2345 Chesterfield Ave Suite 301
Charleston WV 25304
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 13732
Request Appointment Information
Awards & Recognitions
Medical Malpractice Cases
Medical Board Sanctions
Methods for specific electrode resistance measurement during transcranial direct current stimulation. - Brain stimulation
Monitoring of electrode resistance during tDCS is considered important for tolerability and safety. Conventional resistance measurement methods do not isolate individual electrode resistance and for HD-tDCS devices, cross talk across electrodes makes concurrent resistance monitoring unreliable.We propose a novel method to monitor individual electrode resistance during tDCS, using a super-position of direct current with a test-signal (low intensity and low frequency sinusoids with electrode-specific frequencies) and a sentinel electrode (not used for DC).We developed and solved lumped-parameter models of tDCS electrodes with or without a sentinel electrode to validate this methodology. Assumptions were tested and parameterized in participants using forearm stimulation combining tDCS (2 mA) and test-signals (38 and 76 Î¼A pk-pk at 1 Hz, 10 Hz, & 100 Hz) and an in vitro test (creating electrode failure modes). DC and AC component voltages across the electrodes were compared and participants were asked to rate subjective pain.A sentinel electrode is required to isolate electrode resistance in a two-electrode tDCS system. Cross talk aggravated with electrode proximity and resistance mismatch in multi-electrode resistance tracking could be corrected using proposed approaches. Average voltage and pain scores were not significantly different across test current intensities and frequencies.Using our developed method, a test signal can predict DC electrode resistance. Since unique test frequencies can be used at each tDCS electrode, specific electrode resistance can be resolved for any number of stimulating channels - a process made still more robust by the use of a sentinel electrode.Published by Elsevier Inc.
Spontaneous pneumomediastinum: an important differential in acute chest pain. - BMJ case reports
A 38-year-old man presented with pleuritic chest pain that was present on waking and localised to the left costal margin with no radiation. He was otherwise asymptomatic and denied preceding trauma, heavy lifting, coughing or recent vomiting. Observations and examination were unremarkable; however, a chest radiograph showed a pneumomediastinum. Spontaneous pneumomediastinum (SPM) is a rare condition that tends to follow a benign clinical course. A CT of the chest is generally only indicated if the chest X-ray fails to show an SPM in patients for whom there is a high index of clinical suspicion. A contrast-enhanced swallow study is only indicated if there is suspicion of an oesophageal tear or rupture. Evidence suggests that patients with SPM can be managed conservatively and observed for 24â€…h.2014 BMJ Publishing Group Ltd.
Diagnostic accuracy of ultrasonography in acute appendicitis. - Journal of Ayub Medical College, Abbottabad : JAMC
The diagnosis of acute appendicitis is mainly clinical and to augment the clinical diagnosis ultrasonography and Computerized Tomographic Scan of the abdomen are also being used to help in diagnosis of the disease; which all carry some inherent limitations. This study was done to establish diagnostic accuracy of Ultrasonography (USG) in acute appendicitis taking histopathology of removed appendix as the gold standard.This cross-sectional validation study was conducted in Radiology Department, Military Hospital and Combined Military Hospital Rawalpindi from July 2007 to January 2008. Sixty cases of clinically suspected acute appendicitis were selected on non-probability convenience sampling technique. All of them underwent ultrasound evaluation. Diagnostic accuracy of USG was calculated keeping histopathology of the removed appendix as gold standard whenever appendectomy was carried out.Out of 60 patients whose USG of right lower quadrant was performed, 30 patients were correctly diagnosed as having acute appendicitis on USG out of 34 finally diagnosed cases based on histopathology. Similarly we picked 12 normal appendices out of 26 non-appendicitis patients. This showed that US scan has sensitivity of 88%, specificity of 92%, positive predictive value of 94%, negative predictive value of 86%, and overall accuracy of 90%. The most accurate appendiceal finding for appendicitis was a diameter of 7 mm or larger followed by non- compressibility of inflamed appendix.Ultrasonography has high accuracy in diagnosing acute appendicitis and reduces negative appendectomies. Greater than 6-mm diameter of the appendix under compression is the most accurate USG finding with high positive predictive value for the diagnosis of acute appendicitis.
Clinician accessible tools for GUI computational models of transcranial electrical stimulation: BONSAI and SPHERES. - Brain stimulation
Computational models of brain current flow during transcranial electrical stimulation (tES), including transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS), are increasingly used to understand and optimize clinical trials. We propose that broad dissemination requires a simple graphical user interface (GUI) software that allows users to explore and design montages in real-time, based on their own clinical/experimental experience and objectives. We introduce two complimentary open-source platforms for this purpose: BONSAI and SPHERES. BONSAI is a web (cloud) based application (available at neuralengr.com/bonsai) that can be accessed through any flash-supported browser interface. SPHERES (available at neuralengr.com/spheres) is a stand-alone GUI application that allow consideration of arbitrary montages on a concentric sphere model by leveraging an analytical solution. These open-source tES modeling platforms are designed go be upgraded and enhanced. Trade-offs between open-access approaches that balance ease of access, speed, and flexibility are discussed.Copyright Â© 2014 Elsevier Inc. All rights reserved.
Effects of wastewater microalgae harvesting methods on polyhydroxybutyrate production. - Bioresource technology
Microalgae have gained considerable attention recently as a sustainable means to produce biofuels and bioproducts. It has previously been demonstrated that single strain microalgae can be harvested and processed through a wet lipid extraction procedure (WLEP). After WLEP processing, acetone, butanol, ethanol, and biodiesel can be produced, and growth of recombinant Escherichia coli can be achieved from the microalgae. This study demonstrates the application of different wastewater microalgae harvesting techniques and processing through WLEP on the production of polyhydroxybutyrate (PHB) by E. coli. The harvesting techniques include: cationic potato starch (CPS), cationic corn starch (CCS), aluminum sulfate, and centrifugation. The microalgae-based media were used to grow E. coli to âˆ¼10(13)CFU/mL and produce approximately 7.8% of dry cell weight as PHB. This study demonstrates the feasibility of harvesting wastewater algae to produce PHB and the potential for bioproduct generation.Copyright Â© 2014 Elsevier Ltd. All rights reserved.
Effects of weak transcranial alternating current stimulation on brain activity-a review of known mechanisms from animal studies. - Frontiers in human neuroscience
Rhythmic neuronal activity is ubiquitous in the human brain. These rhythms originate from a variety of different network mechanisms, which give rise to a wide-ranging spectrum of oscillation frequencies. In the last few years an increasing number of clinical research studies have explored transcranial alternating current stimulation (tACS) with weak current as a tool for affecting brain function. The premise of these interventions is that tACS will interact with ongoing brain oscillations. However, the exact mechanisms by which weak currents could affect neuronal oscillations at different frequency bands are not well known and this, in turn, limits the rational optimization of human experiments. Here we review the available in vitro and in vivo animal studies that attempt to provide mechanistic explanations. The findings can be summarized into a few generic principles, such as periodic modulation of excitability, shifts in spike timing, modulation of firing rate, and shifts in the balance of excitation and inhibition. These effects result from weak but simultaneous polarization of a large number of neurons. Whether this can lead to an entrainment or a modulation of brain oscillations, or whether AC currents have no effect at all, depends entirely on the specific dynamic that gives rise to the different brain rhythms, as discussed here for slow wave oscillations (âˆ¼1 Hz) and gamma oscillations (âˆ¼30 Hz). We conclude with suggestions for further experiments to investigate the role of AC stimulation for other physiologically relevant brain rhythms.
Origins of specificity during tDCS: anatomical, activity-selective, and input-bias mechanisms. - Frontiers in human neuroscience
Transcranial Direct Current Stimulation (tDCS) is investigated for a broad range of neuropsychiatric indications, various rehabilitation applications, and to modulate cognitive performance in diverse tasks. Specificity of tDCS refers broadly to the ability of tDCS to produce precise, as opposed to diffuse, changes in brain function. Practically, specificity of tDCS implies application-specific customization of protocols to maximize desired outcomes and minimize undesired effects. Especially given the simplicity of tDCS and the complexity of brain function, understanding the mechanisms leading to specificity is fundamental to the rational advancement of tDCS. We define the origins of specificity based on anatomical and functional factors. Anatomical specificity derives from guiding current to targeted brain structures. Functional specificity may derive from either activity-selectivity, where active neuronal networks are preferentially modulated by tDCS, or input-selectivity, where bias is applied to different synaptic inputs. Rational advancement of tDCS may require leveraging all forms of specificity.
Secretion of polyhydroxybutyrate in Escherichia coli using a synthetic biological engineering approach. - Journal of biological engineering
Polyhydroxyalkanoates (PHAs) are a group of biodegradable plastics that are produced by a wide variety of microorganisms, mainly as a storage intermediate for energy and carbon. Polyhydroxybutyrate (PHB) is a short-chain-length PHA with interesting chemical and physical properties. Large scale production of PHB is not wide-spread mainly due to the downstream processing of bacterial cultures to extract the PHB. Secretion of PHB from Escherichia coli could reduce downstream processing costs. PHB are non-proteinaceous polymers, hence cannot be directly targeted for secretion. Phasin, PhaP1, is a low molecular weight protein that binds to PHB, reducing PHB granule size. In this study PHB is indirectly secreted with PhaP1 from E. coli via type I secretion using HlyA signal peptides.This study demonstrated the successful secretion of phasin and phasin bound PHB outside of the cell and into the culture medium. The secretion of PHB was initiated between 24 and 48Â h after induction. After 48Â h of culturing, 36% of the total PHB produced in the secreting strain was collected in the secreted fraction and 64% remained in the internal fraction. To further support the findings of this study, the PHB secretion phenomenon was observed using SEM.From this study, the ability to use type I secretion to: 1) secrete phasin and 2) successfully secrete PHB has been shown.
Effect of coagulant/flocculants on bioproducts from microalgae. - Bioresource technology
The potential of microalgae as a source of sustainable energy, nutritional supplements and specialized chemicals necessitates a thorough evaluation of the methods of harvesting microalgae with regards to the bioproduct(s) desired. This research assessed the effect of coagulation, flocculation, and centrifugation on the wet lipid extraction procedure, which fractionated microalgae into hydrolyzed biomass for fermentation into acetone, butanol, and ethanol, an aqueous phase as growth media for genetically engineered Escherichia coli, and a lipid fraction for the production of biodiesel. Biomass harvested by cationic starches, alum, and centrifugation produced 30, 19, and 22.5mg/g of dry wt. algae of total combined acetone, butanol, and ethanol, respectively. Higher biodiesel production was also observed for the cationic starches (9.6 mg/g of dry wt. algae) than alum (0.6 mg/g of dry wt. algae) harvested biomass. The results suggested significant effect of the harvesting methods on the yields of bioproducts.Copyright Â© 2013 Elsevier Ltd. All rights reserved.
Cellular effects of acute direct current stimulation: somatic and synaptic terminal effects. - The Journal of physiology
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique to modulate cortical excitability. Although increased/decreased excitability under the anode/cathode electrode is nominally associated with membrane depolarization/hyperpolarization, which cellular compartments (somas, dendrites, axons and their terminals) mediate changes in cortical excitability remains unaddressed. Here we consider the acute effects of DCS on excitatory synaptic efficacy. Using multi-scale computational models and rat cortical brain slices, we show the following. (1) Typical tDCS montages produce predominantly tangential (relative to the cortical surface) direction currents (4-12 times radial direction currents), even directly under electrodes. (2) Radial current flow (parallel to the somatodendritic axis) modulates synaptic efficacy consistent with somatic polarization, with depolarization facilitating synaptic efficacy. (3) Tangential current flow (perpendicular to the somatodendritic axis) modulates synaptic efficacy acutely (during stimulation) in an afferent pathway-specific manner that is consistent with terminal polarization, with hyperpolarization facilitating synaptic efficacy. (4) Maximal polarization during uniform DCS is expected at distal (the branch length is more than three times the membrane length constant) synaptic terminals, independent of and two-three times more susceptible than pyramidal neuron somas. We conclude that during acute DCS the cellular targets responsible for modulation of synaptic efficacy are concurrently somata and axon terminals, with the direction of cortical current flow determining the relative influence.
Map & Directions
2345 Chesterfield Ave Suite 301 Charleston, WV 25304
3200 Maccorkle Avenue Se Pathology Department
3110 Maccorkle Ave Se
4522 Maccorkle Ave Se Suite 3
3100 Maccorkle Ave Se Suite 509