Digital Commons Network^™

Anti-Muc4Β Antibodies As A Novel Therapeutic Modality For The Treatment Of Pancreatic Cancer, Catherine Orzechowski

Theses & Dissertations

The deregulation of cell surface glycoproteins, such as mucins, is a hallmark of many tumors of epithelial origin. The transmembrane mucin MUC4, is differentially overexpressed in several malignancies, including pancreatic, breast, ovarian, lung, cervical, and head and neck cancers. Of all the aforementioned cancers, the role of MUC4 has been the most thoroughly in pancreatic cancer (PC), which is the 4th leading cause of cancer-related deaths in the United States. While MUC4 is undetectable in the normal or inflamed pancreas (pancreatitis), its expression progressively increases during PC progression and its higher expression correlates with poor survival. The role of MUC4 …

Pandemic Driven Innovation: Development Of An Alternative Respiratory Pathogen Self-Collection Device, Thang Nguyen

Theses & Dissertations

The SARS-CoV-2 virus outbreak has underscored numerous weak links in our biodefense countermeasures against highly communicable diseases. Many believe it was our lack of an effective testing model that allowed the virus to become a global pandemic within a short period. The gold standard collection method for the SARS-CoV-2 virus involves mechanical debridement of the nasopharyngeal cavity with a stiff swab applicator, which has been known to cause pain and injury to patients, subsequently resulting in low patient acceptance of the procedure. Due to the invasive nature of the nasopharyngeal swab collection method, it may not be conducive to the …

Long-Acting Nanoformulated Antivirals For The Treatment And Prevention Of Hiv-1 And Hbv Infections, Dhruvkumar M. Soni Dr.

Theses & Dissertations

While antiretroviral therapy (ART) has revolutionized treatment and prevention of human immunodeficiency virus type one (HIV-1) infection, regimen adherence, viral mutations, drug toxicities, stigma and pill fatigue are limitations. These have led to the development of long acting (LA) ART. These include, but are not limited to, implantable devices, new chemical entities, prodrug modifications and nanoformulations. To these ends, this thesis focues on the transformation of nucleoside reverse transcriptase inhibitors (NRTIs) into LA parenterals, While elusive, data from our laboratories demonstrated that modifications to the PROdrug and nucleoTide technology (ProTide) enables improvements in drug apparent half-life and tissue and cell …

Glycemic Variability In Patients With Stage Ii-Iii Colon Cancer, Natalie Mandolfo

Theses & Dissertations

Patients with cancer experience metabolic changes such as hypoglycemia, hyperglycemia, and glycemic variability; collectively termed malglycemia. Glycemic variability, defined as fluctuations in glucose, is a marker of metabolic instability. Higher glycemic variability is associated with adverse health outcomes in the general population and in those with diabetes. Little is known about glycemic variability in patients with cancer, especially those with solid tumor malignancies. Glycemic variability is associated with increased infection, shorter periods of remission, and higher mortality in patients with hematological cancer. This body of work describes the concept and measurement of glycemic variability to assess glycemic control in patients …

Cardioprotective Roles Of Hydrogen Sulfide Donor Treatment In Diabetic Cardiomyopathy, Sumit Kar

Theses & Dissertations

Diabetes mellitus (DM) increases the risk of heart failure 2-4-fold. Intensive glycemic control does not abate this risk in DM patients, suggesting that DM-induced heart failure is beyond hyperglycemia. DM silently induces cardiac muscle disorder termed diabetic cardiomyopathy (DMCM), which progresses to heart failure. The objective of this dissertation is to understand the mechanistic underpinnings of DMCM to develop new solutions to diagnose and treat heart failure in DM.

The heart pumps blood due to the contraction and relaxation of terminally differentiated cardiomyocytes with limited regenerative capacity. The DM environment of hyperglycemia, hyperlipidemia, and inflammation causes cardiomyocyte death and leads …

Investigating The Relationship Between Unavoidable, Hospital Acquired Pressure Injury And Mortality: Is Unavoidable, Hospital Acquired Pressure Injury A Signal Of Increased One-Year Mortality Risk?, Eileen Jimenez

Theses & Dissertations

The purpose of this dissertation was to explore the strength of the relationship between unavoidable Hospital Acquired Pressure Injury (HAPI) and increased risk of one-year mortality for patients age 55 and older who were admitted to a hospital from 2015 to 2018. A quantitative, retrospective case-control study was designed to compare demographics, comorbid conditions, pressure injury risk, and living situation of those patients that developed unavoidable HAPI and hospitalized adults with similar physiological burdens that remained injury-free. The one-year mortality for the HAPI group was 27 of 48 (56%), and 26 of 47 patients (55%) for the Control group. The …

A Preliminary Analysis Of Project Ag Aware: Sbirt In Agricultural Work Settings, Rachel L. Rutt

Capstone Experience

Background: An increasing number of individuals are being negatively affected by substance abuse in the U.S. and Nebraska communities. These communities are seeing immense increases in opioid prescribing rates, especially in rural areas. The aims of this study are to 1) describe the study population of agricultural workers in Nebraska; 2) estimate the prevalence of alcohol misuse, illegal drug use, and anxiety among agricultural workers in Nebraska; and 3) examine factors associated with alcohol misuse among agricultural workers in Nebraska.

Methods: Adult agricultural workers (N=1,206) completed a paper or online survey for Project Ag Aware. Alcohol misuse, illegal drug use, …

Agricultural Injuries Among Central State Region Operators Over A 5-Year Period: Cs-Cash Farm And Ranch Health And Injury Survey 2011-2015, Anthony Johnson Jr

Capstone Experience

Background The high risk of occupational fatalities in agriculture is well documented, but information on non-fatal injuries is lacking due to challenges in injury surveillance. This surveillance study explored the frequency, characteristics, and risk factors for non-fatal injuries among farmers and ranchers in the central United States.

Methods The Central States Center for Agricultural Safety and Health (CS-CASH), in collaboration with the USDA National Agricultural Statistics Service (NASS), conducted annual surveys (n=34,777 sent) during 2011-2015 covering a seven-state region (Iowa, Kansas, Minnesota, Missouri, North Dakota, Nebraska, and South Dakota).

Results The average response rate was 32% in the five consecutive …

A Qualitative Analysis Of Omaha Healthy Kids Alliance’S Client Educational Attainment, Shelby Larson

Capstone Experience

Housing and physical health are inextricably linked. Environmental hazards such as lead poisoning, radon, and mold negatively impact the health of a home’s occupants, particularly children. Omaha Healthy Kids Alliance (OHKA) was founded in 2006 to address these environmental hazards through education and construction interventions with the mission “to improve children’s health through healthy homes.” OHKA clients are primarily served through two direct service programs and are evaluated pre- and post-intervention for changes in educational attainment, behavioral outcomes, environmental characteristics, quality of life, and health. A program evaluation was conducted to 1) determine how OHKA clients utilize environmental education post-intervention, …

Developing A Rabies Prevention Program Based On Rabies Exposure Data In Nebraska, Jill Oatman

Capstone Experience

Eighty-nine percent of Nebraska’s towns are considered rural, with populations of less than 3,000 people and with many towns having less than 1,000 residents. Rural areas consist of crop ground, livestock facilities and regions inhabited by wildlife. Nebraska has two large urban cities, Lincoln and Omaha. Animal and human health in these communities can be greatly impacted by infectious diseases that are transmitted between animals and humans, known as zoonotic diseases. One zoonotic disease of great concern is rabies. Zoonotic diseases not only impact the health of animals and humans, but the social well-being of communities and result in increased …

Developing A Community Innovation Grant In Response To Increasing Rural Critical Incidents In Agricultural Mental Health And Wellbeing, Community Trauma, And Natural Disasters, Chessa S. Quenzer

Capstone Experience

Spink Area Support Network (SASN) is a skilled team of community volunteers that facilitate rural critical incident response services in an effort to prevent a critical incident and offer structured support during the aftermath. SASN was developed in response to identified gaps in rural critical incident response and risk reduction through prevention in Spink County, South Dakota. SASN utilizes a collaborative team approach to fill in gaps between first responder silos and establish community interventions by providing support and resources while utilizing critical incident stress management methods. SASN requires funding to maintain response resources, training, prevention education, and follow-up services. …

Effects Of Climate Change On The Epidemiology Of Flood-Related Waterborne Disease: A Systematic Literature Review, Sarah M. Cadarette

Capstone Experience

Natural disasters, such as flooding related to extreme precipitation, can lead to many adverse health effects (i.e. waterborne disease). Several outbreaks of waterborne disease have been linked to extreme precipitation, and gastrointestinal infection has been shown to increase after floods. Climate change is likely to lead to a higher frequency of waterborne disease through increases in extreme precipitation and associated flooding affecting water and sanitation infrastructure. This review sought to answer 2 research questions: 1. Has the epidemiology of waterborne disease related to floods changed over time? 2. Can this difference be related to climate change? A literature search was …

Effect Of Climate Change On Lyme Disease Cases In 4 New Jersey Counties, Meredith Olson

Capstone Experience

Since its discovery more than 40 years ago, there has been an increasing occurrence of Lyme disease. Lyme disease is a tick-borne illness found predominantly in the Northeastern region of the United States. Studies have shown that environmental factors play an important role on the life cycle of ticks. Due to the complexity of environmental changes as well as the life cycle of different tick species, the variety of factors that could influence the increase in Lyme disease can be different depending on tick species and region. This study compared different regions of New Jersey, a highly Lyme disease endemic …

Perceptions Of Voice Health, Voice Health Care, And Voice Health Education In The Performance Community, Katelyn Nelson

Capstone Experience

There is a medical consensus that proper voice health precautions can protect the voice and decrease the occurrence and severity of voice disorders in vocal performers. Similarly, seeking medical treatment for voice disorders can speed recovery time and preserve the voice. Voice disorders are common in performance students and professionals because of demanding curricula and frequent voice use, but little is known about their voice care needs, preferred voice care resources, and clinical care. The purpose of this study was to add to the research on voice health by interviewing faculty members in the College of Communication, Fine Arts, and …

Development Of A Web-Based Agriculture Health Risk Assessment Tool For Military Veteran Farmers And Ranchers, Alyssa Damke

Capstone Experience

In the U.S., significant health disparities exist among rural populations compared to their urban counterparts. These disparities can be compounded in agricultural workers due to the dangerous and unpredictable nature of their work. Agricultural producers who are also military Veterans may experience additional health pressures that are often overlooked in the healthcare setting. Over 2.5 million Veteran Health Administration (VHA) patients reside in rural areas and the healthcare infrastructure to care for these Veterans may not include an agricultural occupational approach. To address healthcare disparities in Veteran farmers and ranchers, this study, in collaboration with AgriSafe Network, will be used …

Development Of Cholesterol Modified Rnai Polyplexes For Breast Cancer Therapy, Zhen Ye

Theses & Dissertations

Not available.

Exosomes Secreted Under Hypoxia Enhance Stemness In Ewing’S Sarcoma And Transform Microenvironment Cells, Matthew J. Kling

Theses & Dissertations

Intercellular communication between tumor cells and stroma within the hypoxic microenvironment promote aggressiveness and poor patient prognoses in ways that remain unclear. Here we show that hypoxic Ewing’s sarcoma (EWS) cells release exosomes that promote sphere formation, a stem-like phenotype, in EWS cells by enhancing survival and a cancer-associated phenotype in fibroblasts (CAFs). Given that hypoxia enriches for stem-like cells, we exposed EWS cells to hypoxia and hypoxic EWS-derived exosomes and assessed the stem cell phenotype. Hypoxia and hypoxic EWS-derived exosomewere found to enhance TIC formation in vitro and in vivo by reprogramming EWS cells. Analysis of the hypoxic exosomal …

Utilization Of Nurse Practitioners In States With Full Practice Authority: Does Geography Matter?, Jana Zwilling

Theses & Dissertations

Background: Over 80 million Americans reside in or are part of a population designated as Health Professional Shortage Areas (HPSAs). Of the primary medical HPSA areas designated in the U.S., 66.74% are located in rural or partially rural areas (HRSA, 2020). To combat this shortage, 23* states and Washington, D.C. have enacted full practice authority laws for nurse practitioners (NP). Over 60% of NPs work in communities of less than 250,000.

Problem: The variability and extent of utilization of NPs in states with full practice authority (FPA) is unknown. To ensure access to quality healthcare, nurse practitioners need to be …

Identifying, Adapting, And Implementing A Weight Management Program In Rural Primary Care, Gwenndolyn Porter

Theses & Dissertations

Rural adults are at heightened risk for obesity, yet evidence‐based interventions lack consistent translation into clinical practice. This multi-phase study addresses this gap. First, a systematic review and meta-analysis of rural adult weight loss interventions were conducted to assess overall impact. Though few studies reported participant representativeness, meta‐analyses revealed a significant weight reduction among interventions. Second, 10 focus groups were conducted with primary care (PC) staff to determine the feasibility of implementing a weight-management program through PC. Differences in responses among rural, micropolitan, and metropolitan was also assessed. Thematic analyses revealed rural PC currently lacks the capacity to manage patient …

Evaluation Of The Humoral Immune Response As A Potential Indicator Of Disease Severity For Patients Hospitalized With Covid-19, Spencer Sterling

Capstone Experience

Members of the family Coronaviridae, including the severe acute respiratory syndrome coronaviruses (SARS-CoV-1 and SARS-CoV-2), Middle East respiratory syndrome coronavirus (MERS-CoV) and seasonal human coronaviruses (HCoV-HKU1and HCoV-OC43), are highly communicable respiratory viruses; SARS-CoV-1, SARS-CoV-2, and MERS can cause severe disease, while seasonal human coronaviruses present with mild to moderate illness. Coronavirus envelope spike (S) glycoproteins are involved in receptor binding and cell fusion, and are the primary target for a neutralizing humoral response. The S protein is comprised of the S₁ and S₂ subunits; the S₁ subunit contains the receptor-binding domain (RBD), while the S_{2 …}

Development Of Hyaluronic Acid-Derived Macromolecular Agents For Multimodal Imaging Probes And Nanomedicine, William M. Payne

Theses & Dissertations

Cancer, one of the most challenging maladies facing modern medicine, is a complex family of diseases that requires a multifaceted treatment regime. In recent years, increased research effort has been placed on the development of nanoscale formulations as a potential method to improve therapeutic efficacy and offer better treatment. Both drug formulation and biomedical imaging has benefitted from the development of new, nanoscale agents. Hyaluronic Acid (HA), a naturally occurring glycosaminoglycan, is a promising platform for the development of new drug delivery systems. Furthermore, hyaluronic acid is the principal ligand for the cell surface receptor CD44, which is overexpressed on …

Smart Delivery Of Genes And Drugs For Treatment Of Cancer, Feng Lin

Theses & Dissertations

The ineffective delivery of genes and drugs have become a big obstacle for the treatment of cancer, due to either poor stability or low aqueous solubility. In the first part, A ROS responsive polymer named poly(ethylene glycol)–poly[aspartamidoethyl(p-boronobenzyl)diethylammonium bromide] (PEG-B-PAEBEA) was developed for codelivery miR-34a mimic and small molecule PLK1 inhibitor volasertib (BI6727) for the treatment of pancreatic ductal adenocarcinoma (PDAC), since tumor suppressor microRNA-34a (miR-34a), which targets many oncogenes related to proliferation, apoptosis, and invasion is significant downregulated while Polo-like kinase 1 (PLK1) closely associated with short survival rates of pancreatic cancer patients is remarkably upregulated . In part 2, …

Delivery For Hydrophobic Drugs For Treating Pancreatic Cancer, Saud Almawash

Theses & Dissertations

Purpose The aim of this study was to determine whether coadministration of hedgehog (Hh) pathway inhibitor cyclopamine (CYP) and microtubule stabilizer docetaxel (DTX) as polymer-drug conjugates, methoxy poly(ethylene glycol)-block-poly(2-methyl-2-carboxyl-propylenecarbonategraft- dodecanol-graft-cyclopamine) (P-CYP) and methoxy poly(ethylene glycol)-block-poly(2-methyl-2-carboxyl-propylene carbonate-graft-dodecanol-graft-docetaxel) (P-DTX) could synergistically inhibit orthotopic pancreatic tumor growth in NSG mice.

Methods P-DTX and P-CYP were synthesized from mPEGb- PCC through carbodiimide coupling reaction and characterized by 1H–NMR. The micelles were prepared by film hydration and particle size was measured by dynamic light scattering (DLS). Cytotoxicity, apoptosis and cell cycle analysis of P-DTX and P-CYP were evaluated in MIA PaCa-2 cells. In vivo efficacy …

The Role Of Extracellular Vesicles In Cancer-Related Fatigue And Its Co-Occurring Symptoms, Dilorom M. Sass

Theses & Dissertations

Cancer survivors report many debilitating symptoms associated with cancer and its treatments. About 30% will report long-term cancer-related fatigue (CRF) which often co-occurs with depressive symptoms, sleep disturbances, cognitive fatigue, and poor overall health-related quality of life. The underlying causes of these co-occurring symptoms have been related to systemic processes such as inflammation. Extracellular vesicles (EVs) contain systemic markers such as genetic and protein materials that inform about cell-to-cell interactions that influence immune signaling and inflammatory processing. No study to date has explored the associations of EVs with cancer-related symptoms. So, the purpose of this dissertation was to investigate the …

Ocular, Neural, And Cellular Biodistribution Of Multifunctional Antioxidants, Damian Daszynski

Theses & Dissertations

Aging is a complex biological process which stems from a growing imbalance between the regenerative capacity of an organism and endogenous as well as exogenous damaging factors. This imbalance leads to the slow deterioration of individual cells, organs, and eventually the entire organism. The free radical theory of aging combines the evolutionary and mechanistic aspects of aging, postulating that the innate process is caused by deleterious, irreversible, and inevitable changes in biological systems caused by oxidative damage that accumulates over the lifespan. Evidence of this phenomenon is supported by the pathogenesis of age-related diseases, such as age-related macular degeneration and …

Self-Management For Individuals Using Long-Term Urinary Catheterization, Lisa Krabbenhoft

Theses & Dissertations

Many individuals with adult neurogenic lower urinary tract disorder require long-term urinary catheterization for bladder management. The daily use of urinary catheterization increases the risk for chronic complications including catheter associated urinary tract infections. Previous studies have used self-management interventions to reduce chronic complications in the community setting. However, there are limited intervention studies focused on reducing chronic complications after discharge from a rehabilitation hospital. The purpose of this dissertation study is to examine the feasibility and impact of a self-management intervention on individuals after leaving rehabilitation hospital for home within the community.

This dissertation comprises two studies, the first …

The Evolving Management Of Aortic Valve Disease: Trends In The Utilization And Cost Of Savr, Tavr, And Medical Therapy, Andrew Goldsweig

Theses & Dissertations

Aortic stenosis (AS) and regurgitation (AR) may be treated with surgical aortic valve replacement (SAVR), transcatheter AVR (TAVR), or medical therapy (MT). Data are lacking regarding usage and cost of SAVR, TAVR, and MT for patients hospitalized with aortic valve disease. From the Nationwide Readmissions Database, we determined utilization and cost trends for SAVR, TAVR, and MT in patients with aortic valve disease admitted 2012-2016 for valve replacement, heart failure, unstable angina, non-ST-elevation myocardial infarction, or syncope. From 2012 through 2016, there was a 48.1% increase in the number of patients hospitalized for aortic valve disease annually. Overall, 19.9%, 6.7%, …

Planning And Facilitating The Training Of Emergency Medical Services On The Safe Transport Of Patients With Highly Infectious Diseases, Mohammed Alhallaf

Theses & Dissertations

Emergency Medical Services (EMS) personnel are the first line of treatment and are the first exposed health care workers to infectious diseases (IDs). Consequently, the EMS setting is a relatively vulnerable environment for disease transmission and cross-contamination. Also, serious and emerging IDs, such as highly pathogenic viral hemorrhagic fevers and novel Coronaviruses, in a time of increased globalization, require comprehensive EMS training and preparedness. This project had the objective of identifying best practices for the EMS transport of patients with IDs. The methods for this project were done in two phases. In the first stage, we …

Characteristics Of Tobacco Retailers And Proximity To Schools In A Midwest City, Sierra N. Garth

Capstone Experience

This descriptive epidemiology project provides an overview of the number, characteristics, and proximity of retailers that sell tobacco and vaping products to middle and high schools. ArcGIS was used to map the proximity of these retailers to public and private middle and high schools in Lincoln, Nebraska. Mapping the retailers and schools allowed us to explore the potential exposures to these products teens experience on a daily basis.

An Assessment Of Occupational Heat Stress In A Central Utility Plant, Abdoulaye Abdoulaziz

Capstone Experience

Global climate change has been declared a threat to human health, which includes occupational safety issues. As temperatures continue to increase, heat stress and heat-related illness are occupational safety issues that need to be better understood. Assessments of workplace heat exposures are key to implement appropriate health and safety interventions. This study attempted to assess whether workers’ perception of work environment temperature in a Central Utility Plant was associated with heat-stress prevention behaviors. Therefore, we used a questionnaire to collect Central Utility Plant employees’ demographic characteristics, data regarding their perceived work environment temperatures, and their behaviors related to preventing heat-related …