Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Feasibility Of Using Raman-Based Techniques For Breast Cancer Detection, Sara Mollamohammada

Department of Civil and Environmental Engineering: Dissertations, Theses, and Student Research

Breast cancer is one of the common types of cancer among women all over the world. Early diagnosis is an effective way that improve the treatment process and gives the patients a better chance of survival. Many of the patients infected by breast cancer choose breast conservation surgery (BCS). However, some of those will be subjected to mastectomy, and many will have tumor recurrence as there is no precise technique to show the tumor margins. Raman-based methods are powerful techniques with potential to rapidly differentiate normal from tumor tissues and provides a solution to detect tumor margin. This is because …

Improved Sensitivity To Fluorescence For Cancer Detection In Wide-Field Image-Guided Neurosurgery, Michael Jermyn, Yoann Gosselin, Pablo A. Valdes, Mira Sibai, Kolbein Kolste

Dartmouth Scholarship

In glioma surgery, Protoporphyrin IX (PpIX) fluorescence may identify residual tumor that could be resected while minimizing damage to normal brain. We demonstrate that improved sensitivity for wide-field spectroscopic fluorescence imaging is achieved with minimal disruption to the neurosurgical workflow using an electron-multiplying charge-coupled device (EMCCD) relative to a state-of-the-art CMOS system. In phantom experiments the EMCCD system can detect at least two orders-of-magnitude lower PpIX. Ex vivo tissue imaging on a rat glioma model demonstrates improved fluorescence contrast compared with neurosurgical fluorescence microscope technology, and the fluorescence detection is confirmed with measurements from a clinically-validated spectroscopic probe. Greater PpIX …

Allogeneic Autophagosome-Enriched Composition For The Treatment Of Disease, Traci Hilton, Sandra Aung, Rieneke Van De Ven, Christopher Paustian, Tarsem Moudgil, Christopher Dubay, Christopher Twitty, Hong-Ming Hu, Bernard A Fox

Technology Transfer - Patents

A method is presented for screening cells that produce allogeneic autophagosome enriched compositions able to induce expression of a selective marker on a subpopulation of peripheral blood mononuclear cells, the method comprising contacting a cell with a proteasome inhibitor, contacting the cell with a lysosome inhibitor, harvesting the resulting autophagosomes, determining a molecular signature of the harvested autophagosomes, and selecting cells that divert one or more Toll-like receptor agonist and/or one or more molecular chaperones to the harvested autophagosomes. By screening for cells that divert one or more Toll-like receptor agonist and/or one or more molecular chaperones to the harvested …

Therapeutic Exercises: A Conservative Approach To The Treatment Of Chronic Low Back Pain, Austin England

University Honors Program

Chronic low back pain is becoming a worldwide epidemic; millions suffer from this condition every year. Back pain is one of the most frequent reasons cited for patient visits every year. It is the second most reason for days of missed work following the flu. Chronic low back pain is defined as pain persisting in the low back region for greater than three months. This pain may originate from a variety of factors. These factors can include, but are not limited to injury, disease, or different stressors on the body. Pain in the low back region may be felt as …

Cardiopulmonary Exercise Testing-Based Algorithm And Its Usefulness In Clinical Cardiology, Mirza Nubair Ahmad, Syed Hasan Yusuf, Rafath Ullah, Mary Ellis, Haroon Yousaf, Timothy E. Paterick, Khawaja Afzal Ammar

Journal of Patient-Centered Research and Reviews

Background: Only cardiopulmonary exercise (CPX) testing provides information on the ability of the cardiovascular system to meet the body’s metabolic demands in terms of oxygen consumption (VO₂) and carbon dioxide production (VCO₂). However, CPX testing is underutilized by cardiologists due to complex diagnostic algorithms involving up to 30 variables as well as lack of validation studies. In addition, CPX also provides oxygen (O₂) pulse as a continuous measure of stroke volume, which is its superiority to other stress modalities in which systolic function is measured at peak stress and rest. In the literature, it …

Real-World Relevance Of Manual Electrocardiography Qt Interval Measurement, Satish Velagapudi, Zahra Nur Khaled, Bilal Omery, Firas Zahwe, Michael Anigbogu, Sarah Zukkoor, Indrajit Choudhuri

Journal of Patient-Centered Research and Reviews

Background: Electrocardiography (ECG) QT interval (QTI) prolongation independently predicts sudden death. Hospitalized patients are commonly exposed to multiple QT-prolonging drugs, and manual measurement of ECG QTI based on identifying the intersection of isoelectricity with the tangent to the terminal phase T-wave slope (QTTTT) is advocated due to inaccuracies in automated detection algorithms that may imprecisely identify QT duration.

Purpose: We evaluated the performance of QTTTT compared to a standard automated (12SL, GE Healthcare) method (QT-12SL).

Methods: Consecutively obtained ECGs of 250 hospitalized patients were reviewed. The QTI in leads II, aVR, V5 and V6 determined by QT-12SL and QTTTT were …

The Role Of Traditional Chinese Medicine In The Management Of Chronic Pain: A Biopsychosocial Approach, John Burns, Tiffany A. Mullen

Journal of Patient-Centered Research and Reviews

The National Institute of Medicine revealed that chronic pain affects more than 100 million adults in the United States, citing chronic pain as the leading reason patients seek medical care. Pain is also an extremely costly problem, with $635 billion per year spent nationally, more than cancer, heart disease and diabetes combined. The biomedical model of chronic pain management has largely revolved around the use of narcotic analgesics for pain control. Unfortunately, this corresponds to a growth in the rate of abuse, misuse and overdose of these drugs. Additionally, there is an inherent failure rate to the myriad procedures used …

Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan

Journal of Patient-Centered Research and Reviews

Background: Congestive heart failure afflicts 5.7 million people in the United States with annual incidence of 600,000 and mortality of 280,000. Heart failure accounts for greater than 1 million hospitalizations annually and the single largest inpatient Medicare expense. As the U.S. population ages and greater emphasis is placed on population health as a means to bend projected health care expenditures, large health care organizations will need to develop algorithms to identify patients at high risk with heart failure and possibly preempt hospitalizations. Doppler echocardiography is routinely performed in clinical assessment of severe heart failure.

Purpose: We sought to determine echocardiographic …

Maternal Intuition Of Fetal Gender, Michael P. Mcfadzen, David P. Dielentheis, Ronda Kasten

Journal of Patient-Centered Research and Reviews

Background: Many pregnant mothers feel they have a perception or intuition as to the gender of their unborn baby. There is very little published scientific literature regarding this topic. The study’s goal is to determine accuracy of mothers’ perceptions as to gender of their unborn babies. Many scientists believe a pregnant woman could not determine her baby’s gender by intuition, with a 50% probability of correctly determining the gender. This study should be considered fun science.

Purpose: To objectively measure a pregnant mother’s perception as to the gender of her unborn baby and compare to sonographically proved gender. The study …

Feasibility Of Atrial Delivery And Tracking Of Stem Cells In A Porcine Model, Nina Garlie, Timothy Hacker, Eric G. Schmuck, Jill Koch, Jayant Khitha, Amish Raval, Indrajit Choudhuri

Journal of Patient-Centered Research and Reviews

Background: Many patients undergoing open heart surgery have sinus node dysfunction and atrial fibrillation, leading to adverse outcomes. Mesenchymal stem cells (MSC) delivered at the time of surgery may have a reparative effect on atrial tissue, thereby improving sinus node function and reducing or preventing atrial fibrillation. Stem cell delivery to the atrium is entirely unstudied. This is a significant gap in medical research, as atrial disease contributes significantly to health care costs.

Purpose: The purpose of this pilot study is to establish a technique to deliver MSC to the atria through an open-chest model, to assess the safety of …

Investigating The Influences Of Language Delay And/Or Familial Risk For Dyslexia On Brain Structure In 5-Year-Olds, Nora Maria Raschle, Bryce Larkin Chessell Becker, Sara Smith, Lynn Valérie Fehlbaum, Yingying Wang, Nadine Gaab

Center for Brain, Biology, and Behavior: Faculty Publications

Early language delay has often been associated with atypical language/literacy development. Neuroimaging studies further indicate functional disruptions during language and print processing in school-age children with a retrospective report of early language delay. Behavioral data of 114 5-year-olds with a retrospective report of early language delay in infancy (N = 34) and those without (N = 80) and with a familial risk for dyslexia and those without are presented. Behaviorally, children with a retrospective report of early language delay exhibited reduced performance in language/reading-related measures. A voxel-based morphometry analysis in a subset (N = 46) demonstrated an association between reduced …

Mice Null For The Deubiquitinase Usp18 Spontaneously Develop Leiomyosarcomas, Fadzai Chinyengetere, David J. Sekula, Yun Lu, Andrew J. Giustini, Aarti Sanglikar, Masanori Kawakami, Tian Ma

Dartmouth Scholarship

USP18 (ubiquitin-specific protease 18) removes ubiquitin-like modifier interferon stimulated gene 15 (ISG15) from conjugated proteins. USP18 null mice in a FVB/N background develop tumors as early as 2 months of age. These tumors are leiomyosarcomas and thus represent a new murine model for this disease.

‘The Thing Is Not Knowing’: Patients' Perspectives On Surveillance Of An Indeterminate Pulmonary Nodule, Renda Soylemez Wiener, Michael K. Gould, Steven Woloshin, Lisa M. Schwartz, Jack Clark

Dartmouth Scholarship

Background: The hundreds of thousands of patients found to have a potentially malignant pulmonary nodule each year are faced with tremendous uncertainty regarding what the nodule is and how it should be evaluated.

Objective: To explore patients' responses to the detection and evaluation of a pulmonary nodule.

Role Of Acute Pain Service In Optimizing Postoperative Pain Relief In A Tertiary Care Teaching Hospital, Aliya Ahmed, Muhammad Yasir

Department of Anaesthesia

Objective: To assess the frequency and types of adjustments that acute pain service makes to postoperative analgesic regimes to improve pain relief or treat side effects.Methods: The prospective observational study was conducted at the Aga Khan University Hospital, Karachi, from December 1, 2012, to March 31, 2013. Data was collected from Acute Pain Service register four hours after the pain rounds by a Service member not involved in rounds. Data was collected on a standardised form and analysed using SPSS 19.Results: Of the 323 patients, 209(65%) were receiving epidural infusions and 114(35%) were receiving intravenous patient-controlled analgesia. Overall, 114(35%) required …

Partial Covariance Based Functional Connectivity Computation Using Ledoit-Wolf Covariance Regularization, Matthew R. Brier, Anish Mitra, John E. Mccarthy, Beau M. Ances, Abraham Z. Snyder

Mathematics Faculty Research

Highlights •We use the well characterized matrix regularization technique described by Ledoit and Wolf to calculate high dimensional partial correlations in fMRI data. •Using this approach we demonstrate that partial correlations reveal RSN structure suggesting that RSNs are defined by widely and uniquely shared variance. •Partial correlation functional connectivity is sensitive to changes in brain state indicating that they contain functional information. Functional connectivity refers to shared signals among brain regions and is typically assessed in a task free state. Functional connectivity commonly is quantified between signal pairs using Pearson correlation. However, resting-state fMRI is a multivariate process exhibiting a …

Alkali Therapy In Lactic Acidosis, Zeid J. Khitan, Md, Deepak Malhotra, Md, Dominic S. Raj, Md, Antonios H. Tzamaloukas, Md, Joseph I. Shapiro, Md

Marshall Journal of Medicine

This report attempts to frame the debate about clinical administration of sodium bicarbonate in the setting of lactic acidosis in terms of simple questions. Specifically, we address why we develop lactic acidosis in some circumstances, how acute lactic acidosis impairs cardiovascular function and why sodium bicarbonate may have deleterious effects which limit its utility. We also attempt to explore treatment alternatives to sodium bicarbonate.

Uplc Simultaneous Determination Of Empagliflozin, Linagliptin And Metformin, Bassam M. Ayoub

Pharmacy

© The Royal Society of Chemistry. The first UPLC method for simultaneous determination of empagliflozin, linagliptin and metformin hydrochloride in the different combinations of their pharmaceutical dosage forms was developed. Chromatographic separation was achieved on a Symmetry® Acclaim™ RSLC 120 C18 column (100 mm × 2.1 mm, 2.2 μm) applying isocratic elution based on potassium dihydrogen phosphate buffer pH (4)-methanol (50 : 50, v/v) as the mobile phase. The linearity, accuracy and precision were found to be acceptable over the concentration ranges of 1-32 μg mL-1, 0.5-16 μg mL-1 and 1-100 μg mL-1 for empagliflozin, linagliptin and metformin hydrochloride, respectively. …

Designing A Mobile Application To Support The Indicated Prevention And Early Intervention Of Childhood Anxiety, Mandar Patwardhan, Ashish Amresh, Ryan Stoll, Kevin A. Gary, Derek B. Hamel, Armando Pina

Publications

This paper presents the design of an mHealth application for prevention and early intervention of childhood anxiety. The application is based on REACH, a preventative-early intervention protocol for childhood anxiety. This paper describes the multidisciplinary design process, sharing lessons learned in developing an effective mHealth application. This mHealth application is unique due to participant age, preventive-early intervention focus, and utilization of mobile technology in a situated manner. A design process inspired by user-centered leveraging key informant interviews was used to identify application features, including game based strategies and an animated motivational avatar. Validation was performed through external review and a …

Real-Time Detection Of Breast Cancer Cells Using Peptidefunctionalized Microcantilever Arrays, Hashem Etayash, Keren Jiang, Sarfuddin Azmi, Thomas Thundat, Kamaljit Kaur

Pharmacy Faculty Articles and Research

Ligand-directed targeting and capturing of cancer cells is a new approach for detecting circulating tumor cells (CTCs). Ligands such as antibodies have been successfully used for capturing cancer cells and an antibody based system (CellSearch®) is currently used clinically to enumerate CTCs. Here we report the use of a peptide moiety in conjunction with a microcantilever array system to selectively detect CTCs resulting from cancer, specifically breast cancer. A sensing microcantilever, functionalized with a breast cancer specific peptide 18-4 (WxEAAYQrFL), showed significant deflection on cancer cell (MCF7 and MDA-MB-231) binding compared to when exposed to noncancerous (MCF10A and HUVEC) cells. …

Breast Cancer Rehabilitation: Clinical Examination And Outcomes Assessment, Nicole L. Stout, Shana Harrington, Lucinda Pfalzer, Mary Insana Fisher

Physical Therapy Faculty Publications

Breast cancer is the most commonly diagnosed cancer in women in the United States. The treatment for breast cancer occurs along a protracted time period and includes many different disease treatment modalities. These treatments carry with them a large number of adverse effects that negatively impact function in both the short term and long term. It is necessary for rehabilitation providers to interface with patients being treated for breast cancer throughout the continuum of care so that interval assessments can be conducted to identify emerging impairments and alleviate disability. To achieve this, the rehabilitation provider must have an understanding of …