Digital Commons Network^™

Inflammation In The Pathogenesis Of Diabetic Retinopathy, Haoshen Shi

Wayne State University Dissertations

The general purpose of these studies is to investigate inflammation in diabetic retinopathy in an effort to identify key intervention points to develop as treatments. Firstly, we showed that the neuropeptide VIP displayed protective immunoregulatory effects on retinal endothelial cells cultured under high glucose conditions. This effect was carried out, in part through the VPAC2 receptor.

Next, we studied the β-adrenergic receptor agonist, Compound 49b, and its effect on the pro-resolving RvD1 pathway. Compound 49b was previously shown to suppress both inflammatory and apoptotic responses in DR. We demonstrated that Compound 49b rescued the high glucose-induced decrese in RvD1 and …

Proactive Coordination In Healthcare Service Systems Through Near Real-Time Analytics, Seung Yup Lee

Wayne State University Dissertations

The United States (U.S.) healthcare system is the most expensive in the world. To improve the quality and safety of care, health information technology (HIT) is broadly adopted in hospitals. While EHR systems form a critical data backbone for the facility, we need improved 'work-flow' coordination tools and platforms that can enhance real-time situational awareness and facilitate effective management of resources for enhanced and efficient care. Especially, these IT systems are mostly applied for reactive management of care services and are lacking when they come to improving the real-time "operational intelligence" of service networks that promote efficiency and quality of …

Kilovoltage Intensity Modulated Radiotherapy, Brian Loughery

Wayne State University Dissertations

Contrast enhanced kilovoltage radiotherapy could be a significant improvement over the standard of care in glioblastoma multiforme, but its potential benefit has been hindered by fears of insufficient dose falloff, high skin and skull dose, contrast delivery concerns, and high cost. This dissertation aims to address the validity of these fears.

Contrast delivery concerns are examined by assuming that sufficient dose can be safely delivered to the tumor. Iodine, gadolinium, and gold nanoparticle biological effect and delivery research is examined and the ideal contrast delivery methods are reported. Dose falloff and skull dose are then investigated through treatment planning and …

Arabic Women’S Experience Of Childhood Sexual Abuse: A Mixed-Methods Study, Shahrazad Mahmoud Timraz

Wayne State University Dissertations

Background and purpose: Childhood sexual abuse (CSA) is an existing social problem that affects children worldwide, leading to poor psychological outcomes in adulthood. Childhood adversities including CSA account for 44.6% of childhood and 26%–32% of adult-onset psychiatric disorders. Furthermore, CSA is the second leading cause of posttraumatic stress disorder (PTSD) and influences an array of other outcomes such as depression, anxiety, hostility, and low self-esteem. Worldwide, approximately 8%–13% of girls have experienced sexual abuse. According to the few studies conducted in Arabic countries, CSA ranges from 7%–27%. Coping with CSA is a well-studied factor in regard to its impact on …

Data-Driven Modeling For Decision Support Systems And Treatment Management In Personalized Healthcare, Milad Zafar Nezhad

Wayne State University Dissertations

Massive amount of electronic medical records (EMRs) accumulating from patients and populations motivates clinicians and data scientists to collaborate for the advanced analytics to create knowledge that is essential to address the extensive personalized insights needed for patients, clinicians, providers, scientists, and health policy makers. Learning from large and complicated data is using extensively in marketing and commercial enterprises to generate personalized recommendations. Recently the medical research community focuses to take the benefits of big data analytic approaches and moves to personalized (precision) medicine. So, it is a significant period in healthcare and medicine for transferring to a new paradigm. …

Non-Invasive Mitochondrial Modulation With Near-Infrared Light Reduces Brain Injury After Stroke, Christos Dionisos Strubakos

Wayne State University Dissertations

Acute ischemic stroke is a debilitating disease that causes significant brain injury.

While rapid restoration of blood flow is critical to salvage the ischemic brain, reperfusion

of tissue can further drive brain damage by inducing generation of mitochondrial reactive

oxygen species (Chouchani et al., 2014a). Recent studies by our group found that noninvasive

mitochondrial modulation (NIMM) with near-infrared (NIR) light can limit the

production of reactive oxygen species following global brain ischemia (T. H. Sanderson

et al., 2018). NIR interacts with the rate limiting step of the mitochondrial electron

transport chain (ETC), cytochrome c oxidase (COX), and modulates mitochondrial

respiration. …

Characterizing Novel Radiologic And Pathologic Tissue-Based Risk Factors For Breast Cancer In African American Women With Benign Breast Disease, Asra N. Shaik

Wayne State University Dissertations

African American women (AAW) suffer a higher breast cancer mortality burden than women of other ethnicities in the US. More likely to be diagnosed with aggressive subtypes resistant to therapy and with rapidly fatal course than European American women (EAW), AAW may benefit greatly from earlier detection of breast cancers. However, it remains difficult to predict with a high degree of accuracy which women will develop breast cancer. Current risk assessment is especially poor for AAW, where models consistently underestimate risk in the subset of women with a prior biopsy. Risk assessment can be improved with the inclusion of new …

The Adaptation To Head And Neck Cancer In The Veteran Population, Diane Marie Sobecki-Ryniak

Wayne State University Dissertations

ABSTRACT

ADAPTATION TO HEAD AND NECK CANCER IN THE VETERAN POPULATION: A PILOT STUDY

By

DIANE SOBECKI-RYNIAK

December 2018

Advisor: Dr. Margaret Campbell

Major: Nursing

Degree: Doctor of Philosophy

Post-traumatic stress disorder in the head and neck cancer veteran population may present a challenge to adaptation during diagnosis and treatment of illness. The evaluation of post traumatic stress disorder, anxiety, depression and quality of life were examined and correlated against symptom occurrence and triggering of post traumatic symptoms across experiences. A significant correlation between PTSD-C and PTSD-S was found (r = 0.91, p = 0.001); there was a non-significant correlation …

Managing Operational Efficiency And Health Outcomes At Outpatient Clinics Through Effective Scheduling, Samira Fazel Anvaryazdi

Wayne State University Dissertations

A variety of studies have documented the substantial deficiencies in the quality of health care

delivered across the United States. Attempts to reform the United States health care system in the 1980s and 1990s were inspired by the system's inability to adequately provide access, ensure quality, and restrain costs, but these efforts had limited success. In the era of managed care, access, quality, and costs are still challenges, and medical professionals are increasingly dissatisfied.

In recent years, appointment scheduling in outpatient clinics has attracted much attention in

health care delivery systems. Increase in demand for health care services as well …

The Impact Of Neonatal Pain And Reduced Maternal Care On Brain And Behavioral Development, Sean Michael Mooney-Leber

Wayne State University Dissertations

In the neonatal intensive care unit (NICU) preterm infants are exposed to a multitude of stressors, which include both neonatal pain and reduced maternal care. Clinical and preclinical research has demonstrated that exposure to neonatal pain and reduced maternal care has a profound negative impact on brain and behavioral development. Currently, the biological mechanism by which both of these stressors impacts brain and behavioral outcomes remains widely unknown. To uncover a potential biological mechanism, the current dissertation project utilized a preclinical model of repetitive needle pokes and developed a novel model of reduced maternal care through tea-ball encapsulation. Briefly, rat …

The Influence Of Protein Context On Polyglutamine Toxicity In Spinocerebellar Ataxia Type 3, Joanna Rae Sutton

Wayne State University Dissertations

The polyglutamine (polyQ) disease family is composed of nine neurodegenerative diseases caused by CAG trinucleotide repeat expansions in the associated genes. Although these diseases are caused by similar mutations, the polyQ proteins are otherwise structurally and functionally unique. Thus, the protein domains surrounding the polyQ tracts, as well as their interacting partners, are thought to be critical to the pathogenesis of these clinically distinct diseases. Spinocerebellar ataxia type 3 is caused by polyQ expansion of ataxin-3, a deubiquitinating enzyme implicated in protein quality control, transcriptional regulation, and DNA repair. Rad23 and VCP are two of ataxin-3’s protein quality control partners …

Improving Aav Transduction Efficiency In Retinal Bipolar Cells For Optogenetic Vision Restoration, Shengjie Cui

Wayne State University Dissertations

Recombinant adeno-associated virus (AAV) vectors are the most promising vehicles for therapeutic gene delivery to the retina. We are developing AAV-mediated expression of optogenetic tools in surviving inner retinal neurons as a potential strategy to restoring vision after the death of photoreceptor cells in retinal degeneration. Targeting optogeneitc tools, such as channelrhodopsin-2 (ChR2), to retinal bipolar cells (RBCs) is particularly attractive. In particular, our lab has recently developed an optimized mGluR6 promoter-based virus vector that can mainly target ChR2 to rod bipolar cells. However, AAV-mediated transduction efficiency in RBCs is relatively low. The transduction efficiency could be affected by a …

The Role Of Neurokinin Receptors And Satellite Glial Cells In Herpes Simplex Virus 1 Latency, Andrew Jerome

Wayne State University Dissertations

The ability of herpes simplex virus 1 (HSV-1) to establish a lifelong infection in neurons of the trigeminal ganglion (TG) make it a constant public health threat. Viral reactivation from its latent state is currently the leading cause of viral induced blindness in the United State, as well as the leading cause of herpes simplex encephalitis. Unfortunately, how the virus is able to both establish and maintain its latent state in the TG is not well understood. The purpose of this work was to better understand how neuropeptide signaling through neurokinin receptors, as well as how satellite glial cells (SGCs) …

Venous Thromboembolism (Vte) Harm Measurement And Risk Assessment In Real-Time Using Electronic Health Records(Ehr), Seyed Mani Marashi

Wayne State University Dissertations

Venous Thromboembolism (VTE) is a deadly disease and is considered as one of the top reasons for avoidable hospital deaths in the United States and around the world. Patients who survive this disease often must face life-long complications such as Post-thrombotic syndrome (PTS), Chronic thromboembolic pulmonary hypertension (CTPH), etc. Therefore, it is important to monitor and reduce the number of VTE instances in hospitals. This study shows how Electronic Health Records (EHRs) can be utilized to achieve this goal.

First, a new near real-time VTE harm measurement model was developed. Not only the developed model can deliver near real-time results, …