Europium and dysprosium doped strontium aluminate is used to fabricate an ultrasound modulated, pH sensing film. These methods are indicated for theranostic evaluation of implant associated infection. Bacterial biofilms are inherently resistant to traditional antibiotic treatment and can coat biomedical implants. These biofilm related infections are difficult or impossible to eradicate …

Nursing Perspectives And Opinions On Early Or Delayed Sepsis Treatment: A Mixed Methods Approach, Pamela L. Harris

Theses and Dissertations (ETD)

Purpose. Each year at least 1.7 million adults in America develop sepsis. Sepsis can lead to life threatening organ dysfunction, severe hypotension, and death when severe sepsis or septic shock is involved. Sepsis is responsible for 50% of acute kidney injury (AKI), which is the most common form of organ dysfunction seen in critical care. Sepsis associated AKI results in loss of, or decreased renal function, is associated with adverse long-term outcomes, and carries a higher mortality rate than non-septic AKI, sepsis without AKI, or septic shock without AKI. Surviving sepsis guidelines suggests a 1-hour window from the time of …

Inflammatory Response Following Hemorrhagic Stroke: The Role Of Cytokines, Patrick Devlin

Theses and Dissertations (ETD)

Hemorrhagic stroke is a dangerous form of stroke resulting from the rupturing of weakened blood vessels, releasing blood that increases intracranial pressure and causes the death of surrounding tissue. Treatment options are improving but remain limited, as evidenced by this condition being characterized by high rates of mortality as well as long-term morbidity. Unregulated inflammatory responses that occur following injury may be partially to blame for these poor outcomes. In response to any injury, the immune system releases cytokines to recruit immune cell activation and promote inflammation. But after hemorrhagic stroke, whether aneurysmal subarachnoid hemorrhage (aSAH) or intracerebral hemorrhage (ICH), …

Associations Between Postpartum Depression And Child Overweight And Obesity: Mediating Effect Of Maternal Feeding Behaviors And Beliefs, Michelle Harrison

Theses and Dissertations (ETD)

Purpose. Postpartum depression (PPD) is a mental condition that significantly affects 10% to 25% of women within the first year after the birth of their child. The mother-infant relationship is key to child growth. Previous studies have shown that PPD has a detrimental effect on children’s physical and psychological well-being as it affects the child through the mother’s parenting behavior. Depressed mothers show a lack of engagement with their children, which could extend to feeding practices influencing weight gain. The prevalence and severity of childhood overweight and obesity is a global public health problem. An increase in weight gain in …

Confirming Multiplex Rt-Qpcr Use In Covid-19 With Next-Generation Sequencing: Strategies For Epidemiological Advantage, Rob E. Carpenter, Vaibhav Tamrakar, Harendra Chahar, Tyler Vine, Rahul Sharma

Human Resource Development Faculty Publications and Presentations

Rapid identification and tracking of emerging SARS-CoV-2 variants are critical for understanding the transmission dynamics and developing strategies for interrupting the transmission chain. Next-Generation Sequencing (NGS) is an exceptional tool for whole-genome analysis and deciphering new mutations. The technique has been instrumental in identifying the variants of concern (VOC) and tracking this pandemic. However, NGS is complex and expensive for large-scale adoption, and epidemiological monitoring with NGS alone could be unattainable in limited-resource settings. In this study, we explored the application of reverse transcription-quantitative polymerase chain reaction (RT-qPCR) based detection of the variant identified by NGS. We analyzed a total …

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …

Is Home Blood Pressure Monitoring Effective At Controlling Hypertension In African American Patients? A Clin-Iq, Rebecca Nye, Wilhelm Lehmann, Deborah Simpson

Journal of Patient-Centered Research and Reviews

African Americans are disproportionately affected by hypertension, a modifiable contributor to multiple chronic diseases and premature death. Primary care physicians play an important role in hypertension control. Home blood pressure monitoring (HBPM) is an evidence-based method for confirming diagnosis and monitoring hypertension over time. Some studies have found that HBPM may lead to clinically relevant reductions in blood pressure when combined with additional interventions, but few studies have focused specifically on African American populations. Evidence of effectiveness could increase clinical recommendation of HBPM. This clinical inquiry examined whether HBPM improves blood pressure control in African Americans with uncontrolled hypertension. Reviewed …

Heart To Heart, Mom To Mom, Karis L. Tekwani

Journal of Patient-Centered Research and Reviews

This essay describes the human connection forged between two young moms, one the physician and one the patient, when their paths collided one night in the emergency department of a busy hospital. It describes a challenging and most memorable care experience in the career of a young emergency physician, the clinical outcome, and the patient’s appreciative follow-up message years later.

Cardiac Metastasis After Curative Treatment Of Hepatocellular Carcinoma: Risk Factors, Treatment Options, And Prognosis, Gaurav Jain, Mathew Otto, Mubeen Khan Mohammed Abdul, Manpreet Chadha, Ajay Sahajpal

Journal of Patient-Centered Research and Reviews

Hepatocellular carcinoma (HCC) is primary hepatic malignancy with a high incidence of recurrence. The risk of recurrence directly correlates to patient’s overall prognosis. Management of advanced HCC involves a combination of surgical resection, locoregional therapy, and systemic treatment. Distant metastases are rare, and intraventricular cardiac metastases are even more infrequent. This brief review details an illustrative case of cardiac metastasis after curative treatment of primary HCC and then summarizes the literature on risk factors, treatment options, and patient prognosis in the setting of distant metastases from HCC. Prognosis of metastasis to the heart is generally poor, and available evidence emphasizes …

Partnering To Advance Health Equity And A Welcome Opportunity To Gather: Proceedings From The 28th Annual Conference Of The Health Care Systems Research Network, Robert T. Greenlee

Journal of Patient-Centered Research and Reviews

In April 2022, the Health Care Systems Research Network (HCSRN) — a consortium of 20 research institutions affiliated with large health systems spread across the United States (and one in Israel) — held its 28th annual conference in Pasadena, California, with 275 researchers, health care colleagues, and external academic partners in attendance. With a conference theme of “Promoting Collaboration and Partnerships to Advance Health Equity,” the scientific program was assembled by a multisite planning committee with input from representatives of informal local host Kaiser Permanente Southern California. Objectives of the annual conference are to showcase scientific findings from HCSRN projects …

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

Graduate Medical Education Research Journal

Introduction

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

Methods

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

Results

In all three cases marked improvement was the …

Hyperbaric Oxygen Therapy For Cerebral Radiation Necrosis Secondary To Stereotactic Radiation: A Case Series, Sruti Prathivadhi-Bhayankaram, Jeffrey S. Cooper

Graduate Medical Education Research Journal

Introduction: Stereotactic radiosurgery (SRS) is an excellent option for the treatment of numerous central nervous system diseases. There exist several forms of SRS, including gamma-knife surgery (GKS) and cyber-knife surgery. The most significant complication of SRS is the delayed effects of therapeutic radiation, also known as radionecrosis. The current treatment options for radionecrosis have a significant side effect profile and posit challenges for medical management. More recently, hyperbaric oxygen therapy (HBO2) has emerged as an option for treatment with minimal side effects.

Methods: We present a retrospective case series examining ten patients treated with HBO2 after receiving radiotherapy. Of …