Browsing by Author "Johnson, Raymond"

Now showing 1 - 5 of 5
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    Advancing cognitive engineering methods to support user interface design for electronic health records
    (Elsevier, 2014-04) Thyvalikakath, Thankam P.; Dziabiak, Michael P.; Johnson, Raymond; Torres-Urquidy, Miguel Humberto; Acharya, Amit; Yabes, Jonathan; Schleyer, Titus K.; Department of Cariology, Operative Dentistry and Dental Public Health, IU School of Dentistry
    Background Despite many decades of research on the effective development of clinical systems in medicine, the adoption of health information technology to improve patient care continues to be slow, especially in ambulatory settings. This applies to dentistry as well, a primary care discipline with approximately 137,000 practitioners in the United States. A critical reason for slow adoption is the poor usability of clinical systems, which makes it difficult for providers to navigate through the information and obtain an integrated view of patient data. Objective In this study, we documented the cognitive processes and information management strategies used by dentists during a typical patient examination. The results will inform the design of a novel electronic dental record interface. Methods We conducted a cognitive task analysis (CTA) study to observe ten general dentists (five general dentists and five general dental faculty members, each with more than two years of clinical experience) examining three simulated patient cases using a think-aloud protocol. Results Dentists first reviewed the patient’s demographics, chief complaint, medical history and dental history to determine the general status of the patient. Subsequently, they proceeded to examine the patient’s intraoral status using radiographs, intraoral images, hard tissue and periodontal tissue information. The results also identified dentists’ patterns of navigation through patient’s information and additional information needs during a typical clinician-patient encounter. Conclusion This study reinforced the significance of applying cognitive engineering methods to inform the design of a clinical system. Second, applying CTA to a scenario closely simulating an actual patient encounter helped with capturing participants’ knowledge states and decision-making when diagnosing and treating a patient. The resultant knowledge of dentists’ patterns of information retrieval and review will significantly contribute to designing flexible and task-appropriate information presentation in electronic dental records.
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    CHRONIC TRANSPLANT REJECTION: PROBLEMS, DISCOVERIES, SOLUTIONS
    (Office of the Vice Chancellor for Research, 2012-04-13) Aulds-Stier, Mitchell; Su, Eric; Saltagi, Mohamad; Khan, Karim; Ward, Richard; Johnson, Raymond
    Organ transplantation has become an increasingly important remedy in helping extend the lives of patients with organ failures or deficien-cies. Although the survival rates of organ recipients have dramatically increased in the short term (1-5 years), long-term (5+ years) survival rates have not improved significantly. Additionally, increasingly un-healthy lifestyles have contributed to a dramatic increase in the need for organ transplants, while organ supply has only slightly increased, resulting in a constantly increasing gap between organ demand and organ supply. Dr. Raymond Johnson, an IU Health Physician, discov-ered a new T cell subset that is resistant to medications routinely used to prevent transplant rejection. This discovery is important because it can be used to develop mechanism-specific diagnostic blood tests for chronic rejection and, potentially, new drugs to treat chronic trans-plant rejection. However, innovations developed in faculty labs often face multiple hurdles in reaching the market place. As participants in the Innovation-to-Technology Central (ITEC) program, our unique multidisciplinary team of students investigated Dr. Raymond Johnson’s discovery by conducting literature research and expert interviews on organ transplantation and rejection and pharmaceutical drugs used in preventing acute transplant rejection. Through our research and our interviews, we were able to further document the dire need for meth-ods for increasing survival rates of transplanted organs. Most im-portantly, we have conducted preliminary market research and devel-oped several commercialization strategy recommendations based on comparable innovation analysis and precedent biotechnology start-up strategies. We anticipate that our research will provide Dr. Johnson with new information and perspectives to help seek venture capitalists to invest in his research, which holds the promise to change the lives of thousands of transplant recipients each year. Funding provided by IUPUI’s Innovation-to-Enterprise Central (ITEC).
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    Cutaneous presentation of progressive disseminated histoplasmosis nine years after renal transplantation
    (Wiley, 2013) Rosado-Odom, Vera M.; Daoud, Jacques; Johnson, Raymond; Allen, Stephen D.; Lockhart, Shawn R.; Iqbal, Naureen; Shieh, Wun-Ju; Zaki, Sherif; Sharfuddin, Asif; Medicine, School of Medicine
    Initial presentation of invasive fungal infections such as histoplasmosis can include non-specific clinical manifestations, especially in immunocompromised patients. A high index of suspicion is required to identify atypical manifestations of these diseases, which carry a high risk of mortality, if the diagnosis is delayed or missed. We describe a case of a kidney transplant recipient with cutaneous lesions as initial manifestation of progressive disseminated histoplasmosis where a skin biopsy was crucial to an early diagnosis.
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    HIV-1 Coinfection Profoundly Alters Intrahepatic Chemokine but Not Inflammatory Cytokine Profiles in HCV-Infected Subjects
    (Public Library of Science, 2014-02-06) Hu, Sishun; Ghabril, Marwan; Amet, Tohti; Hu, Ningjie; Byrd, Daniel; Yang, Kai; Vuppalanchi, Raj; Saxena, Romil; Desai, Mona; Lan, Jie; Johnson, Raymond; Gupta, Samir; Chalasani, Naga; Yu, Qigui; Microbiology and Immunology, School of Medicine
    The pathogenesis of accelerated liver damage in subjects coinfected with hepatitis C virus (HCV) and human immunodeficiency virus type 1 (HIV-1) remains largely unknown. Recent studies suggest that ongoing chronic liver inflammation is responsible for the liver injury in HCV-infected patients. We aimed to determine whether HIV-1 coinfection altered intrahepatic inflammatory profiles in HCV infection, thereby hastening liver damage. We used a real-time RT-PCR-based array to comparatively analyze intrahepatic inflammation gene profiles in liver biopsy specimens from HCV-infected (n = 16), HCV/HIV-1-coinfected (n = 8) and uninfected (n = 8) individuals. We then used human hepatocytes to study the molecular mechanisms underlying alternations of the inflammatory profiles. Compared with uninfected individuals, HCV infection and HCV/HIV-1 coinfection markedly altered expression of 59.5% and 50.0% of 84 inflammation-related genes tested, respectively. Among these genes affected, HCV infection up-regulated the expression of 24 genes and down-regulated the expression of 26 genes, whereas HCV/HIV-1 coinfection up-regulated the expression of 21 genes and down-regulated the expression of 21 genes. Compared with HCV infection, HCV/HIV-1 coinfection did not dramatically affect intrahepatic gene expression profiles of cytokines and their receptors, but profoundly altered expression of several chemokine genes including up-regulation of the CXCR3-associated chemokines. Human hepatocytes produced these chemokines in response to virus-related microbial translocation, viral protein stimulation, and antiviral immune responses. Conclusions: HIV-1 coinfection profoundly alters intrahepatic chemokine but not cytokine profiles in HCV-infected subjects. The altered chemokines may orchestrate the tissue-specific and cell-selective trafficking of immune cells and autoimmunity to accelerate liver disease in HCV/HIV-1 coinfection.
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    Real time PCR and fluorescent in situ hybridization in the detection of the physical tsate of human papillomavirus 16 and 18 in paraffin embedded cervical tissue
    (2015-07) Davis, Aisha; Brown, Darron; Ermel, Aaron C.; Johnson, Raymond
    Human papillomaviruses (HPV) are the etiologic agents of most cervical dysplasia and all cervical carcinoma. Integration of high risk HPV into the human genome is thought to be a critical event in the progression from cervical dysplasia to invasive cervical carcinoma. The ability to use molecular assays in the detection and evaluation of HPV integration is essential in informing clinical models for early intervention and therapies. We therefore sought to determine the feasibility of real time-PCR (RT-PCR) as a molecular tool in detecting the physical state, episomal versus integration of HPV 16 and 18 DNA in cervical cancers. Tyramide amplified fluorescent DNA in situ hybridization (FISH) was used to look for evidence of HPV 16/18 integration using formalin-fixed, paraffin-embedded sections of cervical carcinomas. RT-PCR used the ratio of the E2 and E6 genes as a surrogate for determining the physical state of HPV 16 and 18 in 35 infected tissues. Results of RT-PCR showed that 16 cervical specimens (45.7%) contained episomal HPV, 17 cervical samples (48.6%) harbored the integrated form of HPV DNA, and 2 samples (5.7 %) contained both integrated and episomal forms of HPV. Results of the two assays were compared in 25 cervical carcinomas. For 13 of the 25 cervical samples there was an agreement in determining the physical state of HPV. RT-PCR, using the E2/E6 ratio as an assay for HPV integration appears to be promising and may prove to be an essential clinical method in the future.