Medicine and Health Sciences Commons^™

To Decipher Genomic Evolution Of Dengue Virus And To Probe The Activation Mechanism Of A Her2 Directed Chimeric Antigen Receptor Toward Computer Aided Drug Design (Cadd), Mariya Hryb

Theses and Dissertations

This study encompasses three significant chapters focusing on diverse yet interconnected aspects of pharmaceutical research. Chapter 1 delves into the complexities of drug development, emphasizing the challenges and the pressing need for advanced technologies to streamline the process. Computational methods like Computer-Aided Drug Design (CADD) extend their scope beyond small molecules, aiding in the design of intricate biomolecules vital for biomedical advancements, especially in immunotherapy. Chapter 2 introduces the Near-Neutral Balanced Selectionist Theory (NNBST) validated through analysis of Dengue virus evolution. The unique features observed align with NNBST, surpassing existing theories. This approach offers a deeper understanding of viral evolution …

Tunable Dual-Phase Dual-Drug Delivery System Using A Plga Microparticle/Pva Hydrogel Composite, Timothy John Eck

Theses and Dissertations

Current drug-eluting coatings have demonstrated controlled long-term, sustained release but have only tried to mitigate short-term burst release as a negative side effect. For applications like wound healing, there is a need for a drug-eluting coating which is adjustable in both short- and long-term release, independent of each other. We present a tunable dual-phase dual-drug delivery coating composed of drug-loaded polymer microparticles and drug-loaded hydrogel which can control short term and long term release individually in this study. This coating was created using lidocaine and dexamethasone encapsulated in poly(D,L-lactide-co-glycolide) particles combined with lidocaine- and dexamethasone-loaded poly(vinyl alcohol) hydrogel. Hydrogel drug …

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Targeting Strategies To Optimize The Therapeutic Potential Of Gold Compounds Against Her2-Positive Breast Cancers, Afruja Ahad

Dissertations, Theses, and Capstone Projects

The overexpression of HER2 accounts for 20-30% of breast cancer tumors and not only serves as a marker for poor predictive clinical outcomes but also as a target for treatment. Antibody-drug conjugates (ADCs) combine the selectivity of monoclonal antibodies (mAbs) with the efficacy of chemotherapeutic drugs to provide targeted treatment without toxicity to normal tissue. Most of the ADCs currently in the clinic for cancer chemotherapy are based on complex organic molecules. In contrast, the conjugation of metallodrugs to mAbs has been overlooked when there is enormous potential in this area with the resurgence of metal-based drugs as prospective cancer …

Behavioral Effects Of Novel Treatments For Pain Using Different Pathways, Danya M I Aldaghma

Theses and Dissertations

Pain is defined as an unpleasant sensation that is mostly caused by a stimulus from our surroundings. This sensation has the potential to become a significant concern, disrupting daily activities, and diminishing overall quality of life. However, it could also hold significant importance as it serves as a protective mechanism. Pain acts as an alarm system for the human body, alerting it to potentially harmful situations where tissues may be at risk of damage1. Despite the considerable advancements in pain treatment and the extensive knowledge scientists possess regarding the pathophysiology and pathways of pain, numerous medications aimed at alleviating pain …

N-Vitro Time-Kill Assays And Semi-Mechanistic Pharmacokinetic-Pharmacodynamic Modeling Of A Beta-Lactam Antibiotic Combination Against Enterococcus Faecalis: Optimizing Dosing Regimens For The Geriatric Population, Zeel Saumin Shah

Selected Full-Text Dissertations 2020-

Pharmacokinetic-pharmacodynamic (PKPD) modeling and simulation have emerged as pivotal tools in drug development and usage. Such models characterize typical trends in data and quantify the variability in relationships among dose, concentration, and desired effects. For antibacterial applications, models characterizing bacterial growth and antibiotic-induced bacterial killing offer insight into interactions between antibiotics, bacteria, and the host. Simulations from these models predict outcomes for untested scenarios, refine study designs, and optimize dosing regimens.

Enterococcus faecalis, a significant opportunistic bacterial pathogen with increasing clinical relevance, is commonly found in the gastrointestinal tract but can lead to severe infection, such as endocarditis. Treatments for …

The Influence Of English Proficiency In Online Health Information-Seeking: A Comprehensive Model Of Information-Seeking (Cmis) Based Study Using Health Information National Trends Survey (Hints) Data, Lauren M. Perez

Pharmaceutical Sciences ETDs

Understanding language-related challenges is crucial for addressing health and healthcare access disparities. This study examines differences in online health information seeking (OHIS) experiences by English proficiency. It explores factors influencing OHIS that patients in the United States with Limited English Proficiency (LEP) may encounter to shed light on the online health information needs of patients with LEP. The research utilizes data from the 2017 Health Information National Trends Survey (HINTS) 5 Cycle 1 to analyze the OHIS experiences of patients. Findings will inform healthcare providers, policymakers, and researchers, promoting equitable access to reliable health information.

Analyzing Functional Interactions Of Designed Peptides By Nmr Spectroscopy, Wonsuk Choi

Pharmaceutical Sciences (MS) Theses

The development of small peptide-based therapeutics can be accelerated by the knowledge of relationships between the peptide structure and its functional interactions. Here, we report the analysis of two groups of synthetic peptides designed for two applications – broad bactericidal action and inhibition of protein-protein interactions in human cells. Novel amphiphilic peptides designed for antibacterial application incorporated arginine as cationic amino acids and non-natural amino acids that have aromatic side chains with similar hydrophobic properties as tryptophan. The interaction of lead cyclic peptides and their linear analogs with a phospholipid bilayer mimicking a bacterial membrane was studied using nuclear magnetic …

Geospatial Distribution Of Pharmacist Diabetes Management Within A Patient Centered Medical Home Model In Omaha, Nebraska, Anthony Donovan

Capstone Experience

Patients with uncontrolled diabetes, defined as a hemoglobin A1c value greater than 9%, are at an increased risk of diabetes progression. Primary care is often the first point of contact where patients with uncontrolled diabetes are identified and treated. Pharmacists are utilized in diabetes medication management of patients with uncontrolled diabetes as one component of primary care multidisciplinary models of care. This descriptive project describes the geospatial distribution of patients with uncontrolled diabetes from a single institution in the Omaha, Nebraska area who were exposed to pharmacists within a Patient Centered Medical Home (PCMH) model of care compared to those …

Pharmacogenomic Precision Medicine: Best Practice Toolkit For Improving Patient Screening For Adult Metastatic Cancer Patients, Rena L. Stewart

Student Scholarly Projects

Precision medicine utilizes pharmacogenomic testing as a therapeutic approach. Genomic testing can assess the impact of an individual's genome on their reaction to specific medications. The main objective is to find variants that may affect an individual's response to a given medication. The implementation of pharmacogenomics in oncology facilitates informed decision-making by clinicians in drug selection and dosage determination.

Dietary Analysis For Hashimoto’S Thyroiditis: An Integrative Review, Evan Thompson, Alison Hultquist

Master of Science in Nursing Final Projects

Abstract

Hashimoto’s Thyroiditis (HT) is the leading cause of primary hypothyroidism in the United States. In HT, there is an infiltration by lymphocytes which leads to the production of autoantibodies against the thyroid gland. Throughout this integrative review, the aim was to evaluate the effectiveness of micronutrient supplementation and dietary management as adjunct treatments in HT. The purpose was to assist primary care providers in the development of a more holistic plan of care. Literature published within the past seven years was gathered and reviewed from PubMed, CINAHL, and Cochrane Library. Findings indicate that many patients with HT may benefit …

Primary Care Intervention: Medication Reconciliation Reduces Rehospitalizations, Dianna Twombly

Student Scholarly Projects

Practice Problem: Patients are put at risk for adverse medications events when diligent care is not taken by healthcare staff. Medication discrepancies and oversights from medical personal can lead to severe illness or even death of a patient.

PICOT: The PICOT question for this project is: For patients 65 years and older (P) does a review of a hard copy of discharge instructions (I)compared to current practice during a visit, (C) impact the number of hospital readmission (O)in eight weeks (T)?

Evidence: Medication reconciliation at each point of care, patient education on medication management, and involving patients in their own …

Design And Synthesis Of Small Molecule Drugs For Cns Disorders, Kirsten T. Tolentino

Theses & Dissertations

Dopamine (DA) is an important neurotransmitter for the regulation and long-term function of the central nervous system (CNS). DA binds to Dopamine Receptors (DR) to stimulate or inhibit adenyl cyclase production to further elicit a pharmacological response. DRs were cloned, and it was determined that there are two families separated by their function and five total subtypes distinguished by their amino acid structure. The Dopamine 4 receptor (D4R) is the second least studied subtype but has high expression in the frontal cortex, amygdala, hippocampus, hypothalamus, globus pallidus, substantia nigra pars reticula, and thalamus. Dopamine signaling and transmission, especially in the …

Isolation And Total Synthesis Of Sigma-2 Ligands From Marine Cyanobacteria, Andrea Hough

Electronic Theses and Dissertations

Cyanobacteria have been studied for over 50 years as a source of new antibiotics, antiviral, and anticancer drugs. The research described in this dissertation investigates marine cyanobacteria as a source of natural products with activity within the central nervous system and with cytotoxicity against breast cancer cells. Barbamide (1) is a known cyanobacterial metabolite that has been re-isolated from a variety of species and collection sites suggesting broad utility as a signaling molecule. Utilizing the psychoactive drug screening program, we screened barbamide for CNS activity and found that barbamide exhibited affinity for the kappa opioid receptor (KOR) and …

Exploring The Experiences Of Underrepresented Students Pursuing Health-Related Graduate Or Professional Programs, Alison Williams

Electronic Theses and Dissertations

For many years graduate and professional education programs for the health professions have sought to increase the diversity of their student body to include students from a wider variety of backgrounds. Increasing the diversity of healthcare providers is an essential component of addressing inequities in healthcare. However, despite initiatives to increase racial and ethnic diversity in the health professions, these professions remain largely White and female. Previous researchers have sought to identify the reasons that racial and ethnic minorities are underrepresented in healthcare, and the barriers to persistence and success. Little research exists explaining why men are underrepresented in the …

Studies On The Leukocyte-Associated Ig-Like Inhibitory Receptor-1 Signaling Pathway In T Lymphocytes, Chidi Zacheaus

Theses and Dissertations (ETD)

Inflammation is a natural process in which the immune system concertedly responds to pathogens and abnormal cell growth to protect the host. For an efficient/effective immune response that circumvents tissue atrophy, a delicate balance between stimulatory and inhibitory mechanisms is essential for the proper functioning of the immune system. Immuno-receptor Tyrosine-based Inhibitory Motif (ITIM)-bearing receptors in immune cells, including T lymphocytes, play a major role in preventing autoimmune responses. Leukocyte-associated Ig-like Inhibitory Receptor 1 (LAIR-1) is one of ITIM-bearing receptors. The mechanism by which LAIR-1 attenuates T-cell response has yet to be completely understood. In this study, I investigated a …

Mitigating Risks To Improve Hypertension Medication Adherence In A Medically Vulnerable Population, Donna Hales-Teat

Doctor of Nursing Practice Projects

This project assessed the effect of an evidence-based medication adherence intervention on adherence rates at a Northern Indiana clinic led by a sole nurse practitioner, receptionist, and continuous rotation of graduate nursing students from several nursing programs in the Northern Indiana area. Patient education and comprehension were poor in terms of understanding disease process, treatment options, and disease management that led to poor communication with the medical provider. The process and steps in which patients matriculate through was described by Johnson’s (2002) Medication Adherence Model (MAM) with concepts of purposeful action, pattern behavior, and feedback; these helped to construct, steer, …

Influence Of Material Properties On Granules Prepared By Dry Co-Rotating Twin Screw Extrusion And Counterrotating Batch Mixing, Afstathios Steve Pafiakis

Dissertations

Recently, the pharmaceutical industry has shown interest in continuous granulating technology because of the flexibility it offers as an option that bypasses the costly scale-up process associated with batch manufacturing. However, the granulation mechanism(s) using twin screw co-rotating hot melt extrusion (HME) has not been fully explored, and it is not yet well understood. This leads to costly experiments during development and process reliability problem in commercial manufacturing. The main objective of this dissertation is to increase the mechanistic understanding of the twin screw granulation process of systems containing an active pharmaceutical ingredient (API) and a polymer excipient. This is …

Novel Natural Compounds Derived From Tcm In The Treatment Of Food Induced Anaphylaxis, Ibrahim Musa

NYMC Student Theses and Dissertations

Food allergy is a highly prevalent disease affecting about 30 million people in the U.S. It is managed primarily by food avoidance due to lack of promising treatment options. ASHMI (anti-asthma herbal intervention) which consists of three components, Sophorae flavescentis, Ganoderma lucidum, Glycyrrhiza uralensis has been shown to inhibit allergic lung inflammation in antigen sensitized and challenged mice. In this study we isolate and identify the active compound in Sophorae flavescentis, characterized the mechanism of IgE inhibitory effect, biomarkers and potential to prevent food anaphylaxis.

To separate and identify the compounds we used column chromatography, high-performance liquid chromatography, mass …

Adverse Effects And Pharmacokinetic Characteristics Of High-Dose Glucocorticoid Treatment In Children With Rheumatic Diseases, Renee X. Pang

Electronic Thesis and Dissertation Repository

This integrated-article thesis explores the impact of long-term glucocorticoid (GC) therapy on children with RD. Long-term GC treatment is potentially associated with severe adverse drug reactions (ADRs). Our scoping review summarizes the current evidence health-related quality of life (HRQOL) impacts of this treatment on children with RD. We describe the frequency of ADRs related to long-term GC treatment in a convenience sample of pediatric RD patients on long-term prednisone therapy and evaluate clinical characteristics that may be associated with risk for of GC-related ADRs. Lastly, we present a pilot study to evaluate the feasibility of monitoring GC PK in children …

Artemisinin And Its Derivatives Reactions: Characterization Of The Reaction Products Using Lc/Tof Ms, Kogila Vijayan

Theses and Dissertations

Artemisinin (ART) is a sesquiterpene lactone and a popular malaria drug with potential anticancer properties. In this work, LC/TOF MS was used to investigate the reaction of ART with DNA bases and estradiol. ART-deoxyadenosine and ART-deoxycytidine interactions were studied in the presence of Fe (II) ions. ART-deoxyadenosine and ART-deoxycytidine reaction mixtures gave chromatographic signatures that remained unchanged at room temperature but grew after incubation at 37°C. The change in temperature from room temperature to 37°C was the main driver of adduct formation in these reactions. ART was found to react with Fe (II) ions as observed from several new chromatographic …

Scoping Review Of The Best Practices In Drug Courts In The United States, Elise Crumrine, Blakely Camille Culp

Honors Theses

Purpose: Drug courts are reform programs that are utilized in America to reduce the amount of incarcerations due to non violent drug charges. A successful drug court has a high number of graduates and low recidivism rates. To accomplish this, a variety of methods are utilized such as medication assisted therapy (MAT), random and mandatory drug testing, positive reinforcement in the form of words or tangible items, etc. The purpose of our study was to identify the best practices of drug courts, as defined as increased graduation rates and decreased recidivism, so that the findings may be applied in the …

Is My Prescription Ready Yet? A Qualitative Examination Of Patients' Understanding Of The Prescription Filling Process In Community Pharmacies, Maria Sallee

Honors Theses

Long lines at the pharmacy can frustrate patients. Consequently, patients becoming frustrated can add stress to an already overworked pharmacy. Without knowing what patients understand about the often complicated prescription filling process at community pharmacies, it can be difficult for pharmacists and pharmacy technicians to communicate the reason behind any delays in patients receiving their medication. To learn what patients understand about the prescription filling process, fifteen interviews were conducted over the phone after mailing recruitment flyers to members of a diabetes research collaborative in North Mississippi. The interviews revealed that while patients have a positive relationship with their pharmacists, …

The Opioid Epidemic: How Genetics Play A Role In Addiction And Treatment, Kirsten Houston

Honors College Theses

The opioid epidemic is an issue within the pharmaceutical industry in the United States of America due to prescription and non-prescription substances being made available to the population. Opioids include chemical substances that affect the body and brain through opioid receptors, including the mu, kappa, and delta receptors. These substances are derived and synthesized from the poppy plant. Multiple causes have been linked to opioid abuse disorder, including but not limited to employment, income, housing, nutrition, mental health disorders, and genetics. By gathering information from previous literature, genetics may be the main cause of narcotic analgesic tolerance and abuse. Specific …

The Great Transition: A Qualitative Examination Of The Transition From Pharmacy Student To Pharmacist, Jessica Marlee Wilson

Honors Theses

Background: Over the years, community pharmacy practice has expanded and increased the number of responsibilities pharmacists must manage. Tasks such as managing the pharmacy, counseling patients, and administering vaccines are among the duties that pharmacists must carry out. The recent Covid-19 pandemic placed a significant strain on the retail pharmacy work environment and acted as an obstacle to the jobs of community pharmacists. Recent pharmacy graduates are often thrown into this variable work environment, and it seems that there is limited literature regarding the preparedness that they feel in this area of pharmacy work.

Objectives: To uncover the level of …

Medical Cannabis In Mississippi: Practitioner Education And Continuing Research, Andrea Cleveland

Honors Theses

Use of medical cannabis in Mississippi was legalized in February 2022 following many years of cannabis research at the University of Mississippi. Issues immediately became apparent, beginning with the lack of education about medical cannabis among providers. A 2017 study showed that the majority of physicians are not exposed to information about medical cannabis despite its legalization in 37 states. Another issue with Mississippi’s medical cannabis program is the cost of the product itself. The most effective way to decrease spending on medication is for patients to have access to medication that is guaranteed to work. Further research on cannabis …

All Clear: A Workbook For Sexually Active Accutane Users Who Can Become Pregnant, Taylor Petersen

Honors Projects

Accutane is a pill-based derivative of Vitamin A used to treat cystic acne. The process to start and continue the medication each month is tedious and full of potential for error. This is especially true for female patients who are able to become pregnant as they have the additional step of monitoring and updating their birth control through an online portal. Patients are treated like numbers and there is little to no customization within Accutane treatment from patient to patient. To make this worse, reliable information about the drug is scarce and many turn to social media platforms or other …

Application Of Informatics Tools To Facilitate The Practice Of Precision Medicine With Genomic Testing And Clinical Data, Michael Sayer

Pharmaceutical Sciences (PhD) Dissertations

The practice of precision medicine considers a variety of sources of information to optimize patient care. Factors such as patient demographics, clinical history, and lab test values have well understood effects on treatment outcomes and influence decision making. However, effective inclusion of biomolecular data such as protein expression and DNA sequencing data within the practice of precision medicine needs continued study. Informatics tools offer solutions to allow these complex data sources to be effectively embraced. Utilization of informatics tools to visualize data pertaining to the gene selection practices of pharmacogenomic (PGx) tests effectively communicated large amounts of information into concise …

An Analysis Of Trends Of Generic Drugs And Biologic Prices In The U.S., Mohammed Jamjoom

Pharmaceutical Sciences (PhD) Dissertations

Introduction: Drug prices are a significant problem for the US healthcare system. Generic and biosimilar market competition reduces drug and biologic prices, results in substantial savings, and improves patient access and outcomes. As the costs of healthcare and prescription drugs continue to rise, the discussion about drug prices has taken a prominent place at the forefront of national discourse. This study assessed impacting trends in prices of generic, biosimilar, and reference products in the US. We also evaluated the effect of the Affordable Care Act (ACA) of 2010 on biologic prices.

Methods: We extracted a list of the new generic …

Genetic Mutations Of KCa2.3 And KCa3.1 Channels Affect Ca2+ Sensitivity, Razan Orfali

Pharmaceutical Sciences (PhD) Dissertations

The Ca²⁺-activated potassium channels K_Ca channels are a unique family of potassium channels activated by intracellular calcium. K_Ca channels are critical for maintaining K⁺ homeostasis and modulate several physiological processes, from the firing properties of neurons to the control of the transmitter release. The Ca²⁺ sensitivity of these channels allows intracellular Ca²⁺ to regulate the electrical activity of the cell membrane. Increased Ca²⁺ sensitivity of K_Ca channels caused by gain of function mutations (GOF) in the KCNN genes results in a broad spectrum of human channelopathies, including Zimmermann- Laband syndrome (ZLS), …