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- Creators: School of Life Sciences
Description
For more than twenty years, clinical researchers have been publishing data regarding incidence and risk of adverse events (AEs) incurred during hospitalizations. Hospitals have standard operating policies and procedures (SOPP) to protect patients from AE. The AE specifics (rates, SOPP failures, timing and risk factors) during heart failure (HF) hospitalizations are unknown. There were 1,722 patients discharged with a primary diagnosis of HF from an academic hospital between January 2005 and December 2007. Three hundred eighty-one patients experienced 566 AEs, classified into four categories: medication (43.9%), infection (18.9%), patient care (26.3%), or procedural (10.9%). Three distinct analyses were performed: 1) patient's perspective of SOPP reliability including cumulative distribution and hazard functions of time to AEs; 2) Cox proportional hazards model to determine independent patient-specific risk factors for AEs; and 3) hospital administration's perspective of SOPP reliability through three years of the study including cumulative distribution and hazard functions of time between AEs and moving range statistical process control (SPC) charts for days between failures of each type. This is the first study, to our knowledge, to consider reliability of SOPP from both the patient's and hospital administration's perspective. AE rates in hospitalized patients are similar to other recently published reports and did not improve during the study period. Operations research methodologies will be necessary to improve reliability of care delivered to hospitalized patients.
ContributorsHuddleston, Jeanne (Author) / Fowler, John (Thesis advisor) / Montgomery, Douglas C. (Thesis advisor) / Gel, Esma (Committee member) / Shunk, Dan (Committee member) / Arizona State University (Publisher)
Created2012
Description
Mathematical modeling and decision-making within the healthcare industry have given means to quantitatively evaluate the impact of decisions into diagnosis, screening, and treatment of diseases. In this work, we look into a specific, yet very important disease, the Alzheimer. In the United States, Alzheimer’s Disease (AD) is the 6th leading cause of death. Diagnosis of AD cannot be confidently confirmed until after death. This has prompted the importance of early diagnosis of AD, based upon symptoms of cognitive decline. A symptom of early cognitive decline and indicator of AD is Mild Cognitive Impairment (MCI). In addition to this qualitative test, Biomarker tests have been proposed in the medical field including p-Tau, FDG-PET, and hippocampal. These tests can be administered to patients as early detectors of AD thus improving patients’ life quality and potentially reducing the costs of the health structure. Preliminary work has been conducted in the development of a Sequential Tree Based Classifier (STC), which helps medical providers predict if a patient will contract AD or not, by sequentially testing these biomarker tests. The STC model, however, has its limitations and the need for a more complex, robust model is needed. In fact, STC assumes a general linear model as the status of the patient based upon the tests results. We take a simulation perspective and try to define a more complex model that represents the patient evolution in time.
Specifically, this thesis focuses on the formulation of a Markov Chain model that is complex and robust. This Markov Chain model emulates the evolution of MCI patients based upon doctor visits and the sequential administration of biomarker tests. Data provided to create this Markov Chain model were collected by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. The data lacked detailed information of the sequential administration of the biomarker tests and therefore, different analytical approaches were tried and conducted in order to calibrate the model. The resulting Markov Chain model provided the capability to conduct experiments regarding different parameters of the Markov Chain and yielded different results of patients that contracted AD and those that did not, leading to important insights into effect of thresholds and sequence on patient prediction capability as well as health costs reduction.
The data in this thesis was provided from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). ADNI investigators did not contribute to any analysis or writing of this thesis. A list of the ADNI investigators can be found at: http://adni.loni.usc.edu/about/governance/principal-investigators/ .
Specifically, this thesis focuses on the formulation of a Markov Chain model that is complex and robust. This Markov Chain model emulates the evolution of MCI patients based upon doctor visits and the sequential administration of biomarker tests. Data provided to create this Markov Chain model were collected by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. The data lacked detailed information of the sequential administration of the biomarker tests and therefore, different analytical approaches were tried and conducted in order to calibrate the model. The resulting Markov Chain model provided the capability to conduct experiments regarding different parameters of the Markov Chain and yielded different results of patients that contracted AD and those that did not, leading to important insights into effect of thresholds and sequence on patient prediction capability as well as health costs reduction.
The data in this thesis was provided from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). ADNI investigators did not contribute to any analysis or writing of this thesis. A list of the ADNI investigators can be found at: http://adni.loni.usc.edu/about/governance/principal-investigators/ .
ContributorsCamarena, Raquel (Author) / Pedrielli, Giulia (Thesis advisor) / Li, Jing (Thesis advisor) / Wu, Teresa (Committee member) / Arizona State University (Publisher)
Created2018
Description
Students Organize for Syria (SOS) is the student led initiative for Syria. With 18 registered chapters across the United States, this student organization is targeting a multidimensional cause by different means. Though it is now a national movement, it started off with one group at Arizona State University, with one student. Zana Alattar, founder and student director of SOS, tells the story of how she took an ASU organization, Save Our Syrian Freedom (SOS Freedom), to the national level as SOS. As a pre-medical student, she also combines her work in human rights with her future in healthcare. After all, health and human rights have long maintained a synergistic relationship.
ContributorsAlattar, Zana (Author) / Graff, Sarah (Thesis director) / McClurg, Sharolyn (Committee member) / School of Molecular Sciences (Contributor) / School of Social Transformation (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Human subject research is a sensitive ethical topic in today's society, and with good cause. The history of human subject research is full of tragedy and wrongdoing, which is what has led to the firm restrictions we presently have. At the same time, we also acknowledge the value behind human subject research and the information science can obtain from such endeavors. This project analyzes this conundrum through a narrative describing a group of scientists who choose to ignore some of the laws and regulations concerning human subject research in order to pursue neurological based research for a "greater good." In the novella, the scientists end up harming several people while performing their illegal research, but are able to obtain successful results. However, the group is eventually caught, and end up having to face the consequences of their actions. The situations and interactions the story presents are meant to juxtapose both sides of the human subject research ethical argument in a unique way in order to allow the reader to critically think through the argument themselves and form their own opinions on the matter.
ContributorsPirotte, Benjamin Daniel (Author) / Finn, Edward (Thesis director) / Cook, Paul (Committee member) / McGregor, Joan (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / School of Historical, Philosophical and Religious Studies (Contributor)
Created2015-05
Description
In this study, we propose and then assess the efficacy of a new approach to static suspension to correct for facial paralysis. Our method involves placing barbed sutures through the superficial muscular aponeurotic system (SMAS) and anchoring them in the temporal fascia parallel to the underlying facial muscles. We first analyzed the ability of this procedure to improve facial symmetry by comparing the degree of asymmetry between the paralyzed and unaffected sides of a patient's face (N=10) prior to and following surgery. Then, to determine if symmetry is improved as a result of placing the sutures parallel to the direction of facial muscle forces, we measured the vectors of levator labii superioris and zygomaticus major in cadaver hemifaces (N=3) and compared them to the angles of the vectors of correction from the patient sample to angles of muscle vectors in three facial hemispheres from cadaver controls. Results indicate that: (1) facial symmetry was significantly improved in these patients and (2) this improvement. We conclude that, compared to existing protocols, our novel surgical method is a better means of static suspension for reconstruction following onset of facial paralysis as it is simple to perform, easy to replicate, able to be post-operatively adjusted in-office, has a good long-term prognosis, and, as we have demonstrated, effectively corrects the appearance of asymmetry by working with the underlying facial anatomy.
ContributorsLeach, Garrison Alecsander (Co-author) / Joganic, Jessica (Co-author) / Hooft, Nicole (Co-author) / Joganic, Edward (Co-author, Committee member) / Foy, Joseph (Thesis director) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Curative arts and art therapy have been increasingly implicated in promoting health and well-being for patients, but little research has been done for the benefits of drawing therapy for stress management or individuals in a non-diseased state. College students and healthcare professionals are particularly susceptible to high levels of stress, as I experienced firsthand as a medical scribe in the Emergency Room during my undergraduate experience. For this reason, I wanted to focus on using curative arts as a mediator for high-stress situations. My creative project is therefore a portable framework for curative drawing. The framework is designed to help people process complex emotional states in a more effective way using mark-making and color. Specifically, the framework is designed for those who have limited experience with art making but can be used by anyone who feels a need for curative drawing. I used this framework in both individual and group settings, culminating in a final gallery show in which viewers were able to participate in the framework and take home a booklet with the framework printed inside. In conjunction with outside research, the help of my thesis committee, and the students of Drawing and Painting as Seeing and Thinking, the final project can be viewed as one part of the intersection between art and medicine in our ever-changing healthcare environment.
ContributorsCadigan, Megan Sierra (Author) / Button, Melissa (Thesis director) / Belgrave, Melita (Committee member) / School of Art (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Influenza is a deadly disease for which effective vaccines are sorely lacking. This is largely due to the phenomena of antigenic shift and drift in the influenza virus's surface proteins, hemagglutinin (HA) and neuraminidase (NA). The ectodomain of the matrix 2 protein (M2e) of influenza A, however, has demonstrated high levels of conservation. On its own it is poorly immunogenic and offers little protection against influenza infections, but by combining it with a potent adjuvant, this limitation may be overcome. Recombinant immune complexes, or antigens fused to antibodies that have been engineered to form incredibly immunogenic complexes with one another, were previously shown to be useful, immunogenic platforms for the presentation of various antigens and could provide the boost in immunogenicity that M2e needs to become a powerful universal influenza A vaccine. In this thesis, genetic constructs containing geminiviral replication proteins and coding for a consensus sequence of dimeric M2e fused to antibodies featuring complimentary epitopes and epitope tags were generated and used to transform Agrobacterium tumefaciens. The transformed bacteria was then used to cause Nicotiana benthamiana to transiently express M2e-RICs at very high levels, with enough RICs being gathered to evaluate their potency in future mouse trials. Future directions and areas for further research are discussed.
ContributorsFavre, Brandon Chetan (Author) / Mason, Hugh (Thesis director) / Mor, Tsafrir (Committee member) / Diamos, Andrew (Committee member) / Department of Psychology (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
The current Enterprise Requirements and Acquisition Model (ERAM), a discrete event simulation of the major tasks and decisions within the DoD acquisition system, identifies several what-if intervention strategies to improve program completion time. However, processes that contribute to the program acquisition completion time were not explicitly identified in the simulation study. This research seeks to determine the acquisition processes that contribute significantly to total simulated program time in the acquisition system for all programs reaching Milestone C. Specifically, this research examines the effect of increased scope management, technology maturity, and decreased variation and mean process times in post-Design Readiness Review contractor activities by performing additional simulation analyses. Potential policies are formulated from the results to further improve program acquisition completion time.
ContributorsWorger, Danielle Marie (Author) / Wu, Teresa (Thesis director) / Shunk, Dan (Committee member) / Wirthlin, J. Robert (Committee member) / Industrial, Systems (Contributor) / Barrett, The Honors College (Contributor)
Created2013-05
Description
The medical field is one that depends on human interaction. I have noticed through my love of both English Literature and Medicine that one of the best ways to connect people, is by sharing their stories. To accomplish this, I interviewed eleven physicians to understand their human story. From those interviews, I worked to emulate their voices, to create a chapter for each of them. Through this, I was able to understand what they personally went through to get to where they are today. This has allowed me to better understand the field I plan to be in.
ContributorsAgha, Iya A (Author) / Lussier, Mark (Thesis director) / Essary, Alison (Committee member) / Department of English (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
While the transition from sectarian to allopathic medicine was almost entirely beneficial due to our perceived value in the type of evidence and transparency that science provides, key values within sectarian practice were lost in this transition. Attention to these values helps us better understand the role and treatment of patients in modern medicine. Modern scientific physicians have proven the inefficacy of sectarian treatments by scientific practices, but the efficacy of exact sectarian remedies may not have bearing on the importance of sectarian values. These values were: medical simplicity, harmlessness in treatment, independence from physicians and accessibility of treatment. A more in-depth analysis of sectarian values allows us to understand that while the values of allopathic medicine have become ubiquitous, it has not always been that way. It is time to consider the validity in the sectarian values we have abandoned; this analysis was one of many on medicine's imminent developmental horizon. This realization allows us to call into question the importance of our current practicing values, and the necessity that they continue to stand alone.
ContributorsAyala, Erik Richard (Author) / Brian, Jennifer (Thesis director) / Ross, Christian (Committee member) / Department of Psychology (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05