Digital Commons Network^™

Perivascular Waste Metabolites Clearance In Central Nervous System (Cns), Yiming Cheng

Dissertations

Efficient clearance of interstitial waste metabolites is essential for normal brain homeostasis. Such effective clearance is hampered by the lack of a lymphatic system in the brain, and the cerebrospinal fluid (CSF) is unable to clear large size waste metabolites in the brain. Here, a novel idea that brain arterial endothelium and smooth muscle cells reactivity regulates the clearance of these water-insoluble large size waste metabolites through the perivascular dynamic exchange, and that low dose ethanol promotes this perivascular clearance is proposed.

In Aim 1, the biodistribution of a large size waste metabolite (Amyloid-β protein mimic) in rat perivascular space …

Mitochondria Imaging And Targeted Cancer Treatment, Tinghan Zhao

Dissertations

Mitochondria are essential organelles as the site of respiration in eukaryotic cells and are involved in many crucial functions in cell life. Dysfunction of mitochondrial metabolism and irregular morphology have been frequently found in human cancers. The capability of imaging mitochondria as well as regulating their microenvironment is important both scientifically and clinically. Mitochondria penetrating peptides (MPPs), certain peptides that are composed of cationic and hydrophobic amino acids, are good candidates for mitochondria targeting. Herein, a novel MPP, D-argine-phenylalanine-D-argine-phenylalanine-D-argine-phenylalanine-NH₂ (rFrFrF), is conjugated with a rhodamine-based fluorescent chromophore (TAMRA). The TAMRA-rFrFrF probe exhibits advantageous properties for long-term mitochondria tracking of …

To Disclose Or Not To Disclose? Self-Disclosure Of Mental Health In The Workplace, Samantha Margaret Reynolds

Dissertations and Theses

When making the decision to disclose a mental illness, individuals may be met with a number of factors that impact disclosure. This study examines the relationship between self-stigma, psychological safety, social support and self-disclosure of mental illness in the workplace. The present study surveyed 756 participants and found a positive relationship between stigma and self-disclosure as well as a positive relationship between social support and self-disclosure. For work outcomes, there was a negative relationship between both job satisfaction and productivity in relation to self-disclosure. This study potentiates the antecedents and consequences of self-disclosure of mental illness and how it impacts …

Predictive Modeling Of Influenza In New England Using A Recurrent Deep Neural Network, Alfred Amendolara

Theses

Predicting seasonal variation in influenza epidemics is an ongoing challenge. To better predict seasonal influenza and provide early warning of pandemics, a novel approach to Influenza-Like-Illness (ILI) prediction was developed. This approach combined a deep neural network with ILI, climate, and population data. A predictive model was created using a deep neural network based on TensorFlow 2.0 Beta. The model used Long-Short Term Memory (LSTM) nodes. Data was collected from the Center for Disease Control, the National Center for Environmental Information (NCEI) and the United States Census Bureau. These parameters were temperature, precipitation, wind speed, population size, vaccination rate and …

Effect Of 3d Printed Tablet Shape On Drug Release Profile, Christina Gedeon

Theses

There is a growing interest in utilizing additive manufacturing (AM) as a manufacturing tool to develop oral tablets for personalized medicine. This ultimate goal in mind, this study explores the feasibility of extrusion-based fused deposition modeling (FDM) to 3D print oral tablets with tunable design to control drug release profile. Tablets are printed using poly(vinyl alcohol) (PVA) loaded with model drugs: acetaminophen and caffeine. Hot melt extrusion (HME) is used to fabricate PVA filaments loaded with acetaminophen and caffeine. These filaments are used to fabricate a range of tablets with varying designs to prepare immediate and delayed release tablets. Thermal …

Frontline Nurse Leader Orientation Programs: A Review Of Literature, Shanelle Renee House

DNP Qualifying Manuscripts

Abstract

Aim This manuscript aims to synthesize the literature on the skills and knowledge needed by frontline nurse leaders and effective orientation or training programs developed to meet those needs.

Background Frontline nurse leaders are often promoted to positions of leadership due to their strong clinical skills; they often do not receive formal training.

Evaluation A literature search was conducted to identify and critically appraise journal articles that discuss orientation and training programs offered to frontline nurse leaders.

Key Issues The literature review revealed that frontline nurse leaders require a variety of skills and knowledge to be successful. Orientation and …

Preoperative Smoking Cessation Education Plan For Patients And Health Care Professionals, Amy Anderson

Nursing Capstones

Surgical site infections are an undesired consequence of surgery. Smoking has been identified as a risk factor for developing a postoperative infection (Anderson, 2019). Patients undergoing elective colorectal surgery should be required to be tobacco-free for at least four weeks before surgery. Health care organizations can implement a preoperative smoking cessation program within their facility to assist patients in achieving this requirement. To do so, an education plan is needed to effectively disseminate the main components of the program to both patients and health care professionals. The efficacy of the education plan can be exponentially increased by selecting learning strategies …

Improving Patient Communication With Bedside Medical Interpreters: Nursing Education Focus On Providing Culturally Competent Care, Molly Murch

Nursing Capstones

Patient-centered care is achieved through effective communication between the patient and the healthcare team members. The purpose of this independent study project is to show that the increasing cultural, ethnic, and linguistic diversity in the United States healthcare system has resulted in an increased need for professionally trained medical interpreters, as well as the continued need to educate pre-licensure nursing students on the importance of providing culturally competent care. This paper will first focus on Limited English Proficiency (LEP) patients in healthcare. Information discussed will include data on the number of LEP patients who require healthcare, laws protecting LEP patients, …

Education Strategies For The Interdisciplinary Team Of An Early Mobility Protocol, Malori Paplow

Nursing Capstones

Implementation of early mobility protocols in the intensive care unit has been well documented to prevent multiple complications associated with prolonged immobility and to improve patient outcomes. Expectations to implement evidence-based healthcare is growing and the most difficult steps in the process is education and implementation, and it is often left to busy nursing leaders who may be unprepared for the challenge. The literature provides little direction for nurses regarding when to use specific educational strategies when implementing an early mobility protocol, especially amongst the interdisciplinary team. The purpose of this paper is to create an evidence-based education plan for …

Teaching Methodologies For Improved Student Engagement In Online Or Distance Education Courses, Erin Williams

Nursing Capstones

Research demonstrates the importance of learner engagement and social presence achievement of student learning outcomes and increased student satisfaction. However, little guidance is available to educators on how to create effective online and distance education courses that are engaging, interactive, student-centered, and effective. A literature review was completed to determine which online and/or distance education teaching methodologies are best for improving student engagement, and therefore improving student outcomes. Thirteen articles published between January 2014 and December 2019 were identified from a search of two databases. Ten of these articles were further analyzed according to the Community of Inquiry (CoI) framework. …

Training And Support Of Unit Preceptors_A Literature Review Of Most Successful Tools, Corinne E. Jones

Nursing Capstones

With nurses entering the workforce in the millions, preceptors are used to educate and train preceptees in clinical settings. A knowledge-practice gap exists when preceptors are put into their roles without any training regarding how to perform their preceptor duties. While preceptor education is desired among preceptors, there are no set standards for how preceptor training is delivered or what content is included. This paper reviews current literature and synthesizes results to form general guidelines regarding how best to deliver preceptor education and concept themes to be included in preceptor education. The databases CINAHL, PsycINFO, and ERIC were searched for …

Patient Satisfaction With Substance Use Disorder Rehabilitation Services, Trupti Dhumal

Electronic Theses and Dissertations

Background: Patient satisfaction is considered as an important indicator in the evaluation of healthcare quality across an array of treatments and services. It is deemed vital especially in the field of substance use disorder (SUD) research due to an increased emphasis on understanding patients’ perceptions regarding their treatment and the attributes that drive their progress towards recovery. Despite the potential value, gaps have been recognized in the exploration of these satisfaction-related assessments among patients undergoing SUD treatment in residential rehabilitative settings. Thus, there is a need for understanding the dimensions contributing to satisfaction which would facilitate the development of …

Determining Nurse Practitioner Core Competencies Utilizing A Delphi Approach, Tracey Chan

Electronic Theses and Dissertations

Background: Competency-based education (CBE) has been recommended for nurse practitioner (NP) education. To implement CBE, existing NP core competencies need to be reduced in number and refined.

Purpose: This study refined and reduced redundancy in the National Organization of Nurse Practitioner Faculties (NONPF) and American Association of Colleges of Nursing (AACN) NP core competencies through the consensus of experts in NP practice. This study used the current NP Core Competencies (NONPF, 2017), the Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006), and the Common Advanced Practice Registered Nurse Doctoral-Level Competencies,(AACN, 2017a) …

Characterization Of The Effect Of Exercise Dose And Integrative Nonpharmacological Therapies In The Treatment Of Chronic Pain, Anna M. Polaski

Electronic Theses and Dissertations

Chronic pain includes debilitating conditions affecting large populations of people throughout the world. These diseases are further complicated by comorbid psychological disorders which make chronic pain conditions difficult to treat. Nonpharmacological treatment options have more recently become an important mainstay of effective therapies and are currently being used to supplement or replace traditional pharmacological treatment methods. Exercise-based therapies in particular are of interest due to their demonstrated success in reducing pain symptoms as well as improving psychological outcomes. Dose is an important factor in being able to effectively prescribe treatments in the context of specific exercise interventions and specific pain …

Perspectives Of Occupational Therapy Practitioners On Benefits And Barriers On Providing Occupational Therapy Services Via Telehealth, Taylor Corey

Student Capstone Papers

The purpose of this project is to gain a better understanding of the provider’s perspectives about the strengths and barriers of occupational therapy (OT) services provided via telehealth. Based on the evidence that will be collected through surveys and interviews, this research can help determine specific factors on whether or not therapist choose to provide services through telehealth. Centered around those perspectives of telehealth, the results can help explore more in depth on the issues and concerns therapists have regarding telehealth as a service delivery model.

The Ethical Justification Of Increasing Awareness Of Preventive Medicine Among Healthcare Professionals, Patients And The General Public In The United States, Karishma Ether Moazzam

Electronic Theses and Dissertations

While practiced for centuries, preventive medicine has received increased attention during the recent times. Preventive medicine has a distinct mission to protect, promote, and maintain health as well as to prevent diseases, disabilities, and premature deaths. It aims to fulfill its mission through the combined form of clinical intervention and health promotion. In the recent years, preventive medicine has begun to lean more towards the clinical interventions, taking away from the health promotion. This imbalance has caused preventive medicine to lose its effectiveness in fulfilling its mission. One of the leading causes for such imbalance is the lack of proper …

Caregiver Perspectives On Telehealth: A Service Delivery For Occupational Therapy, Rebecca Johnston

Student Capstone Papers

Telehealth; also known as telerehabilitation, telecare, telemedicine, teletherapy, and telepractice; is an emerging healthcare service that is utilized in various healthcare facilities with a span of ages, conditions, and locations (World Federation of Occupational Therapy [WFOT], 2014). Telehealth utilizes information and communication technologies to deliver services to a patient when the healthcare provider is not in the same location (WFOT, 2014). Telehealth can provide an online platform for evaluations, consultations, monitoring, supervision, and intervention with patients and other professionals (WFOT, 2014).

Telehealth is an emerging method of delivering occupational therapy (OT) services to various populations, including: children and youth; productive …

Characterizing The Combination Of Rpa Inhibitors With Parp Inhibitors In High-Grade Serous Ovarian Cancer, Yat Tang

Theses & Dissertations

High-grade serous ovarian cancer (HGSC) is the most common and deadly gynecologic malignancy. HGSC patients with BRCA1/2 mutations have homologous recombination deficiency (HRD), requiring parallel pathways to maintain genome integrity (e.g., PARP1, PARP2). Approximately 50% of ovarian carcinomas are estimated to exhibit HRD. For the remaining 50% and the large percentage of HRD patients with acquired or innate resistance to single-agent PARP inhibitors, there is a need to develop alternative therapeutic strategies.

Replication Protein A (RPA) is a heterotrimeric protein crucial for genome maintenance. Phosphorylation of RPA in DNA damage response (DDR) is a negative regulator of DNA end resection. …

Enhancing The Identification Of Rheumatoid Arthritis-Associated Lung Disease, Bryant England

Theses & Dissertations

Rheumatoid arthritis (RA) is a systemic autoimmune disease that predisposes afflicted individuals to reduced quality of life, physical disability, and premature mortality. While joint involvement is the primary manifestation of RA, extra-articular features including lung disease are responsible for a significant portion of the excess mortality. In this dissertation I demonstrate the contribution of chronic lung diseases to premature mortality in RA, contrasting with the more widely recognized comorbidity in RA of cardiovascular disease. Then, I establish that a novel serum biomarker, anti-malondialdehyde-acetaldehyde adduct (MAA) antibody, is associated with the presence of interstitial lung disease (ILD) in RA subjects. Further …

The Development Of Hyaluronan-Based Contract Agents For The Intraoperative Detection Of Pancreatic Tumors, Bowen Qi

Theses & Dissertations

Pancreatic ductal adenocarcinoma is highly lethal and surgical resection is the only potential curative treatment for the disease. Tumor-specific intraoperative fluorescence imaging could improve staging and surgical resection, thereby improving prognosis. In the first study, hyaluronic acid derived NPs with physico-chemically entrapped indocyanine green, termed NanoICG, were utilized for intraoperative near infrared fluorescence detection of pancreatic cancer. NanoICG accumulated significantly in an orthotopic pancreatic ductal adenocarcinoma model with safety profile both in vitro and in vivo. To maximize tumor signal, while minimizing signal in healthy pancreas and RES capture of macromolecules, in the next study, we describe the rational …

Theranostics For Antiretroviral Biodistribution And Pharmacokinetics, Brendan M. Ottemann

Theses & Dissertations

RATIONALE: Our laboratories birthed the field of human immunodeficiency virus (HIV) theranostics. The new field allows simultaneous detection (diagnostics) and treatment (therapeutic) for the identification, treatment and inevitable elimination of virus in cell and tissue compartments. By employing theranostics, antiretroviral drugs (ARVs) can be tracked in lymph nodes, gut, spleen and liver. Cellular viral reservoirs including CD4+ T cell populations and mononuclear phagocytes (MP; monocytes, macrophages, microglia and dendritic cells) along with subcellular endosomal structures can now be targeted for drug delivery bringing therapeutics to areas where virus replicates. The overarching idea rests in improving precision targeted ARV delivery. …

Charge-Based Optimization Of Neurotensin For Neurotensin-Receptor-1 Targeting Utilizing A One-Bead One-Compound Peptide Library Approach, Trey Neeley

Theses & Dissertations

Neurotensin-receptor-1 (NTSR1) is regularly overexpressed in various cancers and contributes to the proliferation, survival, migration, invasion, and angiogenesis of tumors. NTSR1-targeting vectors have demonstrated promise in both diagnostic and therapeutic aspects. Unfortunately, the relatively poor in vivo metabolic stability and high renal uptake and retention of NTSR1-targeted compounds have hampered the translation to the clinic. In this research, we utilized a one-bead one-compound (OBOC) peptide library approach to make targeted modifications at the naturally charged residues of an NTS (4-13) sequence to discover an NTS derivative with comparable affinity to NTSR1, acceptable in vivo stability, and tolerable renal retention. Subsequent …

Hiv-1 Elimination In Humanized Mice, Hang Su

Theses & Dissertations

Human immunodeficiency virus type one (HIV-1) exclusively infects humans and chimpanzees. Therefore, animal models are required for all investigations of viral pathogenesis, therapy and cure. Immunodeficient mice transplanted with human hematopoietic stem cells, termed humanized mice, support the development of multiple human cell lineages throughout the cell’s life span. To this end, we used humanized mice to evaluate the dynamic changes of host immunologic and viral profiles during both acute and chronic HIV-1 infection. We identified the temporal and spatial distribution of HIV-1 cell and tissue compartment infections and outlined correlations made between viral progression and host immunity by comparing …

Orthodontically Induced External Root Resorption In Extraction Versus Non-Extraction Treatment Modalities – A Retrospective Cone-Beam Computed Tomography (Cbct) Study, Jaykishan Patel

Theses & Dissertations

Purpose of this study was to evaluate orthodontically induced external apical root resorption using cone beam computed tomography in patients receiving orthodontic treatment with or without extractions. Records of 188 consecutively treated patients who received orthodontic treatment with or without extractions were evaluated. Pre-and post-treatment root lengths of maxillary incisors, volumes of maxillary central incisors, and apex displacement of either right or left maxillary central incisors were measured using Invivo 5.4 or ITK-SNAP 3.8.0 software. After adjusting for initial length, treatment duration, tooth, sex, race, bracket type, and malocclusion, maxillary incisor reduction of root length in extraction group was 0.37 …

Identification Of More Potent And Efficacious Analogs Of The Novel Host-Derived Immunostimulant Ep67, Abdul Alshammari

Theses & Dissertations

EP67 is a human C5a-derived decapeptide agonist of C5a Receptor 1 (C5aR1/CD88) that selectively activates mononuclear phagocytes over neutrophils to stimulate protective innate and adaptive immune responses while potentially minimizing neutrophil-mediated toxicity. Two N-alkyl amino acids Pro⁷ and N-methyl-Leu⁸ (nme-Leu⁸) within EP67 induce structural changes that increase potency and selective activation of mononuclear phagocytes over neutrophils. Cis/trans isomerization at these positions, however, likely limits the activity of EP67 and low coupling efficiency between Pro⁷ and nme-Leu⁸ increases scale-up costs for clinical use. Thus, the goals of this study were to …

The Effectiveness Of Resin-Modified Glass Ionomer Varnish In Preventing White Spot Lesions During Fixed Appliance Orthodontic Therapy: An In Vitro Study, Bradley Herman

Theses & Dissertations

The purpose of this investigation was to evaluate the efficacy of a glass ionomer varnish in preventing demineralization of enamel adjacent to and some distance away from an orthodontic bracket. Forty extracted human molars were divided into four different treatment groups (varnish in distilled water, varnish in acetic acid, enamel in acetic acid, and enamel in distilled water). Two 3 x 3 mm graphite windows were drawn on the tooth, one adjacent to the bracket and one 3 mm away from the first window, indicating the scanning area. Varnish was applied to the teeth in the varnish groups and all …

Defining The Role Of Tyrosine Phosphorylation In The Regulation Of Connexin43 In Cardiac Diseases, Li Zheng

Theses & Dissertations

Connexins are integral membrane proteins that oligomerize to form gap junction channels. Ions and small molecules diffuse intercellularly through these channels, allowing individual cellular events to synchronize into the functional response of an entire organ. Gap junction channels composed of Connexin43 (Cx43) mediate electrical coupling and impulse propagation in the normal working myocardium. In the failing heart, Cx43 remodeling (decreased expression, altered phosphorylation state, loss at intercalated discs, and increased presence at lateral membranes) contributes to rhythm disturbances and contractile dysfunction. While there is considerable information regarding key interactions of Cx43 in the regulation of gap junction channels, unfortunately, the …

Delivery Of Small Molecule And Rna Using Synthetic Polymeric Micelles And Multifunctional Exosomes For The Treatment Of Type 1 Diabetes, Yang Peng

Theses & Dissertations

Type 1 diabetes is one of the most challenging chronic autoimmune diseases. The destruction and dysfunction of insulin-secreting β cells are the results of inflammatory infiltration and the synergistic effect of multiple immune cells. The aim of this dissertation is to develop novel and reliable therapeutic approaches to advance the treatment of T1D: including chemical modification of a broad-spectrum immunosuppressant, co-application of small molecule based immune intervention and siRNA based β cell preservative therapy, and administration of a PI3K-δ/γ dual inhibitor to specifically target immune cells, utilizing synthetic polymeric micelles or natural produced multi-functional exosomes derived from human bone marrow …

Burden And Risk Of Non-Aids Defining Cancers In Hiv-Infected Persons Receiving Antiretroviral Therapy, Brittney L. Dickey

Theses & Dissertations

The burden of cancers not previously associated with an HIV infection, called non-AIDS defining cancers (NADCs), have increased in the years since highly active anti-retroviral therapy has been introduced. The studies in this dissertation attempted to quantify this burden via incidence and mortality compared to the general population. Further, an assessment of risk factors and creation of a predictive risk model, a nomogram, were utilized to better understand how factors associated with demographics, lifestyle, and immune response affected risk for an NADC diagnosis once therapy was initiated and HIV better controlled. Standardized incidence and mortality ratios showed that burden of …

The Potential For Dickeya Dianthicola To Be Vectored By Two Common Insect Pests Of Potatoes, Jonas K. Insinga

Electronic Theses and Dissertations

Dickeya dianthicola (Samson) causing blackleg and soft rot was first detected in potatoes grown in Maine in 2014. Previous work has suggested that insects, particularly aphids, may be able to vector bacteria in this genus between plants, but no conclusive work has been done to confirm this theory. In order to determine whether insect-mediated transmission is likely to occur in potato fields, two model potato pests common in Maine were used: the Colorado potato beetle (Leptinotarsa decimlineata Say) and the green peach aphids (Myzus persicae Sulzer). Olfactometry and recruitment experiments evaluated if either insect discriminates between infected and …