Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

An Algorithm For Extracting The Ppg Baseline Drift In Real-Time, Tuan Ngoc Nguyen

Theses: Doctorates and Masters

Photoplethysmography is an optical technique for measuring the perfusion of blood in skin and tissue arterial vessels. Due to its simplicity, accessibility and abundance of information on an individual’s cardiovascular system, it has been a pervasive topic of research within recent years. With these benefits however there are many challenges concerning the processing and conditioning of the signal in order to allow information to be extracted. One such challenge is removing the baseline drift of the signal, which is caused by respiratory rate, muscle tremor and physiological changes within the body as a response to various stimuli.

Over the years …

The Physician’S Perspective On The Impact Of Interpretive Services On The Physician- Patient Relationship, Amrita Pandey

Williams Honors College, Honors Research Projects

The basis of the physician-patient relationship relies heavily on communication. It has been known that conversation between physician and patient is important in both diagnosing and providing therapeutic support. However, according to the US Census Bureau twenty percent of the US population does not use English as their first language. These residents face language barriers on a daily basis, including when they are being treated medically. The aim of this study was to research the physician’s perspective on the use of interpretive services and how it impacts the physician- patient relationship. The research consisted of surveying physicians who encounter patients …

Vague Neuroglycopenic Complaints Camouflage Diagnosis Of Adolescent Insulinoma: A Case Report., Kelsee Halpin, Ryan Mcdonough, Patria Alba, Jared Halpin, Vivekanand Singh, Yun Yan

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Insulinoma is a rare diagnosis in the general population with estimates of 1 in 250,000 people per year. Reports of these pancreatic islet cell tumors are even more unusual in children and adolescents. Chronic hypoglycemia due to an insulinoma often presents with neuroglycopenic symptoms that can easily be overlooked, especially in adolescents where nonspecific complaints are common. This may result in delayed diagnosis with prolonged periods of untreated hypoglycemia and associated complications. The rarity of pediatric insulinoma, vagueness of presenting symptoms, and challenge of tumor localization make insulinoma a true diagnostic quandary for clinicians.

CASE PRESENTATION: In this report, …

Reducing Overutilization Of Testing For Clostridium Difficile Infection In A Pediatric Hospital System: A Quality Improvement Initiative., J Michael Klatte, Rangaraj Selvarangan, Mary Anne Jackson, Angela Myers

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Study objectives included addressing overuse of Clostridium difficile laboratory testing by decreasing submission rates of nondiarrheal stool specimens and specimens from children ≤12 months of age and determining resultant patient and laboratory cost savings associated with decreased testing.

METHODS: A multifaceted initiative was developed, and components included multiple provider education methods, computerized order entry modifications, and automatic declination from laboratory on testing stool specimens of nondiarrheal consistency and from children ≤12 months old. A run chart, demonstrating numbers of nondiarrheal plus infant stool specimens submitted over time, was developed to analyze the initiative's impact on clinicians' test-ordering practices. A …

Does Music Therapy Reduce Anxiety Levels In End-Stage Renal Disease Patients Undergoing Hemodialysis?, Andrew C. Konopacki

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not music therapy reduces anxiety levels in end-stage renal disease patients undergoing hemodialysis.

STUDY DESIGN: Systematic Review of two randomized controlled trials and one crossover study published in English in 2008, 2012 and 2013, respectively.

DATA SOURCES: Two non-blind randomized controlled trials and one cross-over study were found via PubMed and EBSCOhost databases.

OUTCOMES MEASURED: Subjective Anxiety Levels were measured in ESRD patients undergoing hemodialysis pre and posttest via patient self-reporting. An anxiety level survey graded on a scale of 1-10 was used in the study by …

Is Non-Nutritive Sucking An Effective Method Of Providing Analgesia To Newborns Undergoing Painful Procedures?, Eric B. Hooper

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: “The objective of this selective EBM review is to determine whether or not nonnutritive sucking is an effective method of providing analgesia to infants undergoing painful procedures.”

STUDY DESIGN: A systematic review of three blinded randomized-controlled trials (RCT’s), published from 2011 to 2013. All were published in English, one of which was translated from its original Spanish version to an English publication. DATA

SOURCES: Three RCT’s were found using the PubMed database and all were published in peer-reviewed journals.

OUTCOMES MEASURED: The incidence and severity of pain were measured during procedures using the Premature Infant Pain Profile (PIPP) and/or …

Does Exogenous Melatonin Improve Quality Of Sleep In Patients Experiencing Sleep Disturbances Secondary To Chronic Diseases?, Blessen B. Thomas

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Does exogenous melatonin improve quality of sleep in patients experiencing sleep disturbances secondary to chronic diseases?”

Study Design: Three Randomized, placebo-controlled studies (RCT) published in 2010, 2013 and 2008. Data Sources: All RCTs searched and located using PubMed database.

Outcomes Measured: Clinical outcome for all three articles using quality of sleep or quality of life questionnaires such as the Leeds Sleep Evaluation. All of which evaluated POEMs, and were self reported by participants.

Results: In a randomized control study (RCT) by Serfaty et al, sleep quality …

The Effect Of Therapeutic Horseback Riding On Balance And Self-Efficacy In Children With Developmental Disabilities, Lauren M. Hurley, Alexandra Smola

Williams Honors College, Honors Research Projects

The prevalence of developmental disabilities in children in the United States is a serious problem. Since children with developmental disabilities often show decreased self-efficacy and balance, researchers have studied the effects of interventions in this population. The purpose of this study is to determine the effect of a 10-week THR session on balance and task-specific self-efficacy in children with physical disabilities ages 6 to 18 years old. Bandura’s social cognitive theory and The Physical Stress Theory will guide the quasi-experimental study. A pre-test post-test design will be implemented over a 12 week span at 3 different riding centers in the …

Association Of Running Biomechanics And Injury In Middle School Cross Country Runners, Rachel Salberg

Williams Honors College, Honors Research Projects

INTRODUCTION: While associations between running biomechanics and injury incidence have been fairly well investigated in the adult population, few studies have targeted the adolescent population. Since the adolescent developmental stage places certain vulnerabilities on athletes, adolescents typically sustain injuries that differ from those of adults (DiFiori J.P., et al, 2014). Due to these vulnerabilities, it would be relevant to investigate the biomechanics-injury relationship specifically in this population. PURPOSE: The purpose of this study was to investigate the associations that exist between running gait characteristics and incidence of injury for middle school cross country runners METHODS: The running gait of 19 …

Chronic Pain Causal Attributions In An Interdisciplinary Primary Care Clinic: Patient-Provider And Provider-Provider Discrepancies, Bryan Jensen

Theses and Dissertations

The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed …

Diagnostic Practices Of Autism Spectrum Disorders In Brazil, Ana Claudia Vespa Mainer Dias

Master's Theses

In Brazil, in spite of over half a million students with special needs in primary education, little research has been conducted about ASD diagnostic practices. This involves learning about the training that professionals are receiving, what diagnostic practices are being implemented on the field, and whether those are being contextualized according to the Brazilian culture. Students with special needs are directly affected by the results of diagnostic practices, since identifying the individuals is one of the first steps. Lack of understanding about that stage may lead to the problematic realities of underidentification or overidentification, exclusion of children who should receive …

Test–Retest, Retest, And Retest: Growth Curve Models Of Repeat Testing With Immediate Post-Concussion Assessment And Cognitive Testing (Impact), Arthur C. Maerlender, Caitlin J. Masterson, Tiffany D. James, Jonathan Beckwith, Per Gunner Brolinson, Joe Crisco, Stefan Duma, Laura A. Flashman, Rick Greenwald, Steven Rowson, Beth Wilcox, Tom W. Mcallister

Department of Psychology: Faculty Publications

Computerized neuropsychological testing has become an important tool in the identification and management of sports-related concussions; however, the psychometric effect of repeat testing has not been studied extensively beyond test–retest statistics. The current study analyzed data from Division I collegiate athletes who completed Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) baseline assessments at four sequential time points that varied over the course of their athletic careers. Administrations were part of a larger National Institutes of Health (NIH) study. Growth curve modeling showed that the two memory composite scores increased significantly with successive administrations: Change in Verbal Memory was best represented …

Selective Action Of Aqueous Maté Extract On Human Breast Cancer, Catherine Nguyen, Kenisha Nisbett, Vanessa Halvorsen, Calvin He, Amina Sadik

College of Osteopathic Medicine (TUN) Publications and Research

Ilex paraguariensis, Yerba Maté, is a subtropical plant native to South America, where it is consumed several times daily as a tea made with roasted leaves. Several studies have been conducted to elucidate the beneficial effects of this plant. A recent study has shown that saponins isolated from Yerba Maté extract induce apoptosis in human colon cancer cells, while another study indicated that the consumption of Maté tea causes higher incidence of esophageal cancer. Our study looked into the effects Yerba Maté extract have on human breast cancer cells and non-cancer cells from the same tissue. The findings show …

Frequency, Indications And Complications Of Pulmonary Artery Catheter Insertion In Adult Open-Heart Surgery Patients Of A Tertiary Care Hospital, Syed Shabbir Ahmed, Mohammad Irfan Akhtar, Rehana Kamal

Department of Anaesthesia

Background: Patients presenting for cardiac surgery have unstable cardiovascular disease and haemodynamics with multiple coexisting diseases. Optimal monitoring in the perioperative period is very important for best perioperative outcome. The introduction of the flow-directed pulmonary artery catheter (PAC) into clinical practice is one of the most important and popular advances in the field of cardiac anaesthesia. The objective of the study was to determine the frequency, indications and complications of pulmonary artery catheter insertion in adult open-heart surgery patients.Methods: A Prospective observational study was conducted at cardiac operating rooms and Cardiac Intensive care unit (CICU) of Aga Khan University Hospital …

Race, Ethnicity, Psychosocial Factors, And Telomere Length In A Multicenter Setting, Shannon M. Lynch, M. K. Peek, Nandita Mitra, Krithika Ravichandran, Charles Branas, Elaine Spangler, Wenting Zhou, Electra D. Paskett, Sarah Gehlert, Cecilia Degraffinreid, Timothy R. Rebbeck, Harold Riethman

School of Medical Diagnostics & Translational Sciences Publications

Background

Leukocyte telomere length(LTL) has been associated with age, self-reported race/ethnicity, gender, education, and psychosocial factors, including perceived stress, and depression. However, inconsistencies in associations of LTL with disease and other phenotypes exist across studies. Population characteristics, including race/ethnicity, laboratory methods, and statistical approaches in LTL have not been comprehensively studied and could explain inconsistent LTL associations.

Methods

LTL was measured using Southern Blot in 1510 participants from a multi-ethnic, multi-center study combining data from 3 centers with different population characteristics and laboratory processing methods. Main associations between LTL and psychosocial factors and LTL and race/ethnicity were evaluated and then …

Methodologies And Considerations For Bladder Cancer Detection With Raman Based Urine Cytology, Laura T. Kerr, Thérése M. Lynn, Ivor M. Cullen, Padraig J. Daly, Nigam Shah, Shirley O'Dea, Alison Malkin, Bryan M. Hennelly

Articles

Bladder cancer has the highest recurrence rate of any cancer. The American Urological Association recommends cystoscopic surveillance every 3–6 months for 3 years, and at least once a year thereafter, particularly for high-risk patients; however, cystoscopy is invasive, expensive, and is not without insignificant morbidity for the patient. Urine cytology is often used as an adjunct to cystoscopy; however, it has a low sensitivity in detecting low grade bladder cancers. Recent studies have investigated the application of Raman micro-spectroscopy for the detection of bladder cancer via urine cytology, and it has been demonstrated to significantly improve the diagnostic sensitivity of …

The Influence Of A Crosshair Visual Aid On Observer Detection Of Simulated Fetal Heart Rate Signals, Rebecca A. Kennedy, Mark W. Scerbo, Brittany L. Anderson-Montoya, Lee A. Belfore Ii, Alfred Z. Abuhamad, Stephen S. Davis

Psychology Faculty Publications

Objective To determine whether a visual aid overlaid on fetal heart rate (FHR) tracings increases detection of critical signals relative to images with no visual aid.

Study Design In an experimental study, 21 undergraduate students viewed 240 images of simulated FHR tracings twice, once with the visual aids and once without aids. Performance was examined for images containing three different types of FHR signals (early deceleration, late deceleration, and acceleration) and four different FHR signal-to-noise ratios corresponding to FHR variability types (absent, minimal, moderate, and marked) identified by the National Institute of Child Health and Human Development (2008). Performance was …

Perception Of Differences In Lip Profile Between 2-D And 3-D, Andrew Hansen

Theses and Dissertations

Past studies evaluating the esthetics of orthodontic treatment have been done using 2-D images. New 3-D imaging offers an improved, real-life representation of a subject. The purpose of this study was to determine how laypeople perceived differences in lip position (flat versus ideal lip fullness) in 2-D compared to 3-D.

3dMD images of 8 Caucasian subjects were adjusted to an ideal and flat lip position in 3-D and then in 2-D from the profile view. 2 surveys were created with paired ideal and flat images on the screen, either in 2-D or 3-D, and evaluators were asked to choose which …

Identifying Risk Factors For Metabolic Syndrome In Division I Fcs Football Players, Julie Woolf

EWU Masters Thesis Collection

"Metabolic syndrome (MetS) is a collection of symptoms or markers leading to a higher risk for health problems including diabetes and cardiovascular disease. These markers include high blood pressure (BP), increased waist circumference (WC), high triglycerides, low HDL-C and increase glucose. Football players may be more at risk for developing MetS and other health problems due to the need for their large size, especially linemen. The purpose of this study was to determine the relationship between the MetS markers as well as the relationship between WC and visceral fat depth and measured with an ultrasound. MetS markers and visceral fat …

Using Convolutional Neural Networks For Fine Grained Image Classification Of Acute Lymphoblastic Leukemia, Richard K. Sipes

EWU Masters Thesis Collection

Acute lymphoblastic leukemia (ALL) is a cancer of bone marrow stems cells that results in the overproduction of lymphoblasts. ALL is diagnosed through a series of tests which includes the minimally invasive microscopic examination of a stained peripheral blood smear. During examination, lymphocytes and other white blood cells (WBCs) are distinguished from abnormal lymphoblasts through fine-grained distinctions in morphology. Manual microscopy is a slow process with variable accuracy that depends on the laboratorian's skill level. Thus automating microscopy is a goal in cell biology. Current methods involve hand-selecting features from cell images for input to a variety of standard machine …