Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Speckle-Tracking Echocardiographic Measures Of Right Ventricular Function Correlate With Improvement In Exercise Function After Percutaneous Pulmonary Valve Implantation., Shahryar M. Chowdhury, Ziyad M. Hijazi, John T. Fahey, John F. Rhodes, Saibal Kar, Raj Makkar, Michael Mullen, Qi-Ling Cao, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Speckle-tracking echocardiographic (STE) measures of right ventricular (RV) function appear to improve after transcatheter pulmonary valve implantation (TPVI). Measures of exercise function, such as ventilatory efficiency (the minute ventilation [VE]/carbon dioxide production [VCO2] slope), have been shown to be prognostic of mortality in patients who may require TPVI. The aim of this study was to evaluate the correlation between STE measures of RV function and changes in VE/VCO2 after TPVI.

METHODS: Speckle-tracking echocardiography and cardiopulmonary exercise testing were performed at baseline and 6 months after TPVI in 24 patients from four centers. Conventional echocardiographic measures of RV function were …

Track Extubation In Pediatric Congenital Heart Disease Open Heart Surgical Patients In Pakistan, Mohammad Irfan Akhtar

Department of Anaesthesia

No abstract provided.

Clinical Outcomes After Drug-Eluting Stents Versus Coronary Artery Bypass Surgery In High Surgical Risk Patients With Left Main Or Three-Vessel Coronary Artery Disease, Tonga Nfor, Kambiz Shetabi, Wael Hassan, Quinta Nfor, Jayant Khitha, Anjan Gupta, Tanvir Bajwa, Suhail Allaqaband

Journal of Patient-Centered Research and Reviews

Purpose

Previous studies comparing percutaneous coronary intervention (PCI) with coronary artery bypass graft surgery (CABG) in patients with unprotected left main or three-vessel coronary artery disease (LM-3VD) have excluded patients at high surgical risk. We compared clinical outcomes after PCI with drug-eluting stents to CABG in high surgical risk patients with LM-3VD.

Methods

Patients with symptomatic LM-3VD who had Society of Thoracic Surgeons (STS)-predicted operative mortality >5% and were undergoing either PCI with drug-eluting stents or CABG at a tertiary care center from January 2009 to December 2010 were enrolled in this nonrandomized prospective study.

Results

Mean STS score was …

Overview Of The Role Of Duplex Ultrasound For Treatment And Surveillance Of Peripheral Arterial Disease, John H. Fish Iii, Peter Klein-Weigel, Gustav Fraedrich

Journal of Patient-Centered Research and Reviews

Imaging strategies for preinterventional planning in symptomatic peripheral artery disease have employed various modalities ranging from duplex ultrasound to noninvasive angiography with computed tomography (CT) or magnetic resonance (MRA). These methods have classically been compared to the gold standard of digital subtraction angiography and are reviewed here in detail through the work of relevant published studies and meta-analyses between 1996 and 2014. In particular, we focus on the diagnostic performance, reproducibility and cost-effectiveness of these aforementioned modalities with respect to mapping the lower extremity arterial tree for planning vascular intervention and surveillance. The data presented suggests comparable sensitivity and specificity …

Use Of Coronary Techniques In Celiac And Hepatic Artery Stenting In Post-Hepatic Transplant Patients, Harpreet Parmar, Ryan Beard, Mark W. Mewissen, Armaan Shaikh, Tanvir Bajwa

Journal of Patient-Centered Research and Reviews

Hepatic artery stenosis (HAS) remains a rare but serious complication after liver transplantation. While invasive surgical techniques were needed for HAS treatment in the past, recently endovascular techniques, including hepatic artery stenting, have been proven to be a safe and effective treatment. The present work focused on a review of the recent literature regarding HAS as well as recent cases demonstrating the various presentations of HAS and the variety of approaches to endovascular intervention. Our single-center experience has shown endovascular treatment of HAS to be safe and effective, including the two specific cases discussed here. While further research is needed, …

Investigation In To The Effect Of Spin Locking On Contrast Agent Relaxivity, Julian Saunders Haigh

Dissertations and Theses

The current trend in magnetic resonance imaging (MRI) is towards higher external magnetic field strengths (B₀) to take advantage of increased sensitivity and signal to noise ratio (SNR). Unfortunately, as (B₀) increases the effectiveness (relaxivity) of clinical gadolinium (Gd³⁺⁾-based contrast agents (CAs) administered to enhance image contrast is significantly reduced. Excellent soft tissue contrast can be generated with current agents despite their non-optimum relaxivities but necessitates large doses. The limits of detection of a CA at high B₀ fields can be lowered by recovering the lost relaxivity and is a pre-requisite to the …

A Non-Invasive Method Of Measuring Respiration While Providing Wireless Power For Rodents With Implantable Devices, Jynx O. Boyne, Daniel J. Pederson, Zhi Wang, Pedro Irazoqui Dr.

The Summer Undergraduate Research Fellowship (SURF) Symposium

Respiratory measurements can be used as diagnostic and research tools. Spirometry is the gold standard for gaining these measurements, but is difficult to use in rodents as it requires an invasive procedure. Total Body Plethysmograpy (TBP) is a non-invasive way to measure respiration rates that does not cause stress to the rodent. In this system, the subject is encased in a solid, constant volume chamber with measurements determining the subject’s respiration. When using TBP in medical or research settings, challenges occur in powering devices within the TBP chamber as wires and other recording equipment compromise the airtightness of the chamber. …

Quantification Of Analyte Concentration From A Paper-Based Lateral Flow Assay Device Using Reflective Sensors, Megan Z. Chiu, Jacqueline Linnes

The Summer Undergraduate Research Fellowship (SURF) Symposium

Paper-based point-of-care (POC) diagnostics is a growing field in global health due to the extreme portability, accuracy, affordability, and ease of use of these tests. Advancements in recent years have led to more accurate detection and improved functionality using multistep molecular diagnostics. Many such assays utilize lateral flow detection strips for visualization of diagnostic results by eye, which limits the results to qualitative Yes/No readouts. This project focused on combining recent developments in paper-based POC diagnostics to develop and optimize an in-house built quantitative paper-based diagnostic reader for lateral flow detection in low-resource settings. Initially different sensors, including photocell sensors, …

Impact Of Standardized Oral Health Assessment On Preventing Ventilator-Associated Events, Juana Ambriz De Williams

Evidence-Based Practice Project Reports

Ventilator-associated pneumonia (VAP) is a common but preventable health-care associated infection that affects up to 20% of mechanically ventilated adult patients, resulting in estimated mortality rates ranging from 13% to 55% (Chahoud, Semaan, Almoosa, 2015; Melsen et al., 2013). In an effort to reduce morbidity, mortality and related costs, the Centers for Disease Control and Prevention (CDC) and the National Healthcare Safety Network (NHSN), proposed ventilator-associated pneumonia prevention as a national patient safety goal. In 2014, amid growing concerns that the subjectivity of existing definitions had led to inconsistent reporting, thereby impeding efforts to reduce VAP, the CDC refocused surveillance …

The Effectiveness Of Implementing Standard Of Care Best Practices Including Use Of Daily Incentive Spirometry To Improve Dyspnea And Quality Of Life In Adults With Chronic Obstructive Pulmonary Disease (Copd), Christine Gallagher

Doctor of Nursing Practice (DNP) Program

Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterized by symptoms of dyspnea, cough, and wheezing. Many patients with COPD are on daily medications for their symptoms yet these symptoms continue to persist, impairing their quality of life. Patients with COPD experience respiratory muscle weakness that contributes to dyspnea and an inability to participate in daily activities. GOLD (2014) guidelines state that the goal of therapy in these patients is to reduce symptoms, increase participation in activities, and restore the highest level of independent functioning. The guidelines recommend the use of inspiratory muscle training (IMT) in …

Kinematic And Kinetic Effects Of Alterations In Lumbar Lordosis In People With Tight Hamstrings, Dema Assaf

Theses and Dissertations (ETD)

The etiology of nonspecific low back pain is sparsely understood. To better understand the contributing factors to nonspecific low back pain, there are often common concurrent pathologies that are investigated to determine their functional relationship to low back pain. One such pathology, investigated further in this thesis, is tight hamstrings. Specifically, the effect of hamstring length on pelvic position during gait and activities of daily living under normal and altered spinal position were investigated as part of this study in a motion analysis lab.

First, a marker validation study was conducted to ensure the accuracy of sagittal spinal measures of …

Review Of Biomedical Čerenkov Luminescence Imaging Applications, Kaveh Tanha, Ali Mahmoud Pashazadeh, Brian W. Pogue

Dartmouth Scholarship

Čerenkov radiation is a fascinating optical signal, which has been exploited for unique diagnostic biological sensing and imaging, with significantly expanded use just in the last half decade. Čerenkov Luminescence Imaging (CLI) has desirable capabilities for niche applications, using specially designed measurement systems that report on radiation distributions, radiotracer and nanoparticle concentrations, and are directly applied to procedures such as medicine assessment, endoscopy, surgery, quality assurance and dosimetry. When compared to the other imaging tools such as PET and SPECT, CLI can have the key advantage of lower cost, higher throughput and lower imaging time. CLI can also provide imaging …

Adverse Effects Of Asparaginase In Pediatric Patients With Acute Lymphoblastic Leukemia, Chengcheng Liu

Theses and Dissertations (ETD)

Acute lymphoblastic leukemia (ALL) is the most common type of childhood cancer. Asparaginase is a critical treatment component for ALL. However, its use is complicated by adverse effects, such as hypersensitivity, osteonecrosis and pancreatitis.

Hypersensitivity to asparaginase typically requires discontinuation of current formulation and substitution with other formulations, but the differential diagnosis can be challenging, and the diagnostic utility of antibody tests is unclear. We comprehensively analyzed anti-Elspar (native E.coli asparaginase) IgG antibodies in 410 pediatric patients treated on an asparaginaseintensive front-line clinical trial. Of 169 patients (41.2%) who exhibited clinical allergy, 147 (87.0%) were positive for anti-Elspar antibody. Of …

Assessment Of Uncertainty In Planning And Dose Delivery Of Proton Therapy In An Iroc- Houston Qa Phantom Due To Variable Ct Technique And Proton Energy, Mattie M. Mcinnis

Dissertations and Theses (Open Access)

As proton therapy increases in popularity, so does the need for effective quality assurance. Proton therapy institutions participating in NCI funded clinical trials rely heavily on the credentialing and auditing services of IROC-H and therefore the process must be well understood. The purpose of this project is to understand the uncertainties in proton therapy treatment planning for the IROC-H proton phantom QA program due to variations in CT technique and proton energy. It was hypothesized that variations in CT technique and proton energy will alter the delivered dose distributions of typical proton treatments by reducing the percent of passing pixels …

Quantifying Measurement Error In Digital Instruments, William B. Laing Iii, Sean Bryant

Faculty Works

A first lab experiment clearly illustrates that a glucose meter is actually an excellent source of both random and systematic error, much to the surprise to students and physicians alike. A histogram is constructed and the utility of the standard deviation and standard error to quantify the uncertainty in each measurement and in the mean value, respectively, is demonstrated. From the first lab on, students are challenged to express and interpret confidence intervals in order to form quantitative conclusions. Assessments reveal that many students find this to be surprisingly challenging.

College Student Understanding Of Informed Consent Terminology, Kishore Garapati

Master's Theses and Doctoral Dissertations

A good, understandable informed consent form (ICF) is key to ethical medical research, and the ICF is necessary according to United States federal regulation. Since they may be written in complex technical language, ICFs are often difficult for subjects to understand. The purpose of this research was to evaluate students' understanding of terminology commonly used in the ICF. An online research survey was sent to active students of Eastern Michigan University (EMU) during the winter 2015 semester. Questions were asked to evaluate the students' understanding of the correct meaning of the terms used in medical research. The majority of students …

Characteristics Of A Novel Treatment System For Linear Accelerator–Based Stereotactic Radiosurgery, Ning Wen, Haisen Li, Kwang Song, Karen Chin-Snyder, Yujiao Qin, Jinkoo Kim, Maria Bellon, Misbah Gulam, Stephen Gardner, Anthony Doemer, Suneetha Devpura, James Gordon, Indrin Cherry, Farzan Siddiqui, Munther Ajlouni, Robert Pompa, Zane Hammoud, Michael Simoff, Steven Kalkanis, Benjamin Movsas, M. Salim Siddiqui

Internal Medicine Faculty Publications

The purpose of this study is to characterize the dosimetric properties and accuracy of a novel treatment platform (Edge radiosurgery system) for localizing and treating patients with frameless, image-guided stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). Initial measurements of various components of the system, such as a comprehensive assessment of the dosimetric properties of the flattening filter-free (FFF) beams for both high definition (HD120) MLC and conical cone-based treatment, positioning accuracy and beam attenuation of a six degree of freedom (6DoF) couch, treatment head leakage test, and integrated end-to-end accuracy tests, have been performed. The end-to-end test of the …

Increased Resting-State Functional Connectivity Of Visual- And Cognitive-Control Brain Networks After Training In Children With Reading Difficulties, Tzipi Horowitz-Kraus, Mark Difrancesco, Benjamin Kay, Yingying Wang, Scott K. Holland

Center for Brain, Biology, and Behavior: Faculty Publications

The Reading Acceleration Program, a computerized reading-training program, increases activation in neural circuits related to reading.We examined the effect of the training on the functional connectivity between independent components related to visual processing, executive functions, attention, memory, and language during rest after the training. Children 8–12 years old with reading difficulties and typical readers participated in the study. Behavioral testing and functional magnetic resonance imaging were performed before and after the training. Imaging data were analyzed using an independent component analysis approach. After training, both reading groups showed increased single-word contextual reading and reading comprehension scores. Greater positive correlations between …

Test-Retest Reliability Of The Sway Balance Mobile Application, Ryan Z. Amick, Alex Chaparro, Jeremy A. Patterson, Michael J. Jorgensen

Publications

The SWAY Balance Mobile Application is an FDA-cleared balance testing system which uses the built-in tri-axial accelerometers of a mobile electronic device to objectively assess postural movement. The system was designed to provide a means of quantitative balance assessment in clinical and on-field environments. The purpose of this study was to determine the intrasession and intersession reliability, as well as the minimum difference to be considered real, of the SWAY Balance Mobile Application.

Wirelessly Connected Sensor Acquisition System For Remote Nursing Applications, Yuhua Hu

Dissertations, Theses and Capstone Projects

Taking advantage of the equipment used in the "Remote Nursing" project, nurses can watch patients' status remotely. The equipment, which is installed in the patient's ward or home, can monitor them and their environment. This project demonstrates this using a microcontroller system that interfaces to a video camera and temperature and humidity sensors in the room. Also a servomotor is installed to control the position of the camera. The microcontroller communicates wirelessly with a PC.

This project is focused on hardware rather than software. It is to test the video camera and sensors being used over the microcontroller through the …