49082 research outputs found
Sort by
Journal of African Christian Biography: v. 6, no. 3: Separate cover file (PDF), print-ready
No full textThe full issue of Journal of African Christian Biography: v. 6, no. 3 is available at: https://hdl.handle.net/2144/4276
Mechanisms of peritoneal adhesions and peritoneal inflammation
No full text2024BACKGROUND: Peritoneal fibrosis and peritoneal adhesion are two long-term complications of peritoneal inflammation and peritoneal infection. Both conditions result from structural and functional alterations in the histological structure of the peritoneal membrane as a result of increased cytokine expression and subsequent aberrant peritoneal healing. Current treatments for both conditions lack preventive components and mainly focus on controlling the symptoms. Pharmacological manipulations to prevent such complications represent an attractive option, especially one emerging from mechanistic analysis. The aryl hydrocarbon receptor (AhR) has been linked to adaptive immune responses and modulates inflammatory responses. In this study, we posited that AhR signaling would be activated in the peritoneal membrane in response to infection and that AhR inhibitors abrogate the pro-inflammatory and pro-fibrotic mediators involved in this peritoneal injury model. METHODS: A group of 24 mice were randomized into 4 groups (N=6). The controls mice were wild-type mice on normal chow diet. The next condition received a daily injection of lipopolysaccharide (LPS) for 5 days. The next group received an injection of LPS and CH22319, a known AhR inhibitor, daily for 5 days. The last condition tested the protective effects of an alternative AHR inhibitor, BAY2416964. Mice in this group were injected intraperitoneally with LPS and BAY2416964 daily for 5 days. After the last injection, mice were immediately sacrificed and the peritoneum was harvested.
RESULTS: The peritoneum of mice in the LPS intraperitoneal (IP) injection alone group could be characterized by increased peritoneal membrane thickness, a marked increase in inflammatory infiltrates, and several inflammatory foci. The peritoneal membrane thickness was protected from LPS with both the AhR inhibitors, however, peritoneal membrane was better preserved with BAY2416964 compared to CH223191 (P=0.0044). The inflammatory infiltrates were reduced in both conditions treated with LPS and AhR inhibitors. Additionally, tissue factor (TF) expression, a downstream target of AhR, and several proinflammatory cytokines were downregulated with treatment of AhR inhibitors (BAY2416964 and CH223191).
CONCLUSION: This body of work shows the activation of AhR in the LPS model. AhR inhibition protected the peritoneum and reduced a set of the pro-inflammatory and pro-fibrotic cytokines. AhR inhibitors can be explored further to maintain peritoneal membrane in the setting of infection and inflammation.
2027-09-24T00:00:00
Effects of household corrosive chemicals on the identification of toolmarks on bone
No full text2024This study investigated toolmarks on porcine bone made by different tools and compared them to test toolmarks made by the same tool to determine the likelihood of achieving an identification for a specific tool. It is possible to make a toolmark identification through macroscopic analysis using both class and individual characteristics depending on the uniqueness of the tool in question. In particular, the results demonstrated that for toolmarks made using the crowbar, similar class and individual characteristics were observed when comparing the test and bone toolmarks, but the toolmarks on bone lacked sufficient detail for a conclusive identification. For toolmarks made using the saw, similar class and individual characteristics were observed when comparing the test toolmarks and toolmarks on bone but no observable individual characteristics could be visualized. For the axe, ice pick, chisel, and knife, similar class characteristics to that of the test toolmarks were observed on bone but no observable individual characteristics were seen. The tool with the most potential for individual identification was the screwdriver, which created some toolmarks on bone that showed similar class and individual characteristics as the test toolmarks.
Secondly, this study looked at the effects of household corrosive chemicals on the visualization of toolmarks on bone. Sulfuric acid 93% was the most corrosive with all toolmarks completely eradicated by 21 hours of submersion. The next most corrosive chemical was caustic lye since all toolmarks were completely erased by 47 hours. After lye, sulfuric acid 51% was most corrosive; all toolmarks were completely eradicated by 7 days of submersion. Acetic acid was more corrosive than hydrofluoric acid 2.5%, since acetic acid completely eroded 2 out of 3 toolmarks by day 6 and hydrofluoric acid 2.5% only completely erased 1 out of 3 toolmarks by day 6. Hydrochloric acid 9.5%, phosphorus 50%, and bleach all showed similar degrees of corrosiveness since all toolmarks were present for the three chemicals at the completion of the experiment
A mixed methods examination of processes underlying disease management in pediatric Sickle Cell disease
No full text2025Sickle Cell Disease (SCD) is a serious lifelong chronic illness which disproportionately affects Black/African American individuals. Hallmark SCD features include significant pain, life-threatening complications, and frequent hospitalizations. Effective SCD management during childhood critically improves health outcomes across the life course; however, current research fails to account for how disease management processes differ across developmental and socioeconomic contexts. This multi-study, mixed-methods dissertation explored processes underlying disease management in pediatric SCD, with specific emphases on the roles of medical decision-making and social determinants of health (SDoH) across childhood and adolescence. Twenty-seven parents/primary caregivers of children ages 0-12 with SCD (Study 1) and 39 adolescents with SCD ages 13-17 and parents from 18 families (Studies 2 and 3) completed semi-structured qualitative interviews exploring SCD management. Families in Studies 2 and 3 also completed quantitative measures of SDoH and perceived stress. Across all studies, participants were primarily Black/African American/Afro-Latino (≥89%) and publicly insured (>50%). Study 1 qualitatively characterized processes and priorities underlying caregivers’ decision-making when managing SCD during childhood. Caregivers prioritized preventing and/or mitigating SCD symptoms when managing SCD. Caregivers’ active engagement in disease management, disease knowledge acquisition, and (mis)trust of medical providers further informed their medical decision-making. Study 2 qualitatively explored how caregivers shift SCD management responsibilities to youth during adolescence. Fear of being underprepared for the transition to adult care influenced the initiation of responsibility-sharing. Gradually sharing SCD management responsibilities fostered adolescents’ sense of self-efficacy and self-advocacy skills, which were considered critical for transition readiness. Study 3 employed a convergent mixed-methods design to characterize how adolescent- and caregiver-reported SDoH and perceived stress influence SCD management during adolescence. In general, housing (e.g., proximity to SCD-related care) and caregivers’ employment (e.g., flexibility and benefits) influenced SCD management and exacerbated perceived stress. Families who reported more risk for adverse SDoH (i.e., housing instability, food insecurity, and/or utility shut-off) felt the impacts of housing and employment on their SCD management most acutely. Together, findings highlight how multi-system level interventions that promote disease knowledge and youth self-efficacy, cultivate trusting family-provider relationships, and address adverse SDoH may improve care and outcomes for youth and families managing pediatric SCD
Healthcare professional student integration into inpatient smoking cessation programs
No full text2024Smoking cessation counseling is an important aspect of preventative care in the United States, as smoking has numerous detrimental effects on health. Many hospital systems, such as Boston Medical Center, have begun to integrate programs in the inpatient setting to help with helping admitted patients to quit smoking. This thesis examines the current state of smoking cessation in the United States, especially with focus on the inpatient setting, as well as explores the current smoking cessation education in healthcare professional programs and related student interventions. This thesis reviewed numerous inpatient smoking cessation programs and identified areas for improvement, including the volume of patients counseled, and identified students as an untapped potential resource for helping to increase the number of patients that can be counseled. A study proposed will integrate Boston University Physician Assistant students into Boston Medical Center’s inpatient smoking cessation programs, and investigate whether hands-on experience with counseling patients leads to improved confidence and knowledge for students. The intervention will consist of interactive lectures about smoking cessation and available pharmacotherapy, followed by small group discussions, and finally opportunities to counsel patients in the inpatient setting. Study variables and measures will include comparison of pre- and post-test scores, as well as self-reported confidence scores before and after the intervention. This study will provide important information for educators about whether hands-on experience in smoking cessation counseling can better prepare healthcare professional students for clinical practice. Additionally, future studies are needed to further build on this framework and explore if students can help to expand volumes of patients counseled in the inpatient setting
Journal of African Christian Biography: v. 1, no. 3-4: Booklet, with cover (8.5 x 11 format), print-ready
No full textThe full issue of Journal of African Christian Biography: v. 1, no. 3-4 is available at: https://hdl.handle.net/2144/3566
The use of blood biomarkers in the detection and management of traumatic brain injury
No full text2024This thesis explores the evolving landscape of blood and serum biomarkers in the detection and management of traumatic brain injury (TBI) and highlights the potential for these biomarkers to revolutionize current practices. TBI, a leading cause of morbidity and mortality globally, presents significant challenges in diagnosis and management owing to its complex pathophysiology and limitations in current imaging techniques. Recent advances in biomarker research have opened new avenues for improving TBI diagnostics and prognostics with the hope of leading to better therapeutic strategies. This review focuses on the diagnostic accuracy, prognostic value, and potential utility in guiding treatment decisions for five primary biomarkers: S100 Calcium-Binding Protein B (S100B), Glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase L1 (UCH-L1), neurofilament light chain (NF-L), and Tau.S100B, a glial protein, has been extensively studied for its role in the acute phase of TBI, offering valuable insights into injury severity and patient outcomes. GFAP and UCH-L1 similarly provide information on glial and neuronal damage, respectively, further enriching the biomarker toolkit for TBI assessment. Neurofilament proteins (NF) and Tau, both associated with axonal injury, have emerged as promising indicators of neurodegeneration, offering prognostic information and a window into the chronic effects of TBI. Looking ahead, inflammatory markers, extracellular vesicles (EV), and microRNAs are identified as promising candidates for TBI biomarker research. These novel biomarkers hold the potential for even more precise diagnosis, understanding the complex biological responses to TBI, and tailoring individualized management plans.
While many of these biomarkers hold promise, GFAP stands above them. With well-validated diagnostic capabilities and defined cutoff values for TBI patients, it currently has the most potential for clinical use and has been approved for use by the U.S. Food and Drug Administration (FDA) in a biomarker panel alongside UCH-L1 to screen patients who may require a head computerized tomography (CT) scan based on biomarker levels. S100B has also been suggested for use as diagnostic criteria to determine a patient’s eligibility for head CT through the establishment and validation of the Scandinavian Guidelines. Further experimentation is necessary to fully validate NF and Tau for diagnostic capabilities, but a lack of clinically relevant cutoff values holds most other biomarkers back in their usefulness for diagnostics. While there does seem to be a significant place for most biomarkers in outcome monitoring and prediction, blood biomarker sampling currently only has enough evidence to slightly impact treatment decisions. However, although they have not been widely implemented, the use of blood biomarkers as a criterion for head CT scans has already lowered the number of unnecessary head CT scans performed and will continue to improve with further research
Soft robotic systems for interventional endoscopy
No full text2025Interventional neurosurgery and bronchoscopy represent two significant surgical theaters where delicate tissues must be effectively contacted and target regions can require navigation of narrow, tortuous paths. Current minimally invasive techniques in these procedures are limited in the safety, access, distal dexterity, and feedback they provide. Therefore, there remains a clinical need for soft robots that can safely interact with tissues, deploy dexterous tools for surgical tasks, and navigate into deep regions to more effectively perform procedures. This thesis work focuses on the design, fabrication, and control of two soft robotic systems to address these challenges. We first propose an origami-inspired soft robotic retractor which leverages its compliant form to vary the level of tissue retraction. Thus, it can distribute contact forces when generating a surgical workspace in neurosurgery. Fabrication via a 2D layering technique facilitates the integration of multiple functionalities not only through controlled pneumatic actuation of its shape but also through the embedding of force sensing units. Actuation and sensing capabilities are validated with respect to clinical requirements and analytical models. Clinical viability of workspace generation and force feedback is demonstrated in an in-vitro environment.
We further investigate how safer contact interactions and software integration can be leveraged to meaningfully operate within the deep surgical environment of the lungs. We present a millimeter-scale soft robot to address the difficulties in diagnosing early stage lung cancer within interventional bronchoscopy. Within this robot, we embed three independent degrees of freedom which enable steering toward the targeted lung branch, stabilization within the lung for increased force transmission, and the deployment of a needle at the distal tip for performing biopsy. Robot performance is characterized and validated with the in-vitro biopsy of simulated tissue. Further, a semi-autonomous navigation platform is developed by implementing algorithms in computer vision, preoperative robotic path planning, and external actuation. In-vitro navigation experiments show the ability to reduce surgeon workload and precisely reach the lung periphery. These soft robotic surgical platforms are demonstrated to enhance surgical capabilities within these crucial MIS procedures paving the way for more effective surgeries and improved patient outcomes.2027-09-03T00:00:00
Fabrication of ophthalmic lenses by Fluidic Shaping
No full textLimited access to corrective eyewear remains a significant medical, societal, and economic challenge in developing countries, with more than 1 billion people suffering from uncorrected vision impairment. Philanthropy has failed to meet the demand, and local manufacturing using standard technologies remains beyond reach due to
inadequate resources. We present a fluidic approach, leveraging the surface tension of liquid polymers, with which high-quality solid lenses, with any prescription, can be created without machining, polishing or any postprocessing steps. We provide an experimentally-validated analytical model relating the geometrical degrees of freedom to the desired prescription. Using a compact low-power device, we demonstrate that the fluidic
approach allows the fabrication of industry-standard eyeglasses in several minutes, opening the door to advanced manufacturing in low-resource settings.Published versio