Medicine and Health Sciences Commons^™

Evaluation Of Extracellular Matrix Composition And Rheology As Determinants Of Growth, Invasion, And Response To Photodynamic Therapy In 3d Cell Culture Models Of Pancreatic Ductal Adenocarcinoma, Gwendolyn M. Cramer

Graduate Doctoral Dissertations

Pancreatic ductal adenocarcinoma (PDAC) is a notoriously lethal disease characterized by prominent stromal involvement, which plays complex roles in regulating tumor growth and therapeutic response. The extracellular matrix (ECM)-rich stroma has been implicated as a barrier to drug penetration, although stromal depletion strategies have had mixed clinical success. It remains less clear how biophysical interactions with the ECM regulate invasive progression and susceptibilities to specific therapies. Here, an integrative approach combining 3D cell culture and quantitative imaging techniques is used to evaluate invasive behavior and motility as determinants of response to classical chemotherapy and photodynamic therapy (PDT), in which light …

Antithrombotic Therapy In Patients Undergoing Coronary Artery Bypass Grafting: A Systematic Review And Network Meta-Analysis, Karla Solo

Electronic Thesis and Dissertation Repository

Comprehensive evidence on the comparative effects of various oral antithrombotic agents on the prevention of saphenous vein graft failure (SVGF) for patients undergoing coronary artery bypass is lacking. A systematic review and frequentist random-effects network meta-analysis of 18 RCTs (n=3,413 patients) comparing the effect of antithrombotic agents on SVGF and clinical outcomes was performed. Based on moderate quality evidence, among the six eligible interventions, dual-antiplatelet therapy with aspirin and clopidogrel was superior to aspirin monotherapy in reducing SVGF (OR: 0.63; 95% CI: 0.41-0.97). No statistical differences were found for major bleeding, mortality, and myocardial infarction between antithrombotic agents, owing to …

Histomorphology Of Trauma In Charred And Decomposed Remains, Mariya Bezugly

Student Theses

Decomposition and burning of human remains are frequently encountered in forensic cases, and pose a challenge at determining an accurate cause of death. At autopsy, macroscopic techniques fail to reach beyond superficial layers of degraded tissue to identify wound morphology that characterizes blunt-force gunshot, and sharp-force trauma. The postmortem damage imparted on tissue with pre-existing injuries, obstructs the external features of trauma. Exploring beyond charred and decayed superficial tissue, histo-morphological patterns of injury are still identifiable as shown in this thesis. With detailed observation to the pattern of tissue disruption- an understanding of the type of trauma imposed can be …

Stasi Brainwashing In The Gdr 1957 - 1990, Jacob H. Solbrig, Jacob Hagen Solbrig

University of New Orleans Theses and Dissertations

This thesis examines the methods used by the Ministerium für Staatssicherheit (MfS), more commonly known as the Stasi, or East German secret police, for extraction of information from citizens of the German Democratic Republic for the purpose of espionage and covert operations inside East Germany, as it pertains to the deliberate brainwashing of East German citizens. As one of the most efficient intelligence agencies to ever exist, the Stasi’s main purpose was to monitor the population, gather intelligence, and collect or turn informants. They used brainwashing techniques to control the people of the GDR, keeping the populace paralyzed with fear …

Cancer Survivorship: Promoting A Lifetime Of Health, Janelle Coleman-Smith

Master's Projects and Capstones

Abstract

Introduction Cancer survivors can face post-cancer treatment effects that need addressing throughout their care trajectory. Education provided to stakeholders and patients will be beneficial in preventing fragmented care, increasing patient satisfaction, and expanding ongoing supportive clinical survivorship care. Methods An adapted Dr. Joanne Lester survivorship needs survey was given to n=7 post-cancer treatment patients within a northern California cancer patient advisory committee. The survey results were analyzed to identify common underserved chronic long-term survivorship needs. Based on the data, an evidence-based educational component was included within a booklet to enhance future survivorship care. Additional surveys were sent to stakeholders …

The Gift That Keeps One Living, Scott R. Axelrod

Capstones

This long-form narrative feature article reports on the shortage of living kidney donors and those in desperate need of kidney transplants. It features interviews with doctors, transplant coordinators, patients, living kidney donors, and kidney recipients. The story culminates with my own personal experience as a kidney donor to my late dad over a decade ago. The presentation includes an extensive photo component capturing characters and elements from the story through a series of detailed portraits, photo essays, and infographics.

https://saxelrod718.wixsite.com/livingkidneydonors

Identification Of Prognostic Cancer Biomarkers Through The Application Of Rna-Seq Technologies And Bioinformatics, Nathan Wong

McKelvey School of Engineering Theses & Dissertations

MicroRNAs (miRNAs) are short single-stranded RNAs that function as the guide sequence of the post-transcriptional regulatory process known as the RNA-induced silencing complex (RISC), which targets mRNA sequences for degradation through complementary binding to the guide miRNA. Changes in miRNA expression have been reported as correlated with numerous biological processes, including embryonic development, cellular differentiation, and disease manifestation. In the latter case, dysregulation has been observed in response to infection by human papillomavirus (HPV), which has also been established as both oncogenic in cervical cancers and oropharyngeal cancers and favorable for overall patient survival after tumor formation. The identification of …

Risk Of Post-Ercp Pancreatitis In Liver Transplant Patients: Single Center Experience, Shailender Singh

Theses & Dissertations

Introduction: Acute pancreatitis remains the most common severe complication of endoscopic retrograde cholangiopancreatography (ERCP). The exact cause of post-ERCP pancreatitis (PEP) is unclear. Regardless of the mechanism that initiates PEP, the pathways of inflammation are similar to other forms of acute pancreatitis and include the activation of various inflammatory cytokines, released from the acinar cells and subsequently from helper T lymphocytes and macrophages. Liver transplants (LTx) patients on immunosuppressive medications have impaired T-cell response and hence decreased ability to generate these cytokines. The aim of this study was to review incidence rates and risk factors of PEP in this …

Cpap-Mad Combination Therapy For Cpap Intolerant Patients With Moderate To Severe Osa, Jacob Stadiem

Theses & Dissertations

The treatment of obstructive sleep apnea (OSA) allows for a multidisciplinary approach between dentistry and medicine. Continuous positive airway pressure (CPAP) is the gold standard for OSA treatment, but the non-adherence rates are high. The mandibular advancement device (MAD) has a higher acceptance rate than the CPAP, however the efficacy is much lower in cases of moderate to severe OSA. This thesis attempted to evaluate if there was a change in compliance when a MAD was added as a combination therapy to moderate to severe OSA subjects that were currently non-compliant with their CPAP. In addition, the change in air …

Two-Component Hydrogel As Biomimetic Vitreous Substitutes, Sruthi Santhanam

McKelvey School of Engineering Theses & Dissertations

The vitreous humor of the eye is a biological hydrogel principally composed of fibrillary collagen interspersed with semi-flexible polyelectrolyte, hyaluronic acid (HA). Certain pathological conditions necessitate its removal and replacement. Current vitreous substitutes, such as silicone oils and perfluorocarbons, are hydrophobic, do not resemble the properties of the vitreous, and have known complications. An ideal vitreous substitute should have properties of the natural vitreous, perform its functions, and be biocompatible in the eye. Inspired by the structure and composition of the natural vitreous, we used bio-mimicry to develop an injectable two-component hydrogel. The hydrogel is composed of a fibrillary gellan, …

Novel Therapeutic Strategies For Treatment Of Castration-Resistant Prostate Cancer, Matthew A. Ingersoll

Theses & Dissertations

Prostate cancer (PCa) remains the most commonly diagnosed solid tumor and is the third leading cause of cancer-related death in United States men. While androgen deprivation therapy is the current standard-of-care treatment for metastatic PCa, most patients eventually relapse and develop castration-resistant (CR) tumors, for which there is currently no effective treatment. Therefore, synthesis of novel therapeutic agents and identification of alternative target proteins are necessary to improve treatment. Herein, I investigate the efficacy of novel imidazopyridine and statin derivatives as alternative therapeutic compounds. These molecules not only inhibit androgen receptor signaling, but also block activation of the AKT axis, …

Prostate Cancer Microparticles In Men Undergoing Radical Prostatectomy, Malcolm James Dewar

Electronic Thesis and Dissertation Repository

Objectives: To determine changes in prostate microparticle (PMP) concentrations in men with prostate cancer (PCa) after digital rectal examination (DRE), after radical prostatectomy (RP), and at follow-up.

Materials and Methods: 22 men were recruited before RP. Four blood specimens were collected – baseline (specimen 1), post-DRE (specimen 2), immediately post-RP (specimen 3), and follow-up (specimen 4). Pre- and post-DRE urine was collected (Specimen A and B respectively). Flow cytometric analysis of biofluids was performed with fluorescent-labeled antibodies against prostate-specific membrane antigen (PSMA) and polysialic acid. Total MP (TMP) and dual positive (PMP) events per µl of plasma or urine were …

Aging, Inflammation, And Gut Microbiota In Mice, Jody Demeo

Honors Projects

Inflammation and gut microbiota are two areas of study that can be linked to aging in the body. As a person ages, systemic inflammation tends to increase, and changes in microbiota in the gastrointestinal system occur as well.

Beyond The End Line - Putting The Mental Health Of Female Athletes First, Katherine Scholten

Honors Projects

Currently one in five adults are affected by mental illness. Student-athletes are a population that is under diagnosed for mental illness. In the world of college athletics, mental pain is as regular as physical pain. Coaches often push their athletes to suffer in silence for the betterment of the team. The NCAA has recognized the importance of mental health in college athletics, yet there is still much work to be done among universities across the country. This document is to serve as a resource and a guide on the effects of mental health among female student athletes and the best …

Evaluation Of Delivery Methods Of Chemical Dependency And Wellness Education, Marissa Coggin

Doctoral Projects

Anesthesia practice is learned in a stressful environment, and these stressors may lead to the students’ development of maladaptive coping mechanisms. Despite significant improvements in our understanding of addiction and our approaches to combat this problem, the risk of substance misuse remains high in nurse anesthesia students. Education and intervention are imperative when taking preventative measures. The purpose of this Doctor of Nursing Practice (DNP) project was to determine whether delivery method of chemical dependency/wellness educational program effects the level of understanding of anesthesia providers and substance misuse and the development of healthy coping mechanisms.

In determining whether the delivery …

A Biomechanical Study Examining The Subacromial Balloon Spacer And Superior Capsular Reconstruction In The Treatment Of Massive, Irreparable Rotator Cuff Tears, Supriya Singh

Electronic Thesis and Dissertation Repository

Rotator cuff tears are common tendon injuries and can be a major source of pain and disability. Massive, irreparable rotator cuff tears are a challenging surgical dilemma as currently there is no gold standard treatment algorithm. Multiple possible treatment options exist yet no clear guidelines for optimal surgical technique for this disorder have been established.

In this study, two new techniques described in the treatment of massive, irreparable rotator cuff tears were explored; the insertion of a subacromial balloon spacer and superior capsular reconstruction. Their ability to restore glenohumeral joint kinematics was examined in cadaveric specimens with surgically created massive, …

Evaluating The Therapeutic Efficacy Of Restoring Wild-Type P53 Activity In P53-Mutant Tumors, Connie A. Larsson

Dissertations & Theses (Open Access)

The p53 transcription factor is the most frequently altered in human cancers usually via missense mutations that undermine its transcriptional activity. Clinically, TP53 mutations have been shown to be remarkably predictive of refractoriness to treatment, resulting in poor outcome. Consequently, the development of p53 pathway activating agents is rapidly evolving and gaining more attention in cancer therapeutics research, with several small molecule compounds currently in preclinical and clinical trials. However, it remains largely unknown what types or proportions of p53-mutant tumors will respond to p53 restoration-based therapies.

Using a mouse model of Li Fraumeni syndrome, we genetically restored wild-type …

Subanesthetic Ketamine For Postoperative Analgesia: An Evidenced-Based Project, Jeremy Vance

Doctoral Projects

Roughly 100 million surgical procedures are performed in the United States (U.S.) each year and more than 80% of these patients experience acute postoperative pain. Pain costs the U.S. an estimated $560 to $635 billion annually and is a significant contributor to national rates of mortality, morbidity, and disability. Despite these findings, patients continue to receive suboptimal postoperative pain relief.

The adjunct administration of subanesthetic ketamine is opioid-sparing and can improve the effectiveness of a multimodal pain management approach. This project used an exploratory descriptive design to examine how an evidence-based presentation impacted the clinical practice of certified registered nurse …

Retrieval Analysis Of Necropsy Total Hip Replacements: Considerations Beyond The Implant, Julie Alyse Lowell

Theses and Dissertations (ETD)

Introduction. Total hip arthroplasty (THA) surgery is one of the most commonly performed and successful orthopedic procedures in the United States. More than 300,000 primary THAs and 40,000 revision THAs performed in the United States every year. While the need for revision surgeries can stem from a variety of causes, there have been, to the author’s knowledge, no studies attempting to correlate the concentrations of certain inflammatory cytokines to metal ion concentrations found in the tissue surrounding the implant, amount of polyethylene wear, or strength of the interface of the modular taper. The purpose of this study was to begin …

Improving Vaccination Rates In Adults With Type Ii Diabetes In A Family Practice Setting: An Evidence-Based Quality Improvement Project, Ronda Gottlieb

Doctor of Nursing Practice

The purpose of this evidenced-based quality improvement project is to implement processes to facilitate providers’ adherence to the American Diabetes Association (2017), American Association of Clinical Endocrinologist (2015), and American College of Endocrinology (2015) immunization guidelines for adults with type II diabetes. Presently, diabetes is the 7th leading cause of death in the United States contributing to serious complications throughout the body as a result of poor glucose control. Adults with diabetes are at increased susceptibility to infectious disease because of hyperglycemia, poor glucose control, and decreased immunity. A protocol was created using The Four Pillars Transformation Program ™ to …

Dopamine Levels In The Brain Of Rat Models Of Human Rheumatoid Arthritis, Amelia Stinson

Theses & Dissertations

Research Focus. Rheumatoid arthritis (RA) is a chronic, debilitating, autoimmune disease that causes the destruction of bone tissue and the articular structures of joints. At least 30% of RA patient populations have cognitive impairment. Acidic dopamine (DA) is the principal neuroimmunotransmitter that links the central nervous system and peripheral nervous system together. The aim of the present study was to determine the levels of DA and its two acidic metabolites: 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in arthritic induced rats, and whether their levels vary across four different parts of the brain: amygdala (AMG), front cerebral cortex (CX), hippocampus …

The Correlation Of Size Of Core Network And Frequency Of Contacts With Agitation And Positive Affect In Elderly With Dementia, Amal Ali Al Ghassani

Theses and Dissertations

In the country of Oman, care needs of older adults are primarily provided by family members in the home. The study was guided by socioemotional selectivity theory, the environmental vulnerability hypothesis, and the need-driven dementia-compromised behavior theories. The central premise was that the size of the person’s activities of daily living (ADL) core network and frequency of contact with the ADL core network would predict agitation and affect. A smaller core network with a higher frequency of contact may be better at identifying and treating the person’s unmet needs. A secondary premise was that the emotional closeness of the core …

Are Tart Cherry Supplements Effective On Reducing Muscle Soreness And Perception Of Pain In Young, Healthy Males Following High Intensity Resistance Training?, Alyssa Davis

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not tart cherry supplements are effective at alleviating muscle soreness and pain following high resistance training.

STUDY DESIGN: Review of two double blind randomized control trials, and one crossover randomized control trial. All three studies were published in English between 2006-2015.

DATA SOURCES: Two double blind randomized control trials and one crossover randomized control trial found using Cochrane and PubMed.

OUTCOMES MEASURED: The outcomes measured were muscle soreness and perception of pain. They were measured using a pressure-pain threshold and 10 point pain …

Are Hylan Injections More Effective In Reducing Stiffness In Primary Knee Osteoarthritis Compared To Hyaluronic Acid Derivative Injections?, Jordan S. Hood

PCOM Physician Assistant Studies Student Scholarship

No abstract provided.

Does Music Therapy Intervention Have An Effect On The Emotional Behavior Of Alzheimer Patients?, Alexandra P. Lahurd

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not music therapy intervention have an effect on emotional behavior of Alzheimer patients. Behavior variables measuring are agitation and anxiety.

STUDY DESIGN: Systematic review of two randomized, controlled trials published in 2009 and 2014, respectively, and one randomized control case study published in 2006.

DATA SOURCE: Three published studies comparing music therapy intervention on behavioral modifications with Alzheimer patients were found using PubMed and Medline

OUTCOMES MEASURES: All three studies measure behavior in Alzheimer patients based on a variety of well validated …

Is Oral Aloe Vera Effective In Reducing Symptoms In Adults With Irritable Bowel Syndrome (Ibs)?, Chelsey J. Gebhardt

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this EBM review is to determine whether or not “Is oral aloe vera effective in reducing symptoms in adults with Irritable Bowel Syndrome (IBS) symptoms?”

Study Design: Systematic review of three English, randomized, controlled, double-blind studies, including one cross-over study, were selected based on their relevance to the clinical question. The studies were published in 2006, 2011, and 2015.

Data Sources: Three RCTs analyzing the effects on IBS symptoms of drinking aloe vera daily compared to a placebo drink were found using PubMed.

Outcomes Measured: Various patient-reported IBS symptom questionnaires were utilized …

Is Mdma-Assisted Psychotherapy An Effective Treatment For Posttraumatic Stress Disorder (Ptsd)?, Joey Rudd

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not MDMA-assisted psychotherapy is an effective treatment for posttraumatic stress disorder (PTSD).

Study Design: Systematic review of three published, randomized controlled trials (double-blind, placebo-controlled) between 2008-2013.

Data Sources: All articles used were published in English, in peer-reviewed journals, and found using PubMed/MEDLINE and Cochrane Review databases.

Outcomes Measured: The primary outcome measure in all three studies was the severity of PTSD symptoms. The primary outcome measure was assessed using the Clinician-Administered PTSD Scale (CAPS) and the Severity of Symptoms Scale for PTSD (SSSPTSD). …

Is Weight Loss An Effective Treatment Of Pain Symptoms Related To Knee Joint Osteoarthritis In Obese Adults?, Samantha Sokol

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not weight loss is an effective treatment of pain symptoms related to knee joint osteoarthritis in obese adults.

Study Design: Systematic review of 2 randomized-controlled trials and 1 cohort study. All three articles were published in English between 2011-2015.

Data Sources: Two randomized, un-blinded, controlled studies and one cohort found using Pubmed.

Outcomes Measured: Each study evaluated change in pain symptoms related to knee osteoarthritis in obese adults as compared to weight loss.

Results: Studies showed that weight loss lead to a …

Does Fecal Microbiota Transplantation Cause Clinical Remission In Patients With Ulcerative Colitis?, Amandeep Singh

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Does Fecal Microbiota Transplantation cause Clinical Remission in Patients with Ulcerative Colitis?”

Study Design: Review of three English language primary studies published in 2015.

Data Sources: Two randomized control trials and a cohort study determining if fecal microbiota transplantation does lead to clinical remission of Ulcerative Colitis were found by using PubMed and Cochrane databases.

Outcome(s) Measured: The outcomes measured in all three studies were patient oriented evidence that matters which is clinical remission. The outcomes in the Moayyedi et al. was …

Memory Potential, Molecular Characterization, And Translational Applications Of The Novel Theo/Tceo T Cell Phenotype, Todd Bartkowiak, Todd Bartkowiak

Dissertations & Theses (Open Access)

T cells comprise a substantial arm of the immune system and are exquisitely adapted to combat pathogens and tumors. The inflammatory environment largely dictates the nature of T cell response. A hallmark of T cell-mediated immunity is formation of immunological memory; the ability to respond more potently to re-encounter with pathogens. The immune system is also capable of recognizing tumors as foreign, much like viral or bacterial pathogens. Tumors have evolved, though, to generate an immunosuppressive environment to avoid destruction. The field of immunotherapy seeks to overcome immune suppression, in part by targeting T cell co-receptors on the cell surface …