Other Medical Sciences Commons^™

Safety Of Infliximab In Children With Ibd: The Experience Of An Academic Center In Wv, Michael Northcutt Md, Awni Al-Subu Md, Brooke Bella Rn, Yoram Elitsur Md

Biochemistry and Microbiology

BACKGROUND: The immune-modulating drug, infliximab, is approved for Inflammatory Bowel Disease (IBD) treatment in children. Chronic therapy with infliximab is associated with the development of early and delayed infusion reactions. We reviewed our experience with infliximab treatment and its side effects in a cohort of children diagnosed with IBD who were treated in our clinic.

METHODS: A retrospective analysis of all IBD children treated with infliximab in our center from 2006-2011 was performed. The demographic, chronological and clinical data were recorded. The infliximab infusion was given at 5mg/ kg according to a standard protocol after pre-treatment with low dose …

Impact Testing Of Youth-Level Helmets Versus College-Level Helmets, Nicole Hermann

Industrial Technology and Packaging

With so many studies being conducted on professional football players regarding concussions and other related brain injuries, it’s amazing that such an important demographic has been missed. While NFL players are just as subjected to serious injuries as anyone else or even more so, it is important to remember that these players are outfitted, in most cases, with top-of-the-line equipment -- especially their helmets. If the focus is shifted to a younger demographic, youth football players in middle school and high school, the equipment is far less advanced and in a vast majority of cases, has been previously used by …

Using Quantitative Disease Dynamics As A Tool For Guiding Response To Avian Influenza In Poultry In The United States Of America, K. M. Pepin, E. Spackman, J. D. Brown, K. L. Pabilonia, Lindsey P. Garber, J. Todd Weaver, D. A. Kennedy, Kelly A. Patyk, K. P. Huyvaert, Ryan S. Miller, Alan B. Franklin, Kerri Pedersen, T. L. Bogich, P. Rohani, Susan A. Shriner, Colleen T. Webb, S. Riley

USDA Wildlife Services: Staff Publications

Wild birds are the primary source of genetic diversity for influenza A viruses that eventually emerge in poultry and humans. Much progress has been made in the descriptive ecology of avian influenza viruses (AIVs), but contributions are less evident from quantitative studies (e.g., those including disease dynamic models). Transmission between host species, individuals and flocks has not been measured with sufficient accuracy to allow robust quantitative evaluation of alternate control protocols. We focused on the United States of America (USA) as a case study for determining the state of our quantitative knowledge of potential AIV emergence processes from wild hosts …

Does The Preparticipation Examination Aid In Identifying Future Risk Of Concussion?, Kassandra E. Johns

Electronic Theses and Dissertations

Context: A pre-participation examination (PPE) has become standard practice among the athletic community. This examination commonly includes a multifaceted baseline concussion assessment and an injury history survey. Recent evidence suggests that neuropsychological testing can aid in predicting individuals at an increased risk of lower extremity injury. However, no known previous study has investigated the relationship between neuropsychological function and potential risk of sustaining a concussion.

Objective: This study sought to identify a relationship between components of a standard PPE and an elevated risk of concussion.

Design: All data was extracted from the institution concussion database.

Setting: A large university in …

An Investigation Of Nurbs-Based Deformable Image Registration, Travis J. Jacobson

Theses and Dissertations

Deformable image registration (DIR) is an essential tool in medical image processing. It provides a means to combine image datasets, allowing for intra-subject, inter-subject, multi-modality, and multi-instance analysis, as well as motion detection and compensation. One of the most popular DIR algorithms models the displacement vector field (DVF) as B-splines, a sum of piecewise polynomials with coefficients that enable local shape control. B-splines have many advantageous properties in the context of DIR, but they often struggle to adequately model steep local gradients and discontinuities. This dissertation addresses that limitation by proposing the replacement of conventional B-splines with a generalized formulation …

The Role Of Microrna In Staphylococcal Enterotoxin B-Induced Inflammation And Acute Lung Injury, Roshni Rao

Theses and Dissertations

Staphylococcal enterotoxin B (SEB) is a potent activator of the Vβ8+T-cells leading to the proliferation of nearly 30% of the T-cell pool. As a consequence, excessive amounts of cytokine mediators are released leading to extensive tissue damage and sometimes toxic shock and death. Due to the ease with which SEB can be aerosolized anddisseminated, it is considered a biological weapon. In the current study, we investigated the pro-inflammatory effects of SEB in two mouse models of acute inflammatory lung injury. Specifically, while inflammatory cues are known to elicit changes in key transcriptional factors and gene expression, we explored for the …

Effects Of Cpla-2 On The Migration And Proliferation Of Human Vascular Smooth Muscle Cells And The 2-D Migratory Patterns Of Tropomyosin In Femoral And Abdominal Aorta Tissue, Jaimeson Thomas Powell

Theses and Dissertations

Abstract 1: Platelet derived growth factor BB (PDGF BB) has an important influence on smooth muscle cell proliferation in restenosis and atherosclerosis. Our understanding of different signal transduction pathways involved in the response of smooth muscle cells to PDGF BB is potentially significant for understanding and manipulating these processes. Prior studies have demonstrated a crucial activation of cytosolic phospholipase A2 (cPLA2) in smooth muscle cells to PDGF BB with the production of arachidonic acid and prostaglandin E2. In these studies we investigated the role for another PLA2, calcium-independent PLA2 (iPLA2) in comparison to cPLA2 on smooth muscle cell migration and …

Immobilizing Mutation In An Unconventional Myosin15a Affects Not Only The Structure Of Mechanosensory Stereocilia In The Inner Ear Hair Cells But Also Their Ionic Conductances, Diana Syam

Theses and Dissertations--Medical Sciences

In the inner and outer hair cells (OHCs) of the inner ear, an unconventional myosin 15a localizes at the tips of mechanosensory stereocilia and plays an important role in forming and maintaining their normal structure. A missense mutation makes the motor domain of myosin 15a dysfunctional and is responsible for the congenital deafness DFNB3 in humans and deafness and vestibular defects in Shaker-2 (Sh2) mouse model. All hair cells of homozygous Shaker-2 mice (Myo15^sh2/sh2) have abnormally short stereocilia, but, only stereocilia of Myo15^sh2/sh2OHCs start to degenerate after the first few days of postnatal development …

Primordium Of An Artificial Bruch's Membrane Made Of Nanofibers For Engineering Of Retinal Pigment Epithelium Cell Monolayers, Patrick Warnke, Mohammad Alamein, Stuart Skabo, Sebastien Stephens, Robert Bourke, Peter Heiner, Qin Liu

Qin Liu

Transplanted Retinal Pigment Epithelium(RPE) cells hold promise for treatment of Age-related Macular Degeneration(AMD) and Stargardt Disease(SD), but it is conceivable that the degenerated host Bruch's membrane(BM) as a natural substrate for RPE might not optimally support transplanted cell survival with correct cellular organization. We fabricated novel ultrathin 3-dimensional(3D) nanofibrous membranes from Collagen type I and poly(lactic-co-glycolic acid) (PLGA) by an advanced clinical-grade needle-free-electrospinning process. The nanofibrillar 3D networks highly mimicked the fibrillar architecture of the native inner collagenous layer of human BM. Human RPE cells grown on our nanofibrous membranes bore striking resemblance to native human RPE. They exhibited a …

Patient Risk And Data Standards In Healthcare Supply Chain, Paiman Farrokhvar

Graduate Theses and Dissertations

Patient safety is one of the most important health care challenges. It is a big concern since 1 in every 10 patients around the world is affected by healthcare errors. The focus of this study is given to preventable adverse events that caused by the errors or system flaw that could have been avoided. In this study, simulation models are developed using Arena to evaluate the impact of GS1 data standards on patient risk in healthcare supply chain. The focus was given to the provider hospital supply chain operations where inventory discrepancy and performance deficiencies in recall, return, and outdate …

Healthcare-Associated Infections-Is Targeting Zero A Global Reality?, Mary Lou Manning Phd, Crnp, Cic, Faan, Denise Murphy Rn, Mph, Cic, Faan

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Generating Hypotheses About Care Needs Of High Utilizers: Lessons From Patient Interviews., Dawn B Mautner, Hauchie Pang, Jeffrey C Brenner, Judy A Shea, Kennen S Gross, Rosemary Frasso, Carolyn C Cannuscio

Department of Family & Community Medicine Faculty Papers

Informed by a largely secondary and quantitative literature, efforts to improve care and outcomes for complex patients with high levels of emergency and hospital-based health care utilization have offered mixed results. This qualitative study identifies psychosocial factors and life experiences described by these patients that may be important to their care needs. Semi-structured interviews were conducted with 19 patients of the Camden Coalition of Healthcare Providers' Care Management Team. Investigators coded transcripts using a priori and inductively-derived codes, then identified 3 key themes: (1) Early-life instability and traumas, including parental loss, unstable or violent relationships, and transiency, informed many participants' …

A Standardized Patient Counseling Rubric For A Pharmaceutical Care And Communications Course, Niambi Horton Pharmd, Kenna D. Payne Pharmd, Michelle Jernigan Pharmd, Jill Frost Pharmd, Stephen Wise Pharmd, Mary Klein Pharmd, Joel Epps Mba, H. Glenn Anderson Pharmd

Pharmaceutical Science and Research

Objective. To restructure a required pharmaceutical care and communications course to place greater emphasis on communication skills and include a high-stakes assessment.

Design. A standardized counseling rubric was developed for use throughout the pharmacy curriculum and the counseling laboratory practicals were changed to high-stakes assessments.

Assessment. An annual mid-semester and end-of-semester high-stakes patient-counseling objective structured clinical examination (OSCE) conducted prior to and after revision of the course and counseling rubric documented improvements in students’ scores. Performance on the post-course annual assessment patient counseling OSCE improved compared to that on the pre-course (p,0.001).

Conclusion. The 2010 course revision improved …

Vitamin D Supplementation Practices During Pregnancy And Infancy Among A Sample Of Muslim Women In Ireland And Saudi Arabia, Imann Khadrawi

Masters

Vitamin D is a steroid hormone, a group of fat-soluble pro-hormones, which encourages the absorption and metabolism of calcium and phosphorous. The requirement for the nutrient is high at particular stages of the lifecycle especially during pregnancy and infancy. Severe vitamin D deficiency during pregnancy may increase the risk of developing preeclampsia and gestational diabetes in pregnancy and rickets in the child. While vitamin D supplementation has been a policy recommendation in Ireland since 2007, at the time of this study, it was not a policy recommendation in Saudi Arabia. The present quantitative cross-sectional survey was conducted to determine the …

Empowerment In Community-Based Participatory Research With Persons With Developmental Disabilities: Perspectives Of Community Researchers, Erin Elizabeth Stack

Dissertations and Theses

Community-based participatory research (CBPR) is a research approach that benefits from the expertise of community members being involved in the research along all stages of a project (Israel et al., 2003). CBPR is often utilized with marginalized populations in order to amplify a community's voice on important issues in their lives (Bastida, Tseng, McKeever, & Jack, 2010; Minkler & Wallerstein, 2008). In the past, persons with disability have been excluded from research in order to protect them from exploitation. This practice of exclusion undermines opportunities for persons with disabilities to be independent and make decisions that are important for themselves …

Effect Of Blood Collection Practices On Emergency Department Blood Specimen Rejection Rates, Barbara K. Vernoski

UNF Graduate Theses and Dissertations

The practice of obtaining blood as part of the placement of a new peripheral venous access device (p-VAD) is a frequent practice in the emergency department (ED). Of the concerns related to this practice is the possibility of laboratory specimen rejection due to p-VAD catheter size, use of the wrong collection device, and the absence of a standardized collection process. The objective of this study, therefore, was to examine the effect of the use of evidence-based venipuncture and p-VAD blood collection protocols on the rejection rate of blood specimens drawn by staff in the adult areas of an urban academic …

Evidence-Based Toxicology For The 21st Century: Opportunities And Challenges, Martin L. Stephens, Melvin E. Andersen, Richard A. Becker, Kellyn Betts, Kim Boekelheide, Ed Carney, Robert Chapin, Dennis Devlin, Suzanne C. Fitzpatrick, John R. Fowle Iii, Patricia Harlow, Thomas Hartung, Sebastian Hoffman, Michael P. Holsapple, Abigail Jacobs, Richard Judson, Olga Naidenko, Tim Pastoor, Grace Patlewicz, Andrew Rowan, Roberta Scherer, Rashid Shaikh, Ted Simon, Douglas Wolf, Joanne Zurlo

Toxicology and Animal Models in Research Collection

The Evidence-based Toxicology Collaboration (EBTC) was established recently to translate evidence-based approaches from medicine and health care to toxicology in an organized and sustained effort. The EBTC held a workshop on “Evidence-based Toxicology for the 21st Century: Opportunities and Challenges” in Research Triangle Park, North Carolina, USA on January 24-25, 2012. The presentations largely reflected two EBTC priorities: to apply evidence-based methods to assessing the performance of emerging pathwaybased testing methods consistent with the 2007 National Research Council report on “Toxicity Testing in the 21st Century” as well as to adopt a governance structure and work processes to move that …

Evaluation Of Polymer Gel Dosimeters For Measurements Of Dose And Let In Proton Beams, Kevin M. Vredevoogd

Dissertations & Theses (Open Access)

This project assessed the effectiveness of polymer gel dosimeters as tools for measuring the dose deposited by and LET of a proton beam. A total of three BANG® dosimeter formulations were evaluated: BANG®-3-Pro-2 BANGkits™ for dose measurement and two BANG®-3 variants, the LET-Baseline and LET-Meter dosimeters, for LET measurement. All dosimeters were read out using an OCT scanner. The basic characteristics of the BANGkits™ were assessed in a series of photon and electron irradiations. The dose-response relationship was found to be sigmoidal with a threshold for response of approximately 15 cGy. The active region of the dosimeter, the volume in …

Development And Implementation Of The Use Of Optically Stimulated Luminescent Detectors In The Radiological Physics Center Anthropomorphic Quality Assurance Phantoms, Jennelle Bergene

Dissertations & Theses (Open Access)

The Radiological Physics Center (RPC) uses both on-site and remote reviews to credential institutions for participation in clinical trials. Anthropomorphic quality assurance (QA) phantoms are one tool the RPC uses to remotely audit institutions, which include thermoluminescent dosimeters (TLDs) and radiochromic film. The RPC desires to switch from TLD as the absolute dosimeter in the phantoms, to optically stimulated luminescent dosimeters (OSLDs), but a problem lies in the angular dependence exhibited by the OSLD. The purpose of this study was to characterize the angular dependence of OSLD and establish a correction factor if necessary, to provide accurate dosimetric measurements as …

Development And Implementation Of A Remote Audit Tool For High Dose Rate (Hdr) 192ir Brachytherapy Using Optically Stimulated Luminescence Dosimetry, Kevin Casey

Dissertations & Theses (Open Access)

This work aimed to create a mailable and OSLD-based phantom with accuracy suitable for RPC audits of HDR brachytherapy sources at institutions participating in NCI-funded cooperative clinical trials. An 8 × 8 × 10 cm³ prototype with two slots capable of holding nanoDot Al₂O₃:C OSL dosimeters (Landauer, Glenwood, IL) was designed and built. The phantom has a single channel capable of accepting all ¹⁹²Ir HDR brachytherapy sources in current clinical use in the United States. Irradiations were performed with an ¹⁹²Ir HDR source to determine correction factors for linearity with dose, dose rate, …