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Item Breast Cancer Detection via Microwave Imaging(Office of the Vice Chancellor for Research, 2011-04-08) Reid, Joshua R.N.; Ghane, Parvin; Shrestha, Sudhir; Agarwal, Mangilal; Varahramyan, KodyBreast cancer is one of the major common diseases among women and takes about 40,000 lives every year. Early detection of breast cancer greatly increases the chance of survival. The norm for today’s detection of breast cancer consists of mammograms, magnetic resonance imaging (MRI), and ultrasonic examination. Unfortunately, the process is a fraction of completeness despite its feeling of discomfort, high cost, and exposure to ionizing radiation which poses cumulative side effects respectively. The present research investigates the efficiency and implementation of microwave imaging to be used in the detection of breast cancer. Microwave imaging (MWI) is a process that illuminates the breast with microwave signals, and receives and analyses scattered signals for breast cancer detection and imaging. The electromagnetic waves that are scattered within the breast provide information that are transmitted and received via microstrip patch antennas, providing an image of detected lesions. In the presented poster, design of a patch antenna and simulation results are presented. In the event of designing, the overall goal was to obtain a voltage standing wave ratio (VSWR) less than 2 at 2.4 GHz signal frequency. To receive the intended results, the dimensions and design of the microstrip patch were important factors given the substrate parameters. Currently, the project is in the prototyping stage for the validation of simulation results and further optimization and development of the antenna for microwave breast cancer detection and imaging applications.Item Changes of glucose levels precede dementia in African Americans with diabetes but not in Caucasians(Elsevier, 2018-12) Hendrie, Hugh C.; Zheng, Mengjie; Lane, Kathleen A.; Ambuehl, Roberta; Purnell, Christianna; Li, Shanshan; Unverzagt, Frederick W.; Murray, Michael D.; Balasubramanyam, Ashok; Callahan, Chris M.; Gao, Sujuan; Psychiatry, School of MedicineINTRODUCTION Changes in glucose levels may represent a powerful metabolic indicator for dementia in African Americans with diabetes. It is unclear whether these changes also occur in Caucasians. METHODS A secondary data analysis using electronic medical records from 5228 African Americans and Caucasians 65 years and older. Mixed effects models with repeated serum glucose measurements were used to compare changes in glucose levels between African Americans and Caucasian patients with and without incident dementia. RESULTS African Americans and Caucasians with diabetes had significantly different changes in glucose levels by dementia status (p<0.0001). African Americans experienced a significant decline in glucose levels before the dementia diagnosis (estimated glucose decline 1.3421 mg/dL per year, p<0.0001) than those who did not develop dementia. Caucasians with and without dementia showed stable glucose levels over time (p=0.3071). DISCUSSION Significant changes in glucose levels precede dementia in African American patients with diabetes but not in Caucasians.Item Comparison of health information exchange data with self-report in measuring cancer screening(BMC, 2023-07-25) Bhattacharyya, Oindrila; Rawl, Susan M.; Dickinson, Stephanie L.; Haggstrom, David A.; Economics, School of Liberal ArtsBackground: Efficient measurement of the receipt of cancer screening has been attempted with electronic health records (EHRs), but EHRs are commonly implemented within a single health care setting. However, health information exchange (HIE) includes EHR data from multiple health care systems and settings, thereby providing a more population-based measurement approach. In this study, we set out to understand the value of statewide HIE data in comparison to survey self-report (SR) to measure population-based cancer screening. Methods: A statewide survey was conducted among residents in Indiana who had been seen at an ambulatory or inpatient clinical setting in the past year. Measured cancer screening tests included colonoscopy and fecal immunochemical test (FIT) for colorectal cancer, human papilloma virus (HPV) and Pap tests for cervical cancer, and mammogram for breast cancer. For each screening test, the self-reported response for receipt of the screening (yes/no) and 'time since last screening' were compared with the corresponding information from patient HIE to evaluate the concordance between the two measures. Results: Gwet's AC for HIE and self-report of screening receipt ranged from 0.24-0.73, indicating a fair to substantial concordance. For the time since receipt of last screening test, the Gwet's AC ranged from 0.21-0.90, indicating fair to almost perfect concordance. In comparison with SR data, HIE data provided relatively more additional information about laboratory-based tests: FIT (19% HIE alone vs. 4% SR alone) and HPV tests (27% HIE alone vs. 12% SR alone) and less additional information about procedures: colonoscopy (8% HIE alone vs. 23% SR alone), Pap test (13% HIE alone vs. 19% SR alone), or mammography (9% HIE alone vs. 10% SR alone). Conclusion: Studies that use a single data source should consider the type of cancer screening test to choose the optimal data collection method. HIE and self-report both provided unique information in measuring cancer screening, and the most robust measurement approach involves collecting screening information from both HIE and patient self-report.Item Glucose level decline precedes dementia in elderly African Americans with diabetes(Elsevier, 2017-02) Hendrie, Hugh C.; Zheng, Mengjie; Li, Wei; Lane, Kathleen; Ambuehl, Roberta; Purnell, Christianna; Unverzagt, Frederick W.; Torke, Alexia; Balasubramanyam, Ashok; Callahan, Chris M.; Gao, Sujuan; Psychiatry, School of MedicineINTRODUCTION: High blood glucose levels may be responsible for the increased risk for dementia in diabetic patients. METHODS: A secondary data analysis merging electronic medical records (EMRs) with data collected from the Indianapolis-Ibadan Dementia project (IIDP). Of the enrolled 4105 African Americans, 3778 were identified in the EMR. Study endpoints were dementia, mild cognitive impairment (MCI), or normal cognition. Repeated serum glucose measurements were used as the outcome variables. RESULTS: Diabetic participants who developed incident dementia had a significant decrease in serum glucose levels in the years preceding the diagnosis compared to the participants with normal cognition (P = .0002). They also had significantly higher glucose levels up to 9 years before the dementia diagnosis (P = .0367). DISCUSSION: High glucose levels followed by a decline occurring years before diagnosis in African American participants with diabetes may represent a powerful presymptomatic metabolic indicator of dementia.Item Loci-specific differences in blood DNA methylation in HBV-negative populations at risk for hepatocellular carcinoma development(Taylor & Francis, 2018) Lubecka, Katarzyna; Flower, Kirsty; Beetch, Megan; Qiu, Jay; Kurzava, Lucinda; Buvala, Hannah; Ruhayel, Adam; Gawrieh, Samer; Liangpunsakul, Suthat; Gonzalez, Tracy; McCabe, George; Chalasani, Naga; Flanagan, James M.; Stefanska, Barbara; Department of Medicine, IU School of MedicineLate onset of clinical symptoms in hepatocellular carcinoma (HCC) results in late diagnosis and poor disease outcome. Approximately 85% of individuals with HCC have underlying liver cirrhosis. However, not all cirrhotic patients develop cancer. Reliable tools that would distinguish cirrhotic patients who will develop cancer from those who will not are urgently needed. We used the Illumina HumanMethylation450 BeadChip microarray to test whether white blood cell DNA, an easily accessible source of DNA, exhibits site-specific changes in DNA methylation in blood of diagnosed HCC patients (post-diagnostic, 24 cases, 24 controls) and in prospectively collected blood specimens of HCC patients who were cancer-free at blood collection (pre-diagnostic, 21 cases, 21 controls). Out of 22 differentially methylated loci selected for validation by pyrosequencing, 19 loci with neighbouring CpG sites (probes) were confirmed in the pre-diagnostic study group and subjected to verification in a prospective cirrhotic cohort (13 cases, 23 controls). We established for the first time 9 probes that could distinguish HBV-negative cirrhotic patients who subsequently developed HCC from those who stayed cancer-free. These probes were identified within regulatory regions of BARD1, MAGEB3, BRUNOL5, FXYD6, TET1, TSPAN5, DPPA5, KIAA1210, and LSP1. Methylation levels within DPPA5, KIAA1210, and LSP1 were higher in prospective samples from HCC cases vs. cirrhotic controls. The remaining probes were hypomethylated in cases compared with controls. Using blood as a minimally invasive material and pyrosequencing as a straightforward quantitative method, the established probes have potential to be developed into a routine clinical test after validation in larger cohorts.Item Melanoma Brain Metastases: A Systematic Review of Opportunities for Earlier Detection, Diagnosis, and Treatment(MDPI, 2023-03-19) Diaz, Michael Joseph; Mark, Isabella; Rodriguez, Daphnee; Gelman, Beata; Thuy Tran, Jasmine; Kleinberg, Giona; Levin, Anna; Beneke, Alice; Root, Kevin Thomas; Vinh Tran, Andrew Xuan; Lucke-Wold, Brandon; Medicine, School of MedicineIntroduction: Melanoma continues to represent the most serious skin cancer worldwide. However, few attempts have been made to connect the body of research on advanced melanoma. In the present review, we report on strides made in the diagnosis and treatment of intracranial metastatic melanoma. Methods: Relevant Cochrane reviews and randomized-controlled trials published by November 2022 were systematically retrieved from the Cochrane Library, EMBASE, and PubMed databases (N = 27). Search and screening methods adhered to the 2020 revision of the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Results: Although the research surrounding the earlier detection of melanoma brain metastasis is scarce, several studies have highlighted specific markers associated with MBM. Such factors include elevated BRAFV600 mutant ctDNA, high LDH concentration, and high IGF-1R. The approach to treating MBM is moving away from surgery and toward nonsurgical management, namely, a combination of stereotactic radiosurgery (SRS) and immunotherapeutic agents. There is an abundance of emerging research seeking to identify and improve both novel and established treatment options and diagnostic approaches for MBM, however, more research is still needed to maximize the clinical efficacy, especially for new immunotherapeutics. Conclusions: Early detection is optimal for the efficacy of treatment and MBM prognosis. Current treatment utilizes chemotherapies and targeted therapies. Emerging approaches emphasize biomarkers and joint treatments. Further exploration toward preliminary identification, the timing of therapies, and methods to ameliorate adverse treatment effects are needed to advance MBM patient care.Item Metabolic Biomarkers for the Early Detection of Cancer Cachexia(Frontiers Media, 2021-09-21) O’Connell, Thomas M.; Golzarri-Arroyo, Lilian; Pin, Fabrizio; Barreto, Rafael; Dickinson, Stephanie L.; Couch, Marion E.; Bonetto, Andrea; Otolaryngology -- Head and Neck Surgery, School of MedicineBackground: Cancer cachexia is a severe metabolic disorder characterized by progressive weight loss along with a dramatic loss in skeletal muscle and adipose tissue. Like cancer, cachexia progresses in stages starting with pre-cachexia to cachexia and finally to refractory cachexia. In the refractory stage, patients are no longer responsive to therapy and management of weight loss is no longer possible. It is therefore critical to detect cachexia as early as possible. In this study we applied a metabolomics approach to search for early biomarkers of cachexia. Methods: Multi-platform metabolomics analyses were applied to the murine Colon-26 (C26) model of cachexia. Tumor bearing mice (n = 5) were sacrificed every other day over the 14-day time course and control mice (n = 5) were sacrificed every fourth day starting at day 2. Linear regression modeling of the data yielded metabolic trajectories that were compared with the trajectories of body weight and skeletal muscle loss to look for early biomarkers of cachexia. Results: Weight loss in the tumor-bearing mice became significant at day 9 as did the loss of tibialis muscle. The loss of muscle in the gastrocnemius and quadriceps was significant at day 7. Reductions in amino acids were among the earliest metabolic biomarkers of cachexia. The earliest change was in methionine at day 4. Significant alterations in acylcarnitines and lipoproteins were also detected several days prior to weight loss. Conclusion: The results of this study demonstrate that metabolic alterations appear well in advance of observable weight loss. The earliest and most significant alterations were found in amino acids and lipoproteins. Validation of these results in other models of cachexia and in clinical studies will pave the way for a clinical diagnostic panel for the early detection of cachexia. Such a panel would provide a tremendous advance in cachectic patient management and in the design of clinical trials for new therapeutic interventions.Item Newborn and infant hearing screening for early detection of hearing loss in Nairobi, Kenya(Makerere University, 2024) Ndegwa, Serah; Tucci, Debara; Lemons, James; Murila, Florence; Shepherd, Susan; Mwangi, Moses; Macharia, Isaac; Ayugi, John; English, School of Liberal ArtsBackground: Early detection of hearing loss and subsequent intervention leads to better speech, language and educational outcomes giving way to improved social economic prospects in adult life. This can be achieved through establishing newborn and infant hearing screening programs. Objective: To determine the prevalence of hearing loss in newborns and infants in Nairobi, Kenya. Methods: A cross-sectional pilot study was conducted at the National hospital and at a sub county hospital immunization clinic. A total of 9,963 babies aged 0-3 years, were enrolled in the hearing screening program through convenient sampling over a period of nine months. A case history was administered followed by Distortion Product Oto-acoustic emissions (DPOAEs) and automated auditory brainstem response (AABR) hearing screening. Results: The screening coverage rate was 98.6% (9963/10,104). The referral rate for the initial screen was 3.6% (356/ 9,963), the return rate for follow-up rescreening was 72% (258 babies out of 356) with a lost to follow-up rate of 28% (98/356). The referral rate of the second screen was 10% (26/258). All the 26 babies referred from the second screen returned for diagnostic hearing evaluation and were confirmed with hearing loss, yielding a prevalence of 3/1000. Conclusions: Establishing universal newborn and infant hearing screening programs is essential for early detection and intervention for hearing loss. Data management and efficient follow-up systems are an integral part of achieving diagnostic confirmation of hearing loss and early intervention.Item Point-of-Care Ultrasound in the Primary Care Office for Early Detection of Squamous Cell Carcinoma of the Supraglottic Larynx: A Case Report(Springer Nature, 2024-07-29) Wilcox, James; Kaefer, Samuel L.; Medicine, School of MedicinePoint-of-care ultrasound (PoCUS) in the head and neck region is still in its early stages, despite decades of formal ultrasound use. A literature gap exists as recent studies primarily focus on general techniques, leaving room for exploration in ambulatory primary care, especially regarding neck masses. Our case demonstrates a 61-year-old female who presented for an annual wellness appointment, reporting a cough and alarming neck symptoms. A prompt investigation using PoCUS identified a suspicious neck mass. This mass was evaluated with bedside POCUS, and the mass was determined to be an abnormal lymph node with findings concerning malignancy. Subsequent diagnostic measures confirmed metastatic squamous cell carcinoma in the supraglottic larynx. This case underscores PoCUS's transformative potential in ambulatory primary care for neck mass evaluation, facilitating swift and thorough diagnostic processes. This successful outcome emphasizes PoCUS's promising role in routine clinical practice, urging future research for standardized evaluation protocols to enhance diagnostic efficiency.Item Potential Health Disparities in the Early Detection and Prevention of Pancreatic Cancer(Springer Nature, 2024-05-13) Yip-Schneider, Michele T.; Muraru, Rodica; Rao, Nikita; Kim, Rachel C.; Rempala-Kurucz, Jennifer; Baril, Jackson A.; Roch, Alexandra M.; Schmidt, C. Max; Surgery, School of MedicineIntroduction: Pancreatic cancer remains one of the deadliest cancers in the United States. Some types of pancreatic cysts, which are being detected more frequently and often incidentally on imaging, have the potential to develop into pancreatic cancer and thus provide a valuable window of opportunity for cancer interception. Although racial disparity in pancreatic cancer has been described, little is known regarding health disparities in pancreatic cancer prevention. In the present study, we investigate potential health disparities along the continuum of care for pancreatic cancer. Methods: The racial and ethnic composition of pancreatic patients at high-volume centers in Indiana were evaluated, representing patients undergoing surgery for pancreatic cancer (n=390), participating in biobanking (972 pancreatic cancer patients and 1984 patients with pancreatic disease), or being monitored for pancreatic cysts at an early detection center (n=1514). To assess racial disparities and potential differences in decision-making related to pancreatic cancer prevention and early detection, an exploratory online survey was administered through a volunteer registry (n=708). Results: We show that despite comprising close to 10% or 30% of the Indiana or Indianapolis population, respectively, African Americans make up only about 4-5% of our study cohorts consisting of patients undergoing pancreatic surgery or participating in biobanking and early detection. Analysis of online survey results revealed that given the hypothetical situation of being diagnosed with a pancreatic cyst or pancreatic cancer, the vast majority of respondents (>90%) would agree to undergo surveillance or surgery, respectively, regardless of race. Only a minority (3-12%) acknowledged any significant transportation, financial, or emotional barriers that would impact a decision to undergo surveillance or surgery. This suggests that the observed racial disparities may be due in part to the existence of other barriers that lie upstream of this decision point. Conclusion: Racial disparities exist not only for pancreatic cancer but also at earlier points along the continuum of care such as prevention and early detection. To our knowledge, this is the first study to document racial disparity in the management of patients with pancreatic cysts who are at risk of developing pancreatic cancer. Our results suggest that improving access to information and care for such at-risk individuals may lead to more equitable outcomes.