Matching Items (17)
Description
Medical students acquire and enhance their clinical skills using various available techniques and resources. As the health care profession has move towards team-based practice, students and trainees need to practice team-based procedures that involve timely management of clinical tasks and adequate communication with other members of the team. Such team-based procedures include surgical and clinical procedures, some of which are protocol-driven. Cost and time required for individual team-based training sessions, along with other factors, contribute to making the training complex and challenging. A great deal of research has been done on medically-focused collaborative virtual reality (VR)-based training for protocol-driven procedures as a cost-effective as well as time-efficient solution. Most VR-based simulators focus on training of individual personnel. The ones which focus on providing team training provide an interactive simulation for only a few scenarios in a collaborative virtual environment (CVE). These simulators are suited for didactic training for cognitive skills development. The training sessions in the simulators require the physical presence of mentors. The problem with this kind of system is that the mentor must be present at the training location (either physically or virtually) to evaluate the performance of the team (or an individual). Another issue is that there is no efficient methodology that exists to provide feedback to the trainees during the training session itself (formative feedback). Furthermore, they lack the ability to provide training in acquisition or improvement of psychomotor skills for the tasks that require force or touch feedback such as cardiopulmonary resuscitation (CPR). To find a potential solution to overcome some of these concerns, a novel training system was designed and developed that utilizes the integration of sensors into a CVE for time-critical medical procedures. The system allows the participants to simultaneously access the CVE and receive training from geographically diverse locations. The system is also able to provide real-time feedback and is also able to store important data during each training/testing session. Finally, this study also presents a generalizable collaborative team-training system that can be used across various team-based procedures in medical as well as non-medical domains.
ContributorsKhanal, Prabal (Author) / Greenes, Robert (Thesis advisor) / Patel, Vimla (Thesis advisor) / Smith, Marshall (Committee member) / Gupta, Ashish (Committee member) / Kaufman, David (Committee member) / Arizona State University (Publisher)
Created2014
Description
The rate of progress in improving survival of patients with solid tumors is slow due to late stage diagnosis and poor tumor characterization processes that fail to effectively reflect the nature of tumor before treatment or the subsequent change in its dynamics because of treatment. Further advancement of targeted therapies relies on advancements in biomarker research. In the context of solid tumors, bio-specimen samples such as biopsies serve as the main source of biomarkers used in the treatment and monitoring of cancer, even though biopsy samples are susceptible to sampling error and more importantly, are local and offer a narrow temporal scope.
Because of its established role in cancer care and its non-invasive nature imaging offers the potential to complement the findings of cancer biology. Over the past decade, a compelling body of literature has emerged suggesting a more pivotal role for imaging in the diagnosis, prognosis, and monitoring of diseases. These advances have facilitated the rise of an emerging practice known as Radiomics: the extraction and analysis of large numbers of quantitative features from medical images to improve disease characterization and prediction of outcome. It has been suggested that radiomics can contribute to biomarker discovery by detecting imaging traits that are complementary or interchangeable with other markers.
This thesis seeks further advancement of imaging biomarker discovery. This research unfolds over two aims: I) developing a comprehensive methodological pipeline for converting diagnostic imaging data into mineable sources of information, and II) investigating the utility of imaging data in clinical diagnostic applications. Four validation studies were conducted using the radiomics pipeline developed in aim I. These studies had the following goals: (1 distinguishing between benign and malignant head and neck lesions (2) differentiating benign and malignant breast cancers, (3) predicting the status of Human Papillomavirus in head and neck cancers, and (4) predicting neuropsychological performances as they relate to Alzheimer’s disease progression. The long-term objective of this thesis is to improve patient outcome and survival by facilitating incorporation of routine care imaging data into decision making processes.
Because of its established role in cancer care and its non-invasive nature imaging offers the potential to complement the findings of cancer biology. Over the past decade, a compelling body of literature has emerged suggesting a more pivotal role for imaging in the diagnosis, prognosis, and monitoring of diseases. These advances have facilitated the rise of an emerging practice known as Radiomics: the extraction and analysis of large numbers of quantitative features from medical images to improve disease characterization and prediction of outcome. It has been suggested that radiomics can contribute to biomarker discovery by detecting imaging traits that are complementary or interchangeable with other markers.
This thesis seeks further advancement of imaging biomarker discovery. This research unfolds over two aims: I) developing a comprehensive methodological pipeline for converting diagnostic imaging data into mineable sources of information, and II) investigating the utility of imaging data in clinical diagnostic applications. Four validation studies were conducted using the radiomics pipeline developed in aim I. These studies had the following goals: (1 distinguishing between benign and malignant head and neck lesions (2) differentiating benign and malignant breast cancers, (3) predicting the status of Human Papillomavirus in head and neck cancers, and (4) predicting neuropsychological performances as they relate to Alzheimer’s disease progression. The long-term objective of this thesis is to improve patient outcome and survival by facilitating incorporation of routine care imaging data into decision making processes.
ContributorsRanjbar, Sara (Author) / Kaufman, David (Thesis advisor) / Mitchell, Joseph R. (Thesis advisor) / Runger, George C. (Committee member) / Arizona State University (Publisher)
Created2017
Description
This study focused on the connection between the EnvZ/OmpR two-component regulatory system and the iron homeostasis system in Escherichia coli, specifically how a mutant form of EnvZ11/OmpR is able to reduce the expression of fepA::lacZ, a reporter gene fusion in E. coli. FepA is one of several outer membrane siderophore receptors that allow extracellular siderophores bound to iron to enter the cells to power various biological processes. Previous studies have shown that in E. coli cells that expressed a mutant allele of envZ, called envZ11, which led to altered expression of various iron genes including down regulation of fepA::lacZ. The wild type EnvZ/OmpR system is not considered to regulate iron genes, but because these envz11 strains had downregulated fepA::lacZ, this study was undertaken to understand the connection and mechanisms of this downregulation. A large number of Lac+ revertants were obtained from the B32-2483 strain (envz11 and fepA::lacZ) and 7 Lac+ revertants that had reversion mutations not directly correcting the envZ11 allele were further characterized. With P1 phage transduction genetic mapping that involved moving a kanamycin resistance marker linked to fepA::lacZ, two Lac+ revertants were found to have their reversion mutations in the fepA promoter region, while the other five revertants had their mutations mapping outside the fepA region. These two revertants underwent DNA sequencing and found to carry two different single base pair mutations in two different locations of the fepA promoter region. Each one is in the Fur repressor binding region, but one also may have affected the Shine-Dalgarno region involved in translation initiation. All 7 reveratants underwent beta-galactosidase assays to measure fepA::lacZ expression. The two revertants that had mutations in the fepA promoter region had significantly increased fepA activity, with the revertant with the Shine-Dalgarno mutation having the most elevated fepA expression. The other 5 revertants that did not map in the fepA region had fepA expression elevated to the same level as that found in the wild type EnvZ/OmpR background. The data suggest that the negative effect of envZ11 can be overcome by multiple mechanisms, including directly correcting the envZ11 allele or changing the fepA promoter region.
ContributorsKalinkin, Victor Arkady (Co-author) / Misra, Rajeev (Co-author, Thesis director) / Mason, Hugh (Committee member) / Foy, Joseph (Committee member) / Biomedical Informatics Program (Contributor) / School of Life Sciences (Contributor) / W. P. Carey School of Business (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Translating research has been a goal of the Department of Health and Human Services since 1999. Through two years of iteration and interview with our community members, we have collected insights into the barriers to accomplishing this goal. Liberating Science is a think-tank of researchers and scientists who seek to create a more transparent process to accelerate innovation starting with behavioral health research.
ContributorsRaghani, Pooja Sioux (Author) / Hekler, Eric (Thesis director) / Buman, Matthew (Committee member) / Pruthi, Virgilia Kaur (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / Biomedical Informatics Program (Contributor)
Created2014-05
Description
The proliferation of interconnected and networked medical devices has resulted in the development of innovative Medical Cyber-Physical Systems (MCPS). MCPS are life-critical, distributed systems that are utilized to monitor and control healthcare organizations in order to provide a more coordinated, cohesive care-continuum focused on the whole patient resulting in better outcomes, and a happier, healthier patient. Medical Cyber Physical (MCPS) systems are life-critical, networked systems used to monitor and control healthcare and medical devices in order to provide more coordinated and cohesive care for the patient. Cyber-securing MCPS is difficult due to their complex and interconnected nature, and this project sets about analyzing current security requirements for MCPS using an ontology and exploration techniques, and developing a risk assessment and monitoring framework to better secure such systems.
ContributorsLamp, Josephine Ann (Author) / Ahn, Gail-Joon (Thesis director) / Rubio-Medrano, Carlos (Committee member) / School of Film, Dance and Theatre (Contributor) / Biomedical Informatics Program (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Title: A Mobile Health Application for Tracking Patients' Health Record Abstract Background: Mobile Health (mHealth) has recently been adopted and used in rural communities in developing countries to improve the quality of healthcare in those areas. Some organizations use mHealth application to track pregnancy and provide routine checkups for pregnant women. Other organizations use mHelath application to provide treatment and counseling services to HIV/AIDs patients, and others are using it to provide treatment and other health care services to the general populations in rural communities. One organization that is using mobile health to bring primary care for the first time in some of the rural communities of Liberia is Last Mile Health. Since 2015, the organization has trained community health assistants (CHAs) to use a mobile health platform called Data Collection Tools (DCTs). The CHAs use the DCT to collect health data, diagnose and treat patients, provide counseling and educational services to their communities, and for referring patients for further care. While it is true that the DCT has many great features, it currently has many limitations such as data storage, data processing, and many others. Objectives: The goals of this study was to 1. Explore some of the mobile health initiatives in developing countries and outline some of the important features of those initiatives. 2. Design a mobile health application (a new version of the Last Mile Health's DCT) that incorporates some of those features that were outlined in objective 1. Method: A comprehensive literature search in PubMed and Arizona State University (ASU) Library databases was conducted to retrieve publications between 2014 and 2017 that contained phrases like "mHealth design", "mHealth implementation" or "mHealth validation". For a publication to refer to mHealth, the publication had to contain the term "mHealth," or contains both the term "health" and one of the following terms: mobile phone, cellular phone, mobile device, text message device, mobile technology, mobile telemedicine, mobile monitoring device, interactive voice response device, or disease management device. Results: The search yielded a total of 1407 publications. Of those, 11 publications met the inclusion criteria and were therefore included in the study. All of the features described in the selected articles were important to the Last Mile Health, but due to issues such as internet accessibility and cellular coverage, only five of those features were selected to be incorporated in the new version of the Last Mile's mobile health system. Using a software called Configure.it, the new version of the Last Mile's mobile health system was built. This new system incorporated features such as user logs, QR code, reminder, simple API, and other features that were identified in the study. The new system also helps to address problems such as data storage and processing that are currently faced by the Last Mile Health organization.
ContributorsKarway, George K. (Author) / Scotch, Matthew (Thesis director) / Kaufman, David (Committee member) / Biomedical Informatics Program (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Methane (CH4) is very important in the environment as it is a greenhouse gas and important for the degradation of organic matter. During the last 200 years the atmospheric concentration of CH4 has tripled. Methanogens are methane-producing microbes from the Archaea domain that complete the final step in breaking down organic matter to generate methane through a process called methanogenesis. They contribute to about 74% of the CH4 present on the Earth's atmosphere, producing 1 billion tons of methane annually. The purpose of this work is to generate a preliminary metabolic reconstruction model of two methanogens: Methanoregula boonei 6A8 and Methanosphaerula palustris E1-9c. M. boonei and M. palustris are part of the Methanomicrobiales order and perform hydrogenotrophic methanogenesis, which means that they reduce CO2 to CH4 by using H2 as their major electron donor. Metabolic models are frameworks for understanding a cell as a system and they provide the means to assess the changes in gene regulation in response in various environmental and physiological constraints. The Pathway-Tools software v16 was used to generate these draft models. The models were manually curated using literature searches, the KEGG database and homology methods with the Methanosarcina acetivorans strain, the closest methanogen strain with a nearly complete metabolic reconstruction. These preliminary models attempt to complete the pathways required for amino acid biosynthesis, methanogenesis, and major cofactors related to methanogenesis. The M. boonei reconstruction currently includes 99 pathways and has 82% of its reactions completed, while the M. palustris reconstruction includes 102 pathways and has 89% of its reactions completed.
ContributorsMahendra, Divya (Author) / Cadillo-Quiroz, Hinsby (Thesis director) / Wang, Xuan (Committee member) / Stout, Valerie (Committee member) / Barrett, The Honors College (Contributor) / Computing and Informatics Program (Contributor) / School of Life Sciences (Contributor) / Biomedical Informatics Program (Contributor)
Created2014-05
Description
Phylogenetic analyses that were conducted in the past didn't have the ability or functionality to inform and implement useful public health decisions while using clustering. Models can be constructed to conduct any further analyses for the result of meaningful data to be used in the future of public health informatics. A phylogenetic tree is considered one of the best ways for researchers to visualize and analyze the evolutionary history of a certain virus. The focus of this study was to research HIV phylodynamic and phylogenetic methods. This involved identifying the fast growing HIV transmission clusters and rates for certain risk groups in the US. In order to achieve these results an HIV database was required to retrieve real-time data for implementation, alignment software for multiple sequence alignment, Bayesian analysis software for the development and manipulation of models, and graphical tools for visualizing the output from the models created. This study began by conducting a literature review on HIV phylogeographies and phylodynamics. Sequence data was then obtained from a sequence database to be run in a multiple alignment software. The sequence that was obtained was unaligned which is why the alignment was required. Once the alignment was performed, the same file was loaded into a Bayesian analysis software for model creation of a phylogenetic tree. When the model was created, the tree was edited in a tree visualization software for the user to easily interpret. From this study the output of the tree resulted the way it did, due to a distant homology or the mixing of certain parameters. For a further continuation of this study, it would be interesting to use the same aligned sequence and use different model parameter selections for the initial creation of the model to see how the output changes. This is because one small change for the model parameter could greatly affect the output of the phylogenetic tree.
ContributorsNandan, Meghana (Author) / Scotch, Matthew (Thesis director) / Liu, Li (Committee member) / Biomedical Informatics Program (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Integrating behavioral and physical health is the key to value-based care. Little is known about data sharing preferences and consent practices for individuals with behavioral health conditions. This study focuses on identifying behavioral health provider perceptions about patient data sharing practices, preferences and perceived impact on care resulting from enhanced patient control of record types during consent for data sharing.
ContributorsHiestand, Megan (Author) / Grando, Adela (Thesis director) / Murcko, Anita (Committee member) / Sharp, Richard (Committee member) / Biomedical Informatics Program (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
Description
Prescription opioid abuse has become a serious national problem. To respond to the opioid epidemic, states have created prescription drug monitoring programs (PDMPs) to monitor and reduce opioids use. We conducted a systematic literature review to better understand metrics used to quantify the effect that PDMPs have had on reducing opioid abuse, and solutions and challenges related to the integration of PDMPs with EHRs. Lessons learned can help guide federal and state-based efforts to better respond to the current opioid crisis.
ContributorsPonnapalli, Aditya Somayajulu (Author) / Murcko, Anita (Thesis director) / Grando, Adela (Committee member) / Wertheim, Pete (Committee member) / Biomedical Informatics Program (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05