Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Rare Causes Of Gastrointestinal Hemorrhage: A Case Series Of Adult Duodenal And Jejunal Gastric Heterotopia, Venkata Vinod Matli, John Kirkikis, Gregory Wellman, Dustin Hadley, Ross M. Dies, David F. Dies

School of Medicine Faculty Publications

Gastric heterotopia (GH) is a rare cause of gastrointestinal bleeding. GH of the small bowel is rare, and the duodenum is more commonly involved than the jejunum. Here, we present five cases of GH involving the duodenum and jejunum, with presentations including gastrointestinal bleeding, symptomatic anemia, and no symptoms. A 63-year-old man presented with melenic stools but could not identify an obvious bleeding source during endoscopy. He was ultimately diagnosed with jejunal GH. A 70-year-old woman with melena and severe anemia had a duodenal bulb mass detected during endoscopy, which was histopathologically diagnosed as GH. A 54-year-old woman experienced nausea, …

Histopathology Imaging And Clinical Data Including Remission Status In Pediatric Inflammatory Bowel Disease, Chloe Martin-King, Ali Nael, Louis Ehwerhemuepha, Blake Calvo, Quinn Gates, Jamie Janchoi, Elisa Ornelas, Melissa Perez, Andrea Venderby, John Miklavcic, Peter Chang, Aaron Sassoon, Kenneth Grant

Food Science Faculty Articles and Research

The incidence of inflammatory bowel disease (IBD) is increasing annually. Children with IBD often suffer significant morbidity due to physical and emotional effects of the disease and treatment. Corticosteroids, often a component of therapy, carry undesirable side effects with long term use. Steroid-free remission has become a standard for care-quality improvement. Anticipating therapeutic outcomes is difficult, with treatments often leveraged in a trial-and-error fashion. Artificial intelligence (AI) has demonstrated success in medical imaging classification tasks. Predicting patients who will attain remission will help inform treatment decisions. The provided dataset comprises 951 tissue section scans (167 whole-slides) obtained from 18 pediatric …

Splenic Artery Embolization In The Treatment Of Blunt Splenic Injury: Single Level 1 Trauma Center Experience, Katelyn Gill, Sarah Aleman, Alexandra H. Fairchild, Bahri Üstünsöz, Dan Laney, Alison A. Smith, Hector Ferral

School of Medicine Faculty Publications

PURPOSE: To describe the experience of a single level 1 trauma center in the management of blunt splenic injuries (BSI). METHODS: This is a retrospective study with Institutional Review Board approval. The medical records of 450 patients with BSI treated between January 2016 and December 2022 were reviewed. Seventy-two patients were treated with splenic artery embolization (SAE), met the study criteria, and were eligible for data analysis. Spleen injuries were graded in accordance with the American Association for the Surgery of Trauma Organ Injury Scale. Univariate data analysis was performed, with P < 0.05 considered statistically significant. RESULTS: The splenic salvage rate was 90.3% (n = 65/72). Baseline demographics were similar between the groups (P > 0.05). Distal embolization with Gelfoam had similar rates …

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

Management Of Post-Extubation Dysphagia Using The Yale Swallow Protocol, Nicole West

Dissertations

Abstract

Problem: Post extubation dysphagia (PED) increases the patient’s risk for long term complications contributing to increased healthcare cost. Intensive care settings rarely use standardized swallow screening assessments for patients post extubation leading to variation in the evaluation of PED. Variation in the assessment of swallowing post extubation can lead to the missed diagnosis of patients with dysphagia.

Methods: This quality improvement (QI) project was a prospective cohort study implementing an evidence-based swallow screening protocol, the Yale Swallow Protocol (YSP), in an intensive care unit. This study was conducted over four months, which included a pre survey, education, implementation, and …

Toward The Development Of A Pan-Lyssavirus Vaccine, Sabrine Ben Hamed, Jacob Myers, Anisha Chandwani, Christoph Wirblich, Drishya Kurup, Nir Paran, Matthias Schnell

Department of Microbiology and Immunology Faculty Papers

In addition to the rabies virus (RABV), 16 more lyssavirus species have been identified worldwide, causing a disease similar to RABV. Non-rabies-related human deaths have been described, but the number of cases is unknown, and the potential of such lyssaviruses causing human disease is unpredictable. The current rabies vaccine does not protect against divergent lyssaviruses such as Mokola virus (MOKV) or Lagos bat virus (LBV). Thus, a more broad pan-lyssavirus vaccine is needed. Here, we evaluate a novel lyssavirus vaccine with an attenuated RABV vector harboring a chimeric RABV glycoprotein (G) in which the antigenic site I of MOKV replaces …

Discordant Prenatal Cell-Free Dna Screening Vs. Diagnostic Results Of Sex Chromosome Aneuploidies: Implications For Newborn Screening And Genetic Counseling, Susan Howell, Shanlee M. Davis, Billie Carstens, Mary Haag, Judith L. Ross, Nicole R. Tartaglia

Department of Pediatrics Faculty Papers

Sex chromosome aneuploidies (SCAs) collectively occur in 1 in 500 livebirths, and diagnoses in the neonatal period are increasing with advancements in prenatal and early genetic testing. Inevitably, SCA will be identified on either routine prenatal or newborn screening in the near future. Tetrasomy SCAs are rare, manifesting more significant phenotypes compared to trisomies. Prenatal cell-free DNA (cfDNA) screening has been demonstrated to have relatively poor positive predictive values (PPV) in SCAs, directing genetic counseling discussions towards false-positive likelihood rather than thoroughly addressing all possible outcomes and phenotypes, respectively. The eXtraordinarY Babies study is a natural history study of children …

Comprehensive Considerations For Dermatologists: The Application Of Fdg-Pet In Evaluating Cutaneous Lesions In Pediatric Langerhans Cell Histiocytosis, Sahithi Talasila, Eric M. Teichner, Robert C. Subtirelu, Naga Chaitanya P. Talasila, Sricharvi Mannam, Thomas Werner, Abass Alavi, Mona-Elisabeth Revheim

Student Papers, Posters & Projects

Langerhans cell histiocytosis (LCH) is a complex disorder characterized by the clonal proliferation of Langerhans cells, primarily affecting children and adolescents. This condition exhibits a wide spectrum of clinical presentations, necessitating a multidisciplinary approach for diagnosis, treatment, and follow-up. Cutaneous manifestations of LCH are significant, mimicking common dermatoses and posing diagnostic challenges. [18F]Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) has emerged as an important tool in the evaluation of pediatric LCH, offering insights into disease activity, extent, and therapeutic response. Moreover, FDG-PET provides a non-invasive means to distinguish between active LCH skin lesions and other dermatological conditions with similar clinical appearances, enhancing diagnostic …

Electrocautery Wire Fenestration Prior To Thoracic Endovascular Aortic Repair To Optimize The Distal Landing Zone In Thoracic Aortic Dissections, Nicola Habash, Gaurang Joshi, Mohammed Ali, Michael Nooromid, Babak Abai

Department of Surgery Faculty Papers

Successful thoracic endovascular aortic repair (TEVAR) for type B aortic dissections (TBAD) relies on securing the stentgraft’s distal landing zone to prevent retrograde flow and false lumen pressurization. We describe a 60-year- old male with a TBAD undergoing TEVAR with electrocautery-wire fenestration of the dissection septum, providing a controlled method to enhance the distal landing zone for graft placement. Postoperatively, the patient experienced spinal cord ischemia, resolving with the placement of a lumbar drain and increasing mean arterial pressures. Follow-up imaging demonstrated a well-sealed repair without endoleaks. This case highlights the importance of surgical technique selection and postoperative monitoring for …

Application Of Histopathology Image Analysis Using Deep Learning Networks, Md Shamim Hossain, Leisa J. Armstrong, David M. Cook, Pauline Zaenker

Research outputs 2022 to 2026

As the rise in cancer cases, there is an increasing demand to develop accurate and rapid diagnostic tools for early intervention. Pathologists are looking to augment manual analysis with computer-based evaluation to develop more efficient cancer diagnostics reports. The processing of these reports from manual evaluation is time-consuming, where the pathologists focus on accurately segmenting individual cancer cells, a vital step in analysis. This paper describes the design and validation of an application which has been developed based on deep learning networks. The application includes a workflow of image pre-processing followed by synthetic image generation, which is crucial due to …

Celecoxib-Tramadol Co-Crystal In Patients With Moderate-To-Severe Pain Following Bunionectomy With Osteotomy: Secondary Analyses By Baseline Pain Intensity And Use Of Rescue Medication Of A Phase 3, Randomized, Double-Blind, Factorial, Active- And Placebo-Controlled Trial, Eugene R. Viscusi, Oscar De Leon-Casasola, Jesús Cebrecos, Adam Jacobs, Adelaida Morte, Esther Ortiz, Mariano Sust, Anna Vaqué, Ira Gottlieb, Stephen Daniels, Derek Muse, Michael E. Kuss, Sebastián Videla, Neus Gascón, Carlos Plata-Salamán

Department of Anesthesiology Faculty Papers

BACKGROUND: In the randomized, phase 3, SUSA-301 trial, celecoxib-tramadol co-crystal (CTC) provided significantly greater analgesia compared with celecoxib, tramadol, or placebo in adults with acute, moderate-to-severe, postoperative pain. This post hoc, secondary analysis further evaluated the use of rescue medication and the incidence of treatment-emergent adverse events (TEAEs).

METHODS: Patients (N = 637) were randomized 2:2:2:1 to receive oral CTC 200 mg twice daily (BID; n = 184), tramadol 50 mg four times daily (QID; n = 183), celecoxib 100 mg BID (n = 181), or placebo QID (n = 89). Post hoc analyses were conducted on the use of …

Emerging Treatments And Therapies For Autism Spectrum Disorder: A Narrative Review, Alan D. Kaye, Kaitlyn E. Allen, Van S. Smith Iii, Victoria T. Tong, Vivian E. Mire, Huy Nguyen, Zachary Lee, Maria Kouri, Carlo Jean Baptiste, Chizoba N. Mosieri, Adam M. Kaye, Giustino Varrassi, Sahar Shekoohi

School of Medicine Faculty Publications

The prevalence of autism spectrum disorder (ASD) has increased over the last decade. In this regard, many emerging therapies have been described as ASD therapies. Although ASD does not have a cure, there are several management options available that can help reduce symptom severity. ASD is highly variable and, therefore, standard treatment protocols and studies are challenging to perform. Many of these therapies also address comorbidities for which patients with ASD have an increased risk. These concurrent diagnoses can include psychiatric and neurological disorders, including attention deficit and hyperactivity disorder, anxiety disorders, and epilepsy, as well as gastrointestinal symptoms such …

Auxiliary Diagnosis Of Dental Calculus Based On Deep Learning And Image Enhancement By Bitewing Radiographs, Tai Jung Lin, Yen Ting Lin, Yuan Jin Lin, Ai Yun Tseng, Chien Yu Lin, Li Ting Lo, Tsung Yi Chen, Shih Lun Chen, Chiung An Chen, Kuo Chen Li, Patricia Angela R. Abu

Ateneo Laboratory for Intelligent Visual Environments

In the field of dentistry, the presence of dental calculus is a commonly encountered issue. If not addressed promptly, it has the potential to lead to gum inflammation and eventual tooth loss. Bitewing (BW) images play a crucial role by providing a comprehensive visual representation of the tooth structure, allowing dentists to examine hard-to-reach areas with precision during clinical assessments. This visual aid significantly aids in the early detection of calculus, facilitating timely interventions and improving overall outcomes for patients. This study introduces a system designed for the detection of dental calculus in BW images, leveraging the power of YOLOv8 …

Using Machine Learning To Determine A Functional Classifier Of Reward Responsiveness And Its Association With Adolescent Psychiatric Symptomatology, Robert James Richard Blair, Johannah Bashford-Largo, Ahria Dominguez, Matthew Dobbertin, Karina S. Blair, Sahil Bajaj

Center for Brain, Biology, and Behavior: Faculty Publications

Background. Machine learning (ML) has developed classifiers differentiating patient groups despite concerns regarding diagnostic reliability. An alternative strategy, used here, is to develop a functional classifier (hyperplane) (e.g. distinguishing the neural responses to received reward v. received punishment in typically developing (TD) adolescents) and then determine the functional integrity of the response (reward response distance from the hyperplane) in adolescents with externalizing and internalizing conditions and its associations with symptom clusters.

Methods. Two hundred and ninety nine adolescents (mean age = 15.07 ± 2.30 years, 117 females) were divided into three groups: a training sample of TD adolescents …

Second Language Learning In Older Adults Modulates Stroop Task Performance And Brain Activation, Douglas H. Schultz, Alison Gansemer, Kiley Allgood, Mariah Gentz, Lauren Secilmis, Zoha Deldar, Cary R. Savage, Ladan Ghazi Saidi

Center for Brain, Biology, and Behavior: Faculty Publications

Introduction: Numerous studies have highlighted cognitive benefits in lifelong bilinguals during aging, manifesting as superior performance on cognitive tasks compared to monolingual counterparts. Yet, the cognitive impacts of acquiring a new language in older adulthood remain unexplored. In this study, we assessed both behavioral and fMRI responses during a Stroop task in older adults, pre- and post language-learning intervention.

Methods: A group of 41 participants (age: 60–80) from a predominantly monolingual environment underwent a four-month online language course, selecting a new language of their preference. This intervention mandated engagement for 90 minutes a day, five days a week. …

Ocular Gene Transfer In The Spotlight: Implications Of Newspaper Content For Clinical Communications, Shelly Benjaminy, Tania M. Bubela

Office of the Provost

Background: Ocular gene transfer clinical trials are raising hopes for blindness treatments and attracting media attention. News media provide an accessible health information source for patients and the public, but are often criticized for overemphasizing benefits and underplaying risks of novel biomedical interventions. Overly optimistic portrayals of unproven interventions may influence public and patient expectations; the latter may cause patients to downplay risks and over-emphasize benefits, with implications for informed consent for clinical trials. We analyze the news media communications landscape about ocular gene transfer and make recommendations for improving communications between clinicians and potential trial participants in light of …

Sexual Well-Being And High-Risk Behaviors : An Exploratory Mixed Methods Study For Questionnaire Development, Stephan R Smith

Covenant Nurses Week 2024

No abstract provided.

Ekg Is Key: A Quality Improvement Project To Decrease Door-To-Ekg Time In A Rural Emergency Department, Amanda Southwell

Doctor of Nursing Practice Projects

Background: Electrocardiograms (EKGs) are the priority when evaluating patients with chest pain who present to the Emergency Department (ED). The American Heart Association and other governing bodies suggest a 10-minute door-to-EKG (DTE) time. The target facility displayed a delay in DTE times.

Purpose: The Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to decrease the average DTE time for patients over 18 years old with chest pain who presented to the ED registration area.

Methods: The DNP project consisted of an EKG suite to perform EKGs near the ED registration/triage area. Registration and ED staff were educated on …

Financial Incentives For Smoking Cessation Among Socioeconomically Disadvantaged Adults: A Randomized Clinical Trial, Darla Kendzor, Michael Businelle, Summer Frank-Pearce, Joseph Waring, Sixia Chen, Emily Hébert, Michael Swartz, Adam Alexander, Munjireen Sifat, Laili Kharazi Boozary, David Wetter

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Socioeconomically disadvantaged individuals (ie, those with low socioeconomic status [SES]) have difficulty quitting smoking and may benefit from incentive-based cessation interventions.

OBJECTIVES: To evaluate the impact of incentivizing smoking abstinence on smoking cessation among adults with low SES.

DESIGN, SETTING, AND PARTICIPANTS: This study used a 2-group randomized clinical trial design. Data collection occurred between January 30, 2017, and February 7, 2022. Participants included adults with low SES who were willing to undergo smoking cessation treatment. Data were analyzed from April 18, 2023, to April 19, 2024.

INTERVENTIONS: Participants were randomized to usual care (UC) for smoking cessation (counseling …

Data-Driven Drug Repurposing For Immune System-Related Diseases, Sabyasachi Mohanty

Department of Biochemistry: Dissertations, Theses, and Student Research

In this research, we explore a data-driven approach for drug repurposing to enhance the immunomodulatory effect by integrating pattern-based search and genome-scale metabolic modeling. This research helps to find a solution to the preexisting problems of drug discovery which includes expenses and a high amount of time consumption. By leveraging the pre-existing data of the approved drugs to identify the major metabolic pathway changes, we can find new drugs with similar effects with less off-target effects.

The focus on the immune system modulating drugs is due to the high prevalence of immune system-involved diseases and the growing demand for effective …