LOUIS University of Alabama in Huntsville
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Informed consent for research : a clinical practice change project
No full textThe informed consent process for research is lengthy and cumbersome. The number of required elements for informed consent and the increasing complexity of clinical trials make it difficult to achieve effective and valid informed consent. There were two aims of this clinical project. The first aim was to implement a standardized checklist for consenters to use during informed consent discussions to increase effective communication and the inclusion of all the required elements of consent. The second aim was to determine if the implementation of a standardized checklist by consenters increased the understanding of the required elements of consent, increased satisfaction with the consent process, and impacted continued enrollment in clinical trials by research participants. To measure effectiveness, the consenters were observed during informed consent discussions and scored using the criteria from the standardized checklist. A standardized assessment tool and satisfaction survey with demographics were implemented with the research participants to measure their level of understanding of the consent information and their overall satisfaction with the informed consent process. Continued clinical trial enrollment by the research participants were collected three months after the informed consent discussion. Pre-intervention data were collected to provide baseline data before implementing the standardized checklist with the consenters. Pre-intervention and post-intervention data were analyzed using Excel and SPSS applying descriptive statistics, non-parametric, and parametric tests. The analyzed results were statistically significant supporting the use of a standardized checklist by consenters during informed consent discussions to increase effective communication, to ensure all elements of consent are included, and to increase understanding of the required elements of consent and satisfaction of the consent process by research participants. It is unclear if the use of the standardized checklist by consenters during informed consent discussions impacted the continued enrollment of research participants in clinical trials. Exclusion of non-therapeutic research studies and participants with limited English proficiency served as a limitation. To enhance understanding of informed consent, future research should include the use of a standardized checklist and a standardized assessment tool with research participants taking part in non-therapeutic studies and participants with limited English proficiency
Referral protocol for women at high risk for breast cancer
No full textBreast cancer is the predominant type of cancer affecting females in the United States. Individualized population screening is widely recommended to detect cancer as quickly as possible. The use of an objective risk assessment tool is endorsed to achieve a more precise, personalized breast health plan. Women at high risk for breast cancer are eligible for close surveillance with more frequent clinical exams, breast magnetic resonance imaging (MRIs), and genetic counseling and testing. At the clinical site for this DNP project, Vanderbilt Breast Center (VBC), the Breast Cancer Risk Assessment Tool (BCRAT) was completed during each mammogram visit, yet the woman’s risk was not consistently communicated to referring providers and patients. The purpose of this DNP project was to implement an evidence-based high-risk referral protocol for women identified at increased risk for breast cancer during her mammogram encounter. The Health Belief Model provided the theoretical framework for this quality improvement project. A weekly query within the electronic health record identified any mammography patient with 20% or greater lifetime risk for breast cancer over 15 weeks. Referring providers were notified of risk status and option for referral to a high-risk breast clinic
Application of a new scale-resolving turbulence model to supersonic retropropulsion flows with chemistry
Get PDFTurbulent compressible flows are ubiquitous in many engineering applications of flight and propulsion. Computational fluid dynamics simulations are commonly performed to analyze these flows. Scale-resolving turbulence models inherently better capture various flow phenomena, including separation and mixing, as well as enable predictions of fluctuations, which can be critical for design compared to traditional steady-state turbulence models. In this work, new scale-resolving blended Partially-Averaged Navier-Stokes (BPANS) turbulence models are developed to account for compressibility effects and are employed to efficiently simulate turbulent compressible flows. Specifically, supersonic retropropulsion flows are investigated. Supersonic retropropulsion is a key technology for next-generation rockets. The new BPANS models are tested on a canonical supersonic mixing layer and experimental retropropulsion configurations. The model is also applied on a Mars lander retropropulsion concept to investigate gas model effects, including finite-rate chemistry to account for afterburning. Results from all these simulations are in good agreement with available experimental data
Adaptive sliding mode control for plants with unknown parameters with adaptive boundary layer thickness for chatter attenuation
Get PDFThis thesis presents the development of an adaptive boundary layer sliding mode control (SMC) methodology tailored for plants with unknown parameters. The primary challenge addressed is the mitigation of chattering while ensuring robust performance in systems subject to high disturbances and parameter uncertainties. The research introduces a control law that combines existing work that dynamically adjusts the boundary layer thickness with existing work that uses adaptive laws to estimate unknown plant parameters. The stability of the proposed controller is validated with Lyapunov analysis. Simulation results demonstrate the effectiveness of the adaptive boundary layer SMC in producing good tracking control in the presence of high disturbance and unknown plant parameters
Fall Risk on Laboratory Instrumented Stairways
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Developing and Testing the Thermofluor Stability Assay for Protein Crystallization
Get PDFhttps://louis.uah.edu/rceu-hcr/1477/thumbnail.jp
Impact of the substrate stiffness on macrophage function
Get PDFThis study explores macrophage cell function in healthy and diseased tissue that alters the synovial membrane housing fibroblasts and macrophages by examining how substrate stiffness impacts macrophage function. Current research suggests macrophages adapt, becoming more inflammatory in this environment. Divalent ions (CaCl2 or SrCl2) are used to adjust alginate hydrogel stiffness. The monocyte cell line THP-1 is transformed into macrophages through PMA, LPS, and IFNγ treatment within hydrogels, then cultured for 12 days. Divalent ions affect macrophage functionality; Sr2+ crosslinked hydrogels show higher viability, as well as an increased expression of M1 markers CD197 and IL1β, while M2 marker expression stays consistent for both ions. Ca2+ crosslinked hydrogels show higher secretion of MCP-1, IL1β, and TNFα, and persist longer compared to Sr2+ crosslinked hydrogels. Despite lower cytokine expression in Sr2+ crosslinked hydrogels, their viability and gene expression surpass Ca2+ crosslinked hydrogels. This suggests Sr2+ hydrogels promote M1 macrophages more effectively