Medicine and Health Sciences Commons^™

Prenatal Genetic Diagnosis Using Transcervically Derived And Immunomagnetically Isolated Trophoblast Cells, Swati Bajpayee

Honors College Theses

Trophoblast cells migrate from the placenta into the endocervical canal early in the first trimester and can be collected non-invasively by transcervical sampling (TCS), potentially providing fetal DNA for prenatal genetic diagnosis. Experiments were conducted to separate fetal cells from maternal cells within the TCS specimens and use the fetal cells to perform genetic analysis. Trophoblast cells were efficiently isolated from TCS specimens during weeks 5-18 of gestation using HLA-G antibody coupled to magnetic nanoparticles. Immunofluorescence microscopy revealed that 99% of isolated cells expressed the chorionic gonadotropin β subunit (β-CG), while the non-bound cell fraction expressed none. Immunomagnetically isolated cells …

Gender Does Not Influence The Relationship Between Posterior Cruciate Ligament Design And Patient-Reported Outcomes In Patients Receiving Primary Unilateral Total Knee Arthroplasty, Ryan Milan

Electronic Thesis and Dissertation Repository

The effect of the interaction between gender and posterior cruciate ligament (PCL) prosthesis design on patient-reported outcomes is an understudied area of research. We evaluated 1613 patients, from the Ontario Joint Replacement Registry (2001-2006), who underwent primary total knee replacement. This study investigated the impact of the gender-PCL design interaction on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) change scores and patient satisfaction, by performing linear regression analysis, using full-adjusted models that also included the gender-PCL prosthesis design interaction variable. PCL prosthesis design did not affect WOMAC change scores or satisfaction (p>0.05). Moreover, Gender did not influence either …

The Impact Of The Neuropeptide Y System On The Progression Of Breast Cancer, Philip J. Medeiros

Electronic Thesis and Dissertation Repository

Chronic stress is associated with elevated levels of sympathetic neurotransmitter release and immunosuppression. A growing body of evidence suggests that stress-related factors may contribute to the initiation, development and progression of breast cancer. Neuropeptide Y (NPY) has recently been determined as such a factor, however few investigations have addressed the functional effects of NPY on breast cells and tumors. Thus, the overall objective of this thesis was to elucidate the mechanisms by which NPY may contribute to the disease. Using the 4T1 murine breast cancer model, we began by first characterizing NPY receptor expression in cancer cells and tumors. Y1R, …

Amelioration Of Experimental Autoimmune Encephalomyelitis Using The Myelin Oligodendrocyte Glycoprotein35-85 Peptide, Vrushali Vinay Agashe

Theses and Dissertations

Multiple sclerosis (MS) is a chronic debilitating disease affecting the central nervous system (CNS) in humans. Experimental autoimmune encephalomyelitis (EAE) remains the primary animal model of MS. MS/EAE are considered to be autoimmune diseases mediated by CD4+ T helper (TH) cells. The role of B cells and antibody is under debate. Previous studies established B cell dependent (induced with recombinant myelin oligodendrocyte glycoprotein, [rMOG]) and B cell independent (induced with the MOG35-55 peptide) animal models of EAE. The identification of a unique B cell epitope (MOG amino acids [aa] 46-85) preceding the identified protective epitope (MOG61-85) led to the hypothesis …

Development Of A Novel Technique For Predicting Tumor Response In Adaptive Radiation Therapy, Rebecca Marie Seibert

Doctoral Dissertations

This dissertation concentrates on the introduction of Predictive Adaptive Radiation Therapy (PART) as a potential method to improve cancer treatment. PART is a novel technique that utilizes volumetric image-guided radiation therapy treatment (IGRT) data to actively predict the tumor response to therapy and estimate clinical outcomes during the course of treatment. To implement PART, a patient database containing IGRT image data for 40 lesions obtained from patients who were imaged and treated with helical tomotherapy was constructed. The data was then modeled using locally weighted regression. This model predicts future tumor volumes and masses and the associated confidence intervals based …

Fibulin-2 Stabilizes Tumor Extracellular Matrix And Drives Malignant Progression Of Lung Adenocarcinoma, Brandi N. Baird

Dissertations & Theses (Open Access)

The ECM of epithelial carcinomas undergoes structural remodeling during periods of uncontrolled growth, creating regional heterogeneity and torsional stress. How tumors maintain ECM integrity in the face of dynamic biophysical forces is still largely unclear. This study addresses these deficiencies using mouse models of human lung adenocarcinoma. Spontaneous lung tumors were marked by disorganized basement membranes, dense collagen networks, and increased tissue stiffness. Metastasis-prone lung adenocarcinoma cells secreted fibulin-2 (Fbln2), a matrix glycoprotein involved in ECM supra-molecular assembly. Fibulin-2 depletion in tumor cells decreased the intra-tumoral abundance of matrix metalloproteinases and reduced collagen cross-linking and tumor compressive properties resulting in …

The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon

Loma Linda University Electronic Theses, Dissertations & Projects

The first study population included 292 unselected consecutive patients from the LLUMC heart failure clinic who were enrolled in the study from January to July 2006 and were followed up through the end of December 2010. The treatment policy at the clinic was to uptitrate dosages of beta-adrenergic blockade (β-blockers), angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) to the most tolerable levels in order to reach target dosages, as recommended by the Heart Failure Society of America (HFSA). Patients were classified into systolic heart failure (ejection fraction (EF) < 40%) or diastolic heart failure (EF≥40%). All dosages of β-blockers, ACEi and ARB were extracted through chart reviews and were used as the main predictors of the patients' survival. Results from analyses showed that reaching target dosages of β-blockers and ACEi/ARB may increase survival when compared to not reaching target among the systolic HF population (HR_{β_biockers}= 0.64, 95% CI 0.26-1.56 and HR_ACEi/ARB=0.50, …

Characterization Of Beryllium As A Novel Agent To Study Cell Cycle Arrest And Cellular Senescence, Priyatham Gorjala

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer cells evade senescence, apoptosis, and other constraints on proliferation, often via mutation of the p53 tumor suppressor gene (TP53). Normal human lung fibroblasts have been shown to enter premature senescence upon exposure to beryllium. In these cells, BeSO₄ stabilizes p53 protein, increases p21 gene expression, induces senescence-associated β-galactosidase activity and causes cell proliferation arrest. In the present study, we have investigated whether BeSO₄ is able to induce similar effects in cancer cells that have wildtype p53. We have demonstrated that beryllium salt at low concentration can induce molecular changes in the p53 signaling pathway leading to cell …

Evaluating The Impact Of Two Different Methods Of Diabetes Self-Management Education On Knowledge, Attitude, And Behaviours Of Patients With Type 2 Diabetes Mellitus, Laura B. Briden

Electronic Thesis and Dissertation Repository

This study compared the effectiveness of diabetes self-management education (DSME) methods by examining changes in knowledge, attitude, and behaviour (KAB) after receiving education. Participants from a convenience sample were randomized into two groups, one receiving education through conversation maps and the other through traditional group education. Participants’ knowledge and attitude changes were measured by using a repeated measures pre-test/post-test design and changes in Hb A1c were observed. Focus groups were conducted after education was received to obtain perceptions and self-reported behaviour changes. Significant knowledge and attitude score changes were observed in the conversation map group after education. When comparing the …

Real-Time Analysis Of Brain Tumor Cell Dynamics: Novel Thermoelectric Detection Of L-Glutamate And Cell Metabolism Using Microfluidics, Siva Mahesh Tangutooru

Doctoral Dissertations

This study describes the design, fabrication and applications of a novel thermoelectric microfluidic bio-sensor. The bio-sensor is used for real time detection of the L-glutamate (L-glu) dynamics and metabolism for brain tumor cells immobilized in a microfluidic device. The microfluidic device is fabricated using a polymer/glass laminating technique (Xurography). An antimony-bismuth thin-film thermopile (primary sensing element) is integrated to the microfluidic device. The brain tumor cells are immobilized over the thermopile covering measuring and reference junctions of the thermopile using a poly-l-lysine coating layer. L-glutamate oxidase (L-GLOD) is immobilized over the measuring junctions of the thermopile prior to the immobilization …

The Development Of A Decision Aid For Patients With Ulcerative Colitis Deciding Between Ileostomy Or Ileal Anal-Pouch Reconstruction, Luc A. Dubois

Electronic Thesis and Dissertation Repository

Objectives: To develop a prototype decision aid used to assist ulcerative colitis patients when deciding between ileal pouch-anal anastomosis (IPAA) and ileostomy.

Methods: Three separate systematic reviews (quality of life studies, IPAA studies, ileostomy studies) were conducted to populate the decision aid with outcome probabilities. Meta-regression was used to select appropriate pooled outcomes.

Results: Of 3920 studies reviewed, 9 studies reported on quality of life, 67 on outcomes following IPAA, and 11 following ileostomy. No difference in quality of life was found between procedures. Among IPAA patients, pooled pouch failure rate was 5.5%, with pouchitis being the most common complication …

A Pilot Trial Comparing The Effects Of Onabotulinumtoxina And Standard Oxybutynin Therapy As First Line Treatment For The Poorly Compliant Pediatric Neurogenic Bladder, Sumit Dave

Electronic Thesis and Dissertation Repository

Research question

Is it feasible to conduct a phase III RCT to compare OnabotulinumtoxinA injections to oxybutynin as primary therapy in pediatric neurogenic bladder?

Methods

Patients on a stable oxybutynin regimen were recruited for a pilot RCT and underwent randomization to either OnabotulinumtoxinA or continuation of oxybutynin. Primary outcomes included an a priori defined feasibility and acceptability assessment. Secondary outcomes included continence, urodynamic parameters, side effects and QOL.

Results

The study enrolled 8 subjects in the OnabotulinumtoxinA group and 6 in the oxybutynin group. The recruitment rate was 75 % and the dropout rate was 6.6 %. There were 2 …

Feasibility, Effectiveness, Costs And Patient Satisfaction Associated With A Web-Based Follow-Up Assessment Following Total Joint Arthroplasty, Jacquelyn Marsh

Electronic Thesis and Dissertation Repository

Objectives: To determine the feasibility, effectiveness, costs and satisfaction involved with a web-based assessment following total joint arthroplasty compared to the usual method of in-person assessment.

Methods: We determined agreement between electronic and paper versions of the WOMAC and SF-12 questionnaires (Chapter 2). We randomized patients who were at least 12 months post-operative to complete a web-based follow-up or to have their appointment at the clinic. We recorded travel distances, costs, and time involved with each appointment. We report the frequency of web-based patients who: 1) indicated they were having problems, 2) had an identified radiographic issue, 3) …

Role Of Interleukin-17 In The Adaptive Immune Response In Lyme Arthritis, Emily Siebers

Theses and Dissertations

Lyme arthritis is a devastating symptom of Lyme borreliosis that causes severe inflammation of the synovial joints. Interleukin-17 (IL-17) plays a role in the pathogenesis of various arthritides, including, possibly, Lyme arthritis, by causing the expression of genes involved in the production of inflammatory cytokines by synoviocytes. However, the cellular sources of IL-17 in the context of Borrelia burgdorferi infection are unknown, as are the effects of these cells on the development of arthritis and stimulation of humoral immunity through the production of borreliacidal antibodies. Using multiple models of Lyme arthritis, the hypothesis that IL-17 produced by CD4+ cells contributes …

Effects Of Consuming Beans Before Or With A Meal On Satiety And Gastrointestinal Hormones Concentration In Obese Men And Women, Lisa Delia Griffith

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Consuming beans and staggering meals may control energy intake. We examined the effect of consuming 0.5 cup of beans 15 minutes before a meal on gastrointestinal (GI) peptides concentrations in obese men and women.

Methods: A randomized crossover design was used to measure GI peptides response to two test meals in 28 healthy obese adults. Subjects consumed a standardized breakfast meal on each test day followed by one of two test meals: a meal incorporating 0.5 cup of beans (control bean meal), and an isocaloric meal (staggered bean meal) in which 0.5 cup of beans was consumed 15 minutes …

The Ratio Of Positive To Negative Affect, Flourishing, And Health Behavior, Michael Stuart Leibow

Loma Linda University Electronic Theses, Dissertations & Projects

The ratio between positive and negative affect, known as the positivity ratio (PR) is thought to be associated with flourishing (psychological and social well-being). However, little research has been done on how PR and flourishing relate to specific health behaviors. The relationships between PR and flourishing with health behavior i.e., physical activity, and diet (fruit, leafy green vegetables [LGV] and meat intake) were investigated in this study. We examined whether PR mediated the relationship between flourishing and health behaviors, and whether flourishing mediated the relationship between PR and these behaviors. Gender and ethnic differences for the above associations were examined …

Augmented Image-Guidance For Transcatheter Aortic Valve Implantation, Pencilla Lang

Electronic Thesis and Dissertation Repository

The introduction of transcatheter aortic valve implantation (TAVI), an innovative stent-based technique for delivery of a bioprosthetic valve, has resulted in a paradigm shift in treatment options for elderly patients with aortic stenosis. While there have been major advancements in valve design and access routes, TAVI still relies largely on single-plane fluoroscopy for intraoperative navigation and guidance, which provides only gross imaging of anatomical structures. Inadequate imaging leading to suboptimal valve positioning contributes to many of the early complications experienced by TAVI patients, including valve embolism, coronary ostia obstruction, paravalvular leak, heart block, and secondary nephrotoxicity from contrast use.

A …

The Relationship Between Cancer-Related Fatigue And Upper Extremity Function In Breast Cancer Survivors, Meryl Marger Picard

Seton Hall University Dissertations and Theses (ETDs)

Background: Cancer-related fatigue (CRF) and arm morbidity constitute the two most common symptom complexes impacting breast cancer survivors (BCS) following surgery and adjuvant treatment, but these multifaceted entities have traditionally been researched as if they were separately occurring events in the survivor’s recovery. Objective: This study examined the relationship between breast cancer survivors’ perceptions of CRF and upper extremity function one to six years post-diagnosis. The study further investigated the impact of multiple adjuvant therapies, node dissection procedures, caring for dependent children, and physical aspects of employment on CRF and upper extremity function. Methods: One hundred fifty-eight BCS responded to …

Development And Validation Methodology Of The Nuss Procedure Surgical Planner, Krzysztof J. Rechowicz

Computational Modeling & Simulation Engineering Theses & Dissertations

Pectus excavatum (PE) is a congenital chest wall deformity which is characterized, in most cases, by a deep depression of the sternum. A minimally invasive technique for the repair of PE (MIRPE), often referred to as the Nuss procedure, has been proven to be more advantageous than many other PE treatment techniques. The Nuss procedure consists of placement of a metal bar(s) underneath the sternum, thereby forcibly changing the geometry of the ribcage. Because of the prevalence of PE and the popularity of the Nuss procedure, the demand to perform this surgery is greater than ever. Therefore, a Nuss procedure …

Influence Of A Short-Term, Multicomponent Intervention On Balance And Strength Among The Elderly, Pamela C. Webert

Master's Theses and Doctoral Dissertations

Background: Few studies have combined strength and balance training to assess improvement of activities of daily living among subjects over the age of 65. The purpose of this study was to demonstrate how an eight-week balance and strength training program can lead to improvements in activities of daily living among elderly individuals.

Methods: The subjects consisted of 14 elderly women and 3 elderly men who were all residents of an independent living community. There were 10 subjects in the intervention group and 7 subjects in the control group. The intervention group participated in a supervised balance and strength …

The Relationship Between Self-Reported Cancer Pain And Personality In Black And White Older Adults Receiving Outpatient Cancer Care, Jessica Krok

USF Tampa Graduate Theses and Dissertations

It is well-established that personality not only affects physical health and longevity, but also mental health and coping mechanisms. One area of limited research is the relationship between cancer pain and personality. This study examined how personality traits affect reported cancer pain severity in older patients (N = 150) receiving outpatient treatment at a comprehensive cancer center. Participants were interviewed regarding their pain severity, personality, affect, and self-efficacy for pain management. Symptom data were collected from the Brief Pain Inventory, while personality data were gathered from the Ten Item Personality Inventory and the Positive and Negative Affect Schedule. Self-efficacy for …

Elucidating The Function Of Transplanted Islets Of Langerhans And Predicting Their Ability To Reverse Diabetes, Andrew R. Pepper

Electronic Thesis and Dissertation Repository

Type 1 diabetics require daily injections of exogenous insulin to control hyperglycemia. Unfortunately, patients are still plagued by vascular and hypoglycemic complications. Beta cell replacement therapy by either whole organ pancreas or islet transplantation has been shown to restore carbohydrate control to these patients. A major barrier to successful islet transplantation is the lack of a reliable pre-transplant assay of post-transplant function thus providing an objective measure of whether a particular islet isolation should be transplanted. Such an assay would also prove to be a valuable tool in the experimental evaluation of innovative islet isolation strategies and technologies. The initial …

Preoperative Angiotensin Converting Enzyme Inhibitor Or Angiotensin Receptor Blocker Use And Acute Dialysis: A Population Based Cohort Study, Mitesh K. Shah

Electronic Thesis and Dissertation Repository

Angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) use prior to major surgery is controversial. We performed a population based retrospective cohort study of 237,208 elderly patients (of whom 101,494 (42.8%) were ACEi or ARB users) who underwent major elective surgery from 1995 to 2010 in Ontario, Canada. The primary outcome was acute kidney injury treated with dialysis (AKI-D) within 14 days following surgery (810 (0.34%) patients). The secondary outcome was all-cause mortality within 90 days following surgery (11,089 (4.67%) patients). After adjusting for potential confounders, preoperative ACEi or ARB use was associated with a lower relative risk …

A Study Of Potential Risk Factors Of Depression Among Latina Breast Cancer Survivors, Claudia Ximena Aguado Loi

USF Tampa Graduate Theses and Dissertations

Women with breast cancer commonly experience depression. However, this condition often goes unrecognized, undertreated, and understudied, especially in ethnic minorities. If left untreated, co-existing depression in women with cancer can complicate cancer treatment, lead to poor treatment adherence for both conditions, and decrease survival. These negative consequences are considerably higher among Latinas. With the growing number of Latinos and diversity within the Latino community, the literature has identified the need to disaggregate Latinos by region of origin. Unfortunately, few studies account for these differences and no study to date has examined risk factors of depression among Latinas diagnosed with breast …

End Of Life Decisions In The Nicu: The Value Of New Life And The Degree To Which Religion Plays A Role In These Ethical Decisions, Maria Battaglia

Honors Theses

This thesis explored the role of religion as a social variable affecting end of life decisions in the NICU. The existing literature has studied many factors that are a part of the tough ethical decisions made in the NICU with some reference to religion. However, there is not adequate attention given to religion specifically. In order to further expand upon religion, various members composing the medical teams of two hospitals were interviewed. The interviewees included neonatologists, nurses, chaplains, and a social worker. This thesis found that religion is a variable that matters more than the existing literature has claimed. Often, …

Diffusion Of The Egfr Assay: The Underutilization And The Urban/Rural Divide, Julie Ann Lynch

Graduate Doctoral Dissertations

Purpose - The EGFR assay is a molecular diagnostic test which identifies a targetable mutation in lung tumors. Guidelines call for EGFR testing for non-small cell lung cancer patients to direct first line treatment. We explored institutional and regional factors predicting the likelihood acute care hospitals ordered the assay. Methods: This was a retrospective study which analyzed US acute care hospitals (n=4780). We linked proprietary industry data for orders of the EGFR assay to public datasets that provided hospital and regional characteristics. We conducted logistic regression to identify significant characteristics that predict likelihood a hospital ordered the assay. Results - …

Does Being Cultured Pay? Racial And Language Concordance And Its Effect On Physician Income, Nayan Patel

Honors Theses

Issues surrounding race and ethnicity in healthcare have increased in number as racial disparities as well as minority physicians become more prevalent in the USA. One such issue is the concordance rate of race and language amongst physicians and their patients. The effect of racial concordance in physician patient relationships has been looked at to determine if it affects the perceived level of health quality. Saha et al. (1999) found that Black and Hispanic patients were more satisfied in their healthcare when treated by a physician of their own race. In this study, I establish whether or not the racial …

Mri-Based Attenuation Correction In Emission Computed Tomography, Harry R. Marshall

Electronic Thesis and Dissertation Repository

The hybridization of magnetic resonance imaging (MRI) with positron emission tomography (PET) or single photon emission computed tomography (SPECT) enables the collection of an assortment of biological data in spatial and temporal register. However, both PET and SPECT are subject to photon attenuation, a process that degrades image quality and precludes quantification. To correct for the effects of attenuation, the spatial distribution of linear attenuation coefficients (μ-coefficients) within and about the patient must be available. Unfortunately, extracting μ-coefficients from MRI is non-trivial. In this thesis, I explore the problem of MRI-based attenuation correction (AC) in emission tomography.

In particular, I …

Methodological Challenges And Clinical Applications Of Hair Cortisol Analysis, Evan W. Russell

Electronic Thesis and Dissertation Repository

This thesis examines methodological and clinical aspects of hair cortisol analysis. The methodological study examines the role of sweat as a contributor to hair cortisol concentrations. Hair cortisol analysis is an effective measure of chronic stress. Cortisol is assumed to enter the hair via blood, sebum, and sweat, however the extent to which sweat contributes to hair cortisol content was unknown. This study concluded that human sweat contains cortisol that likely contributes to hair cortisol content. Subjects with prolonged sweating at the time of hair collection may have increased hair cortisol concentrations that cannot be decreased with conventional laboratory washing …

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

University of New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …