Translational Medical Research Commons^™

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 …

Effect Of Dual Tasking And Levodopa-Induced Dyskinesia On Postural Sway In People With Parkinson's Disease, Joseph Ayotunde Aderonmu, Carolin Curtze

UNO Student Research and Creative Activity Fair

Parkinson's disease (PD) is a neurodegenerative disorder that results in motor impairments such as gait and balance deficits. Levodopa is one of the most effective drugs in treating the slowness of movement in individuals with PD. However, the long-term use of levodopa in treating PD often causes undesirable involuntary and uncontrollable movements, known as levodopa-induced dyskinesia (LID). LID is a known cause of increased postural sway. Yet, the relative contribution of the body segments often affected by dyskinesia to postural sway is unknown. We aimed to investigate the contribution of different body segments to postural sway in PD for individuals …

Thymic Stromal Lymphopoietin Participates In The Host Response To Intra-Amniotic Inflammation Leading To Preterm Labor And Birth, Tomi Kanninen, Li Tao, Roberto Romero, Yi Xu, Marcia Arenas-Hernandez, Jose Galaz, Zhenjie Liu, Derek Miller, Dustyn Levenson, Jonathan M. Greenberg, Jonathan Panzer, Justin Padron, Kevin Theis, Nardhy Gomez-Lopez Phd

Medical Student Research Symposium

Objective: To determine if bacteria (Ureaplasma parvum and Sneathia spp.) associated with intra-amniotic infection can trigger the induction of cytokine Thymic stromal lymphopoietin (TSLP) in human amnion epithelial cells (hAECs) in vitro.

Material or subjects: Amniotic fluid and chorioamniotic membrane (CAM) were collected from women with sPTL who delivered at term (n=30) or preterm without intra-amniotic inflammation (n=34), with sterile intra-amniotic inflammation (SIAI, n=27), or with intra-amniotic infection (IAI, n=17). Amnion epithelial cells (AECs), Ureaplasma parvum, and Sneathia spp. were also utilized.

Methods: The expression of TSLP, TSLPR, and IL-7Rα was evaluated in amniotic fluid or CAM by …

Implicit Bias And Stigma Theory In Clinical Practice: Developing “Habits Of Mind” For Clinical Inquiry, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

The editor introduces a new article type in this issue, Translational Social Science, and reflects on the social theory required to perceive and counteract implicit bias.

Stigma Is A Very Real Part Of Clinical Practice, Aaron Rivkin

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on avoiding stigmatizing language in clinical practice.

Advancing Health Equity In The Us Military, James D. Mancuso, John Young, Jennifer Rusiecki, Shauna Stahlman, Natasha Schvey, Toya Randolph, Candy Wilson, Catherine Witkop, Patrick Hyde, Althea Green, Patcho Santiago, Donald Shell, Tracy Sbrocco

Journal of Health Disparities Research and Practice

Eliminating health disparities and achieving health equity are central to US national health objectives and the Military Health System’s “quadruple aim,” which has readiness as its core aim. Because military service members enjoy universal eligibility for health care, it is sometimes assumed that health disparities do not exist in the Department of Defense (DoD). However, while some studies have shown that disparities have been attenuated or eliminated in the DoD, others suggest that significant disparities remain. Reasons these disparities may remain include that universal eligibility for care does not necessarily result in equal to access to care, and that equal …

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

What? Now A Respiratory Syncytial Virus Epidemic, Aya Allam, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Leveraging Bio-Inspired Molecules For Cancer Theranostics, Douglas S. Macpherson

Dissertations, Theses, and Capstone Projects

A variety of molecules can be radiolabeled and delivered to a cancer site for the purposes of diagnostics and therapy. Among the most promising of tumor targeting molecules are peptides and antibodies. These bio-inspired molecules can be designed and synthesized to target and respond to cancer cells based on the properties of those cells. Matrix metalloproteinase (MMP) enzymes are over-expressed by some metastatic cancers, in which they are responsible for the degradation and remodeling of the extracellular matrix. In recent years, MMPs have emerged as promising targets for enzyme-responsive diagnostic probes because oligopeptides can be designed to be selectively hydrolyzed …

Mst1-Mediated Phosphorylation Of Nur77 Improves The Endometrial Receptivity In Human And Mice, Xinyu Cai, Yue Jiang, Zhiwen Cao, Mei Zhang, Na Kong, Lina Yu, Yedong Tang, Shuangbo Kong, Wenbo Deng, Haibin Wang, Jianxin Sun, Lijun Ding, Ruiwei Jiang, Haixiang Sun, Guijun Yan

Center for Translational Medicine Faculty Papers

Background: Successful embryo implantation requires the attachment of a blastocyst to the receptive endometrial epithelium, which was disturbed in the women with recurrent implantation failure (RIF). Endometrial β3-integrin was the most important adhesion molecule contributing to endometrial receptivity in both humans and mice. Nur77 has been proven indispensable for fertility in mice, here we explore the role of Nur77 on embryo-epithelial adhesion and potential treatment to embryo implantation failure.

Methods: The expression and location of Mst1 and Nur77 in endometrium from fertile women and RIF patients were examined by IHC, qRT-PCR and Western blotting. In vitro kinase assay following with …

The Neuroadvocacy Toolkit: A Knowledge Translation Strategy To Strengthen Food Fortification Policies To Prevent Neural Tube Defects In Latin American Countries. A Mixed-Method Study, Kemel A. Ghotme

Doctor of Philosophy in Translational Health Sciences Dissertations

Background. Neural tube defects are one of the leading congenital malformations that affect children in Latin America and worldwide, leading to pregnancy terminations, morbidity, mortality, and long-term disability. The most cost-effective and equitable way to prevent them is by implementing public health policies for food fortification with folic acid. However, a lack of knowledge translation strategies partly accounts for the incomplete enactment, enforcement, and scaling-up of mandatory fortification. There is no evidence in the scientific literature of studies attempting to identify the factors contributing to the development and implementation of knowledge translation strategies aiming to influence policymakers’ decisions regarding mandatory …

An Entosis-Like Process Induces Mitotic Disruption In Pals1 Microcephaly Pathogenesis, Noelle A Sterling, Jun Young Park, Raehee Park, Seo-Hee Cho, Seonhee Kim

Center for Translational Medicine Faculty Papers

Entosis is cell cannibalism utilized by tumor cells to engulf live neighboring cells for pro- or anti-tumorigenic purposes. It is unknown whether this extraordinary cellular event can be pathogenic in other diseases such as microcephaly, a condition characterized by a smaller than normal brain at birth. We find that mice mutant for the human microcephaly-causing gene Pals1, which exhibit diminished cortices due to massive cell death, also exhibit nuclei enveloped by plasma membranes inside of dividing cells. These cell-in-cell (CIC) structures represent a dynamic process accompanied by lengthened mitosis and cytokinesis abnormalities. As shown in tumor cells, ROCK inhibition completely …

Assessment Of The Interplay Between Regional Β-Amyloid Burden And White Matter Hyperintensities On Cognition And Default Mode Network In Clinically Normal Older Participants, Doaa G. Ali

Theses and Dissertations--Clinical and Translational Science

Objective: Alzheimer’s disease (AD) and subcortical vascular dementia are considered the most common pathologic contributors to dementia in the aging population. Both frequently coexist in over 80% of community dwelling adults with dementia. The neuropathological development of AD arguably begins with β-amyloid (Aβ) deposition in the brain. This series of studies aims to test the hypothesis that early focal regional amyloid deposition in the brain is associated with cognitive performance in specific cognitive domain scores in preclinical AD (pAD) (study1). Since mixed dementia is widely recognized as the norm rather than the exception, the second study aimed to explore the …

Cocaine Sensitizes The Cd4+ T Cells For Hiv Infection By Co-Stimulating Nfat And Ap-1, Adhikarimayum Lakhikumar Sharma, Dylan Shafer, Daniel Netting, Mudit Tyagi

Center for Translational Medicine Faculty Papers

The productive infection of HIV, which generates new viral progeny, depends on the activation status of the cell. In this study, we found cocaine exposure sensitizes partially active CD4+ T cells and makes them poised for productive HIV infection. We discovered that cocaine treatment enhances the metabolic state of the cells by co-stimulating several transcription factors, mainly NFAT and AP-1, the two transcription factors, which specifically play a crucial role in enhancing both HIV and the overall cellular gene expression in T cells. We found that cocaine-induced AP-1 works in tandem with NFAT to boost HIV transcription. The enhanced HIV …

Understanding The Contributions Of Hormonal Contraceptives And Cortisol Levels To Fear Learning In Women, Sahil Bardai

Symposium of Student Scholars

Women are twice as likely to be diagnosed with an anxiety disorder than men. Eighty-five percent of women in the US will use hormonal contraceptives at some point in their lifetime. Women who use hormonal contraceptives show heightened startle reactivity to a threatening stimulus. Previous results from our lab showed a significant increase in fear-potentiated startle (FPS) in women who were on hormonal contraceptives compared to women who were naturally cycling. These results stayed consistent throughout three acquisition trials. Others have shown that the use of OCPs (oral contraceptive pills) is related to the dysregulation of the HPA-axis and elevated …

Bioprosthetic Reoperative Aortic Valve Replacement In Patients Under 50, Aisha Kazeem

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Chan V, Lam BK, Rubens FD, et al. Long-term evaluation of biological versus mechanical prosthesis use at reoperative aortic valve replacement. J Thorac Cardiovasc Surg. 2012;144(1):146-151. https://doi.org/10.1016/j.jtcvs.2011.08.041

for a patient considering reoperative aortic valve replacement.

Renal Replacement Therapy Could Be Initiated In Patients With Severe Aki, Regardless Of Age And Critical Condition, El Hussain Shamsa

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Meersch M, Küllmar M, Schmidt C, et al. Long-Term Clinical Outcomes after Early Initiation of RRT in Critically Ill Patients with AKI. J Am Soc Nephrol. Mar 2018;29(3):1011-1019. https://doi.org/10.1681/asn.2017060694

for a critically ill elderly patient with severe acute kidney injury.

The Effect Of Medical Respite Services On Hospital Readmissions For Those Experiencing Homelessness, Kendrick Belardo

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Kertesz SG, Posner MA, O’Connell JJ, et al. Post-Hospital Medical Respite Care and Hospital Readmission of Homeless Persons. J Prev Interv Community. 2009;37(2):129-142. https://doi.org/10.1080/10852350902735734

for a patient experiencing homelessness.

The Use Of Cold Dialysis Solution In Reducing Fatigue In An End-Stage Renal Disease Patient, Justin Pawloski

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Sajadi M, Gholami Z, Hekmatpour D, Soltani P, Haghverdi F. Cold dialysis solution for hemodialysis patients with fatigue ‐ a cross‐over study. Iranian Journal of Kidney Diseases. 2016;10(5):319‐24.

for a patient with sickle cell disease.

Self-Administered Opat (S-Opat) Is A Potential Cost-Effective Equivalent Option For Uninsured Patients Requiring Opat, Joshua Brady

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Bhavan KP, Brown LS, Haley RW. Self-Administered Outpatient Antimicrobial Infusion by Uninsured Patients Discharged from a Safety-Net Hospital: A Propensity-Score-Balanced Retrospective Cohort Study. PLoS Med. 2015;12(12): e1001922. https://doi.org/10.1371/journal.pmed.1001922

for a patient with fungal peritonitis requiring OPAT.

Cystic Fibrosis Transmembrane Conductance Regulator Modulation May Improve Intestinal Inflammation In Adults With Cystic Fibrosis, Lauren G. Culver

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Ooi CY, Syed SA, Rossi L, Garg M, Needham B, Avolio J, Young K, Surette MG, Gonska T. Impact of CFTR modulation with Ivacaftor on Gut Microbiota and Intestinal Inflammation. Sci Rep. 2018 Dec 13;8(1):17834. https://doi.org/10.1038/s41598-018-36364-6

for a patient with cystic fibrosis experiencing small bowel obstruction.

Partial Outpatient Oral Antibiotic Treatment Of Infective Endocarditis Is Non-Inferior To Inpatient Intravenous Antibiotic Therapy, Nicholas J. Murphy

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Iversen K, Ihlemann N, Gill SU, et al. Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis. N Engl J Med. 2019; 380:415-424. https://doi.org/10.1056/NEJMoa1808312

for a patient with infective endocarditis and intravenous drug use with desire to leave the hospital.

Baclofen As A Helpful Alternative In Treatment Of Painful Paroxysmal Attacks From Trigeminal Neuralgia, Samantha Ryan

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Fromm GH, Terrance CF, Chattha AS. Baclofen in the treatment of trigeminal neuralgia: double-blind study and long-term follow-up. Ann Neurol. 1984;15(3):240. https://doi.org/10.1002/ana.410150306

for a patient with paroxysmal attacks from trigeminal neuralgia who is unable to take carbamazepine.

Indwelling Pleural Catheterization Maximizes Functionality And Quality Of Life In Management Of Recurrent Malignant Pleural Effusions, Avinash Ramkissoon

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Davies HE, Mishra EK, Kahan BC, et al. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: The TIME2 randomized controlled trial. J Am Med Assoc. 2012;307(22):2383-2389. https://doi.org/10.1001/jama.2012.5535

for the management of recurrent malignant pleural effusions in a patient with metastatic renal cell carcinoma.

Exploring Alternative Treatment Options For A Patient With Heavy Menstrual Bleeding And Mistrust Of The Healthcare System, Rachel A. O'Dell

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Tinelli A, Gustapane S, D’Oria O, Licchelli M, Panese G. Nutraceuticals in fibroid management after ulipristal acetate administration: An observational study on patients’ compliance. International Journal of Gynecology and Obstetrics; 2022;156(1):133-138. https://doi.org/10.1002/ijgo.13692

for a patient with chronic, symptomatic anemia with menorrhagia and uterine fibroid.

The Importance Of Stigma Theory For Clinical Decisions Related To Diabetic Foot Amputations, Rachael Garcia, Callie Bartkowiak, Alison Nesbitt Do

Clinical Research in Practice: The Journal of Team Hippocrates

The authors examine the unconsidered impact of social stigma theory on the shared clinical decision-making process for a patient with foot osteomyelitis and MRSA bacteremia facing the prospect of an amputation.

The Role Of Generative Adversarial Networks In Bioimage Analysis And Computational Diagnostics., Ahmed Mosaad Elsaid Mohamed Naglah

Electronic Theses and Dissertations

Computational technologies can contribute to the modeling and simulation of the biological environments and activities towards achieving better interpretations, analysis, and understanding. With the emergence of digital pathology, we can observe an increasing demand for more innovative, effective, and efficient computational models. Under the umbrella of artificial intelligence, deep learning mimics the brain’s way in learn complex relationships through data and experiences. In the field of bioimage analysis, models usually comprise discriminative approaches such as classification and segmentation tasks. In this thesis, we study how we can use generative AI models to improve bioimage analysis tasks using Generative Adversarial Networks …

Piperine Attenuates Cigarette Smoke-Induced Oxidative Stress, Lung Inflammation, And Epithelial-Mesenchymal Transition By Modulating The Sirt1/Nrf2 Axis, Pritam Saha, Sneha Durugkar, Siddhi Jain, P A Shantanu, Samir R Panda, Aishwarya Jala, Sharad Gokhale, Pawan Sharma, V G M Naidu

Center for Translational Medicine Faculty Papers

Piperine (PIP) is a major phytoconstituent in black pepper which is responsible for various pharmacological actions such as anti-inflammatory, antioxidant, and antitumor activity. To investigate the effects and mechanisms of PIP on cigarette smoke (CS)-induced lung pathology using both in-vitro and in-vivo models. BEAS-2B and A549 cells were exposed to CS extract (CSE) for 48 h; BALB/c mice were exposed to CS (9 cigarettes/day, 4 days) to induce features of airway disease. PIP at doses of (0.25, 1.25, and 6.25 µM, in vitro; 1 and 10 mg/kg, in vivo, i.n) and DEX (1 µM, in vitro; 1 mg/kg, in vivo, …

A Moment Of Reflection As We Move Forward, Bruce Morgenstern

Journal of Patient-Centered Research and Reviews

The newly appointed editor-in-chief of the Journal of Patient-Centered Research and Reviews reflects on the original editorial mission of the journal and its continuing commitment to publish patient-centered scholarly works that exhibit respect for each patient’s values and preferences; coordinated and integrated care; patient and family education; alleviation of pain, fear, and anxiety; continuity through care-site transitions; and access to care. The reasoning behind the pursuit of well-developed patient-centered care models, through the dissemination of peer-reviewed research findings and patient perspectives, has only been reinforced since the journal’s launch in 2014.

Understanding How Social Determinants Of Health Are Integrated Within Clinical Decision Science, James Peter Meza Md, Phd, Nicholus H. Yee Md

Clinical Research in Practice: The Journal of Team Hippocrates

The editors reflect on the effect of Social Determinants of Health in Clinical Decision Science on questions of efficacy and effectiveness.