Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Monitoring The Systemic Immune System To Understand And Improve The Efficacy Of Immunotherapy For Metastatic Osteosarcoma, Justin Edward Markel

Graduate Theses, Dissertations, and Problem Reports (ETD)

Osteosarcoma (OS) is a complex tumor with no effective targeted therapies due to its genomic heterogeneity and pleomorphism. The immune response it creates, particularly against metastatic lesions, is considerable; however, various suppressive mechanisms induced by the tumor prohibit its effectiveness. The presence of infiltrating lymphocytes suggests that therapeutic disinhibition through checkpoint blockade could increase antitumor immunity, though none have been successful in clinical trials. The complexities of the immune response to OS tumors have yet to be unraveled; however, there is evidence to suggest that cell-mediated immunity (CMI, specifically T cells, Natural Killer [NK] cells, and myeloid-lineage cells [MLCs]) plays …

Percutaneous Coronary Intervention Using Second Generation Drug-Eluting Stents Vs Coronary Artery Bypass Graft In Left Main Coronary Artery And Multivessel Coronary Artery Disease, Eric Kim

Capstone Showcase

Many of the studies that are used in reference to the clinical decision making between PCI vs CABG use BMS or first-generation DES as a comparison. With the advancement of stent technology, second-generation DES have emerged with improved efficacy and overall outcome rates compared to BMS and first-generation DES. Some of the newer studies such as EXCEL1-2 , demonstrated noninferiority of second-generation DES to CABG but there are limited studies that support this conclusion. Currently, the studies remain divided in the impact of newer-generation PCIs, and 10-year follow up studies may be required to further validate noninferiority before it can …

Altitude Illness, Kali Hepner

Capstone Showcase

With an increasing number of individuals traveling to high altitudes, it is important to address the risk these individuals face of developing altitude related illnesses. An example of high altitude related illness might be the elevation transition of travelers flying into Denver, Colorado (1,673 m) with the intention to then drive up to Rocky Mountain National Park’s Alpine Visitor Center (3,595 m) in the same day. This poses increased risk of unacclimatized visitors experiencing altitude illness in remote areas of the national park. This poster summarizes the diagnosis, prevention, and treatment of altitude illnesses so that clinicians and travelers may …

A Case Of Protein Losing Enteropathy After Fontan Operation, Gina Kim

Capstone Showcase

Protein Losing Enteropathy (PLE) is a condition in which an excessive amount of proteins are lost through the gastrointestinal tract leading to hypoproteinemia and manifesting as edema, ascites, and diarrhea. While in most cases PLE is a treatable disorder with good outcomes, the morbidity and mortality of the disorder is significantly elevated in patients with a history of Fontan surgery–an operation used to palliate patients born with a single ventricle by rerouting venous blood return directly to pulmonary circulation. After failure of first-line therapeutics of diuretics and steroids, this case study explores the successful treatment of a 5-year-old patient with …

Management Of Adult Growth Hormone Deficiency Related To Hypopituitarism, Kellie Jamin

Capstone Showcase

The treatment of growth hormone deficiency (GHD) is well-established in childhood but less understood in adults, given the more complex role that growth hormone (GH) assumes in this population. Decreased functionality of the pituitary gland, otherwise known as hypopituitarism, can present with an isolated GHD in adulthood, which may result from a number of factors including neoplasm, ischemia, infection, traumatic injury, or systemic disease. Adult GHD may be definitively diagnosed with a stimulation test, the insulin tolerance test (ITT) being the study of choice. With a positive ITT, the disorder can be treated with growth hormone replacement therapy (GHRT), which …

Robust Meta-Analysis For Large-Scale Genomic Experiments Based On An Empirical Approach, Sinjini Sikdar

Mathematics & Statistics Faculty Publications

BACKGROUND: Recent high-throughput technologies have opened avenues for simultaneous analyses of thousands of genes. With the availability of a multitude of public databases, one can easily access multiple genomic study results where each study comprises of significance testing results of thousands of genes. Researchers currently tend to combine this genomic information from these multiple studies in the form of a meta-analysis. As the number of genes involved is very large, the classical meta-analysis approaches need to be updated to acknowledge this large-scale aspect of the data.

METHODS: In this article, we discuss how application of standard theoretical null distributional assumptions …

Construction Of A Repeatable Framework For Prostate Cancer Lesion Binary Semantic Segmentation Using Convolutional Neural Networks, Ian Vincent O. Mirasol, Patricia Angela R. Abu, Rosula Sj Reyes

Department of Information Systems & Computer Science Faculty Publications

Prostate cancer is the 3rd most diagnosed cancer overall. Current screening methods such as the prostate-specific antigen test could result in overdiagonosis and overtreatment while other methods such as a transrectal ultrasonography are invasive. Recent medical advancements have allowed the use of multiparametric MRI — a noninvasive and reliable screening process for prostate cancer. However, assessment would still vary from different professionals introducing subjectivity. While con-volutional neural network has been used in multiple studies to ob-jectively segment prostate lesions, due to the sensitivity of datasets and varying ground-truth established used in these studies, it is not possible to reproduce and …

Theta Burst Brain Stimulation In Painful Diabetic Neuropathy Patients: Investigating Neural Mechanisms, Bhushan Thakkar

Theses and Dissertations

Chronic pain (CP) is a significant contributor to disability and disease burden globally. In 2019, approximately 50.2 million adults (20.4% of the US population) experienced chronic pain, contributing to $560-635 billion in direct medical costs. In addition, the worldwide prevalence of diabetes mellitus has reached epidemic proportions and is set to increase to 629 million by 2045. Almost 50% of patients with diabetes present with diabetic neuropathy (DN), and one in five patients with diabetes presents with painful DN (pDN) which is the most common cause of neuropathic pain (NP) in the US. Symptomatic treatment is the mainstay of management …

The Perspectives Of Augmentative And Alternative Communication Experts On The Clinical Integration Of Non-Invasive Brain-Computer Interfaces, Kevin Pitt, Miechelle L. Mckelvey, Kristy Weissling

Department of Special Education and Communication Disorders: Faculty Publications

As brain-computer interface for augmentative and alternative communication access (BCI-AAC) development continues to consider avenues for translation into the clinical setting, the perspectives of clinician experts in AAC should be considered. Therefore, 11 USA-based speech-language pathologists who are experts in AAC completed a semistructured interview along with Likert scale measures to assess their perspectives on BCI-AAC. The interviews and scales explored the potential impact of BCI-AAC, along with barriers and solutions to BCI-AAC implementation. Speech-language pathologists estimated that 1.5% to 50% of their caseload may benefit from BCI-AAC across various settings. Further, identified barriers and solutions included (a) BCI-AAC implementation …

Promotion Of Early Recognition Of Depression To Improve Health Related Quality Of Life In Pediatric Oncology Patients, Jennifer Blankenship

DNP Projects

Background: Depression and anxiety are serious complications of cancer and deemed a challenging diagnosis due to the symptoms of depression mimicking common side effects of chemotherapy and radiation. Signs/symptoms frequently are underrecognized thus appropriate treatment is delayed, compromising the health-related quality of life (HRQOL) for pediatric oncology patients.

Purpose: Analyze existing physician and Advanced Practice Provider (APP) clinical practice regarding depression, via a pre- and post-survey and educational PowerPoint on the use of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to promote early recognition of depression.

Methods: A prospective, single-arm, study was completed in the Kentucky Children’s …

Identification Of Adhd And Comorbid Disorders In Children: The Potential Role Of Minority Group Membership, Rachel H. Tayler

Dissertations and Theses

Identification of ADHD and Comorbid Disorders in Children: The potential role of minority group membership

by

Rachel Tayler, MSc, MA

Advisor: Sarah O’Neill, PhD

Attention-Deficit/Hyperactivity Disorder (ADHD) affects six million US children. Females, Latinx, and possibly Black children have lower rates of diagnosis than their Male and White non-Latinx peers. ADHD is behaviorally defined, and as such, clinicians' perceptions of symptoms and determination of diagnoses may be influenced by demographic factors such as race, ethnicity and sex.

This vignette study examined whether clinicians' implicit ethnic, racial, and sex biases affect diagnosis of ADHD and comorbid conditions. Psychiatry trainees and pediatricians …

Comparison Of The Closed Shoulder Reduction Techniques: An Evidence-To-Practice Review, Kaitlin Sznajder, Dylan Arango, Zachary K. Winkelmann

Clinical Practice in Athletic Training

The shoulder joint is one of the most dislocated joints in the body. It does not have substantial bony support which allows for a large range of motion. Shoulder joints most commonly dislocate anteriorly, and less often dislocate posteriorly and inferiorly. There is a myriad of ways to reduce a shoulder dislocation including closed and open techniques. The purpose of this evidence-to-practice review is to summarize which closed shoulder reduction techniques are most effective and apply those results to an athletic training setting. The authors of this guiding systematic review studied multiple articles that compared different closed shoulder reduction techniques …

Validity Of Selective Tissue Tests For Knee Pathologies: An Evidence-To-Practice Review, Stephanie P. Ulshafer, Samara D. Johnson, Kevin N. Schoell, Zachary K. Winkelmann

Clinical Practice in Athletic Training

The knee is the most commonly injured joint in sport, inherently meaning the knee is also the joint most frequently evaluated by healthcare providers. Clinicians evaluate and treat the knee as efficiently as possible to prevent long-term disability of the patient. Clinicians rely on physical examination tests such as McMurray’s Test, Apley’s Test, Joint Line Tenderness, Lachman Test, Anterior Drawer, Pivot Shift Test, and the Ottawa Knee Rules for initial diagnosis and initiation of care. These physical examination tests have varying levels of diagnostic accuracy and validity. Clinicians should know how definite they can be about a diagnosis from physical …

Refinement Of Alphafold2 Models Against Experimental And Hybrid Cryo-Em Density Maps, Maytha Alshammari, Willy Wriggers, Jiangwen Sun, Jing He

Computer Science Faculty Publications

Recent breakthroughs in deep learning-based protein structure prediction show that it is possible to obtain highly accurate models for a wide range of difficult protein targets for which only the amino acid sequence is known. The availability of accurately predicted models from sequences can potentially revolutionise many modelling approaches in structural biology, including the interpretation of cryo-EM density maps. Although atomic structures can be readily solved from cryo-EM maps of better than 4 Å resolution, it is still challenging to determine accurate models from lower-resolution density maps. Here, we report on the benefits of models predicted by AlphaFold2 (the best-performing …

Development Of A New Spe Uplc–Ms/Ms Method For Extraction And Quantitation Of Toluene Diamine On Gloves Following Toluene Diisocyanate Exposure, Asma Daoud, Pierre-Luc Cloutier, Sébastien Gagné, Livain Breau, Jacques Lesage

Études primaires

Rationale

Toluene diisocyanate (TDI) is a highly reactive isocyanate commonly used as a mixture of 2,4- and 2,6- isomers in the production of flexible foams. Exposure to TDI occurs primarily through vapour inhalation in workplaces where TDI is produced or used, but dermal exposure is also possible during some tasks. To ensure workplace safety, accurate monitoring of TDI and toluene diamine (TDA) levels is required. Methods of quantifying field effectiveness of gloves in preventing dermal exposure have not been established. Therefore, there is a need to develop a new practical method for assessing glove effectiveness for TDI/TDA.

Method

A new …

Plan Quality And Isotoxic Dose Escalation Investigation Using A 0.35t Mr-Linac System In Ablative 5-Fraction Stereotactic Magnetic Resonance-Guided Radiation Therapy (Mrgrt) For Primary Pancreatic Cancer, Robert Eric Hawranko

Theses and Dissertations

This study investigates plan quality generated by an MR-Linac (MRL) treatment planning system (TPS) for 5-fraction stereotactic body radiation therapy (SBRT) of primary pancreatic cancer (PCa). In addition, an isotoxic dose escalation was investigated with the MRL TPS based on the stereotactic MR-guided adaptive radiation therapy (SMART) trial constraints. A clinical workflow was developed for adaptive and non-adaptive treatments with the MRL, on which a time-driven activity-based costing (TDABC) analysis was performed to quantify clinical efficacy. Fifteen Pca patients previously treated with a conventional Linac were retrospectively re-planned for this study. Three plans were generated for each patient: using the …

Modeling Of Patient-Specific Periaortic Mechanics And Pulmonary Artery Hemodynamics Based On Phase-Contrast Magnetic Resonance Imaging Sequences., Johane H. Bracamonte

Theses and Dissertations

Inverse modeling in cardiovascular medicine is a collection of methodologies that can provide non-invasive patient-specific estimations of clinical risk factors using medical imaging as inputs. Its incorporation into clinical practice has the potential to improve diagnosis and treatment planning with low associated risks and costs.

Herein, three different phase contrast magnetic resonance imaging (MRI) modalities were implemented as input data, displacement encoding with stimulated echoes (DENSE MRI) applied, and time-resolved velocity encoding phase-contrast MRI, in 1D and 3D, applied to pulmonary artery (PA) hemodynamics.

A model to account for the effect of periaortic interactions due to static and dynamic structures …

Body Tempering And Its Effect On Ankle Dorsiflexion And Power, Neal Ori, Justin Goins, Jay Patel, Robbie Ingle

Clinical Practice in Athletic Training

Body Tempering (BT) is a newer myofascial release (MFR) technique that is used by athletes and healthcare professionals. The effects of BT are stated to be similar to foam rolling (FR) and other MFR techniques, but there is minimal research assessing the effects of BT on power and range of motion (ROM). The purpose of this study was to determine the effect of BT on ankle dorsiflexion ROM and power, as well as to compare the effects of BT to traditional FR. Twenty college-aged participants (10 males-10 females) were tested before and after intervention on three measurements of the broad …

Concussion Profiles: Moving Beyond The Graded Symptom Scale, Tamara Valovich Mcleod, Brian Vesci

Clinical Practice in Athletic Training

No abstract provided.

Conservative Care Of A Patient With Initial Anterior Shoulder Dislocation Participating In An Intercollegiate Basketball: A Disablement Model Case Study, Lucas Bianco

Clinical Practice in Athletic Training

A 23-year-old male patient participating in intercollegiate basketball, suffered an acute shoulder dislocation. The patient was diagnosed with an anterior glenohumeral labral tear and was treated with an indirect approach to increase range of motion (ROM) and function while decreasing pain. Patient-related outcome (PRO) measures were used along with clinician related outcome (CRO) measures to discharge the patient. The immediate changes in ROM and pain along with follow-up assessments of the Disabilities of the Arm, Shoulder, Hand (DASH) Scale achieved Minimal Clinically Importance Difference (MCID) levels. As rehabilitation specialists, athletic trainers have the opportunity to provide quality care to patients …