Digital Commons Network^™

Stress Relaxation In Orthodontic Aligner Plastics; An In Vitro Comparison Study, Kristopher J. Keller

Theses & Dissertations

The purpose of this study was to ascertain if repeated stresses from extension cycling would result in accumulated damage in aligner materials and affect force delivery. A secondary goal was to identify potential differences in mechanical behavior present among orthodontic aligner polymers. Four thermoplastic polymers (Essix ACE, Taglus, Zendura, and Zendura FLX) were thermoformed, cut into strips, and extension cycled to 0.4 millimeters in a 37C water bath. Force decay, maximum and minimum force, and elastic modulus were measured during cycling. Additional samples were subjected to controlled tension until failure, allowing the measurement of yield strength, ultimate strength, and elastic …

Rilpivirine-Associated Aggregation-Induced Emission Enables Cell-Based Nanoparticle Tracking, Insiya Mukadam

Theses & Dissertations

Antiretroviral therapy (ART) has improved the quality and duration of life for people living with human immunodeficiency virus (HIV) infection. However, limitations in drug efficacy, the emergence of viral mutations and the paucity of cell-tissue targeting remain. We posit that to maximize ART potency and therapeutic outcomes newer drug formulations that reach HIV cellular reservoirs need to be created. In a step towards achieving this goal we discovered the aggregation-induced emission (AIE) property of the non-nucleoside reverse transcriptase inhibitor Rilpivirine (RPV) and used it as a platform for drug cell and subcellular tracking. RPV nanocrystals were created with endogenous AIE …

Mechanisms By Which Mnte-2-Pyp Suppresses Prostate Cancer Cell Growth, Yuxiang Zhu

Theses & Dissertations

Prostate cancer patients are often treated with radiotherapy. MnTE-2-PyP, is a superoxide dismutase (SOD) mimic and a known radioprotector of normal tissues. Our recent work demonstrates that MnTE-2-PyP also inhibits prostate cancer progression with radiotherapy; however, the mechanisms remain unclear. In this thesis, we identified that MnTE-2-PyP-induced intracellular H2O2 levels are critical in inhibiting growth of prostate cancer cells. We found that MnTE-2-PyP induced protein oxidations in PC3 cells and one major group of oxidized protein targets were involved in energy metabolism. The oxidative phosphorylation rates were significantly enhanced in both PC3 and LNCaP cells with MnTE-2-PyP treatment, but mitochondrial …

Joint Loading Factors Of Articular Cartilage Structure In Healthy And Acl-Injured Knees, Elizabeth Wellsandt

Theses & Dissertations

Articular cartilage structure and chondrocyte health are sensitive and reliant on dynamic joint loading during activities. The risk of osteoarthritis (OA) is high after anterior cruciate ligament (ACL) injury, but mechanisms underlying its development are poorly understood. The overall goals of this work were 1) to determine the association between measures of individual and cumulative knee joint loading with T2 relaxation times in the knee cartilage of young individuals without injury and 2) to determine if these same knee joint loading factors are associated with cartilage T2 relaxation time one month after ACL injury. The central hypotheses was that lower …

Pandemic Driven Innovation: Development Of An Alternative Respiratory Pathogen Self-Collection Device, Thang Nguyen

Theses & Dissertations

The SARS-CoV-2 virus outbreak has underscored numerous weak links in our biodefense countermeasures against highly communicable diseases. Many believe it was our lack of an effective testing model that allowed the virus to become a global pandemic within a short period. The gold standard collection method for the SARS-CoV-2 virus involves mechanical debridement of the nasopharyngeal cavity with a stiff swab applicator, which has been known to cause pain and injury to patients, subsequently resulting in low patient acceptance of the procedure. Due to the invasive nature of the nasopharyngeal swab collection method, it may not be conducive to the …

Inflammatory Cytokine Expression Of Immune Cells On Exposure To Invisalign® Material: An In Vitro Pilot Study, Alaina M. Allen

Theses & Dissertations

The purpose of this study is to characterize the inflammatory cytokines that are expressed in peripheral blood mononuclear cells (PBMCs) and THP-1 monocytes exposed to Invisalign^® aligner material in vitro. Invisalign^® material was ground into particles, soaked in artificial saliva, and the eluate was collected. Commercially available cryopreserved pooled and individual human PBMCs and THP-1 monocytes were cultured with Invisalign^® material eluate and positive (lipopolysaccharide) and negative controls. The supernatants were collected and used with a BioLegend LEGENDplex^™ multi-analyte flow assay, a sandwich enzyme-linked immunosorbent assay (ELISA), to identify the expression of TNF-α, IL-6, IL-8, IL-10, …

Glycemic Variability In Patients With Stage Ii-Iii Colon Cancer, Natalie Mandolfo

Theses & Dissertations

Patients with cancer experience metabolic changes such as hypoglycemia, hyperglycemia, and glycemic variability; collectively termed malglycemia. Glycemic variability, defined as fluctuations in glucose, is a marker of metabolic instability. Higher glycemic variability is associated with adverse health outcomes in the general population and in those with diabetes. Little is known about glycemic variability in patients with cancer, especially those with solid tumor malignancies. Glycemic variability is associated with increased infection, shorter periods of remission, and higher mortality in patients with hematological cancer. This body of work describes the concept and measurement of glycemic variability to assess glycemic control in patients …

Anti-Muc4Β Antibodies As A Novel Therapeutic Modality For The Treatment Of Pancreatic Cancer, Catherine Orzechowski

Theses & Dissertations

The deregulation of cell surface glycoproteins, such as mucins, is a hallmark of many tumors of epithelial origin. The transmembrane mucin MUC4, is differentially overexpressed in several malignancies, including pancreatic, breast, ovarian, lung, cervical, and head and neck cancers. Of all the aforementioned cancers, the role of MUC4 has been the most thoroughly in pancreatic cancer (PC), which is the 4th leading cause of cancer-related deaths in the United States. While MUC4 is undetectable in the normal or inflamed pancreas (pancreatitis), its expression progressively increases during PC progression and its higher expression correlates with poor survival. The role of MUC4 …

Long-Acting Nanoformulated Antivirals For The Treatment And Prevention Of Hiv-1 And Hbv Infections, Dhruvkumar M. Soni Dr.

Theses & Dissertations

While antiretroviral therapy (ART) has revolutionized treatment and prevention of human immunodeficiency virus type one (HIV-1) infection, regimen adherence, viral mutations, drug toxicities, stigma and pill fatigue are limitations. These have led to the development of long acting (LA) ART. These include, but are not limited to, implantable devices, new chemical entities, prodrug modifications and nanoformulations. To these ends, this thesis focues on the transformation of nucleoside reverse transcriptase inhibitors (NRTIs) into LA parenterals, While elusive, data from our laboratories demonstrated that modifications to the PROdrug and nucleoTide technology (ProTide) enables improvements in drug apparent half-life and tissue and cell …

Polymeric Drug Delivery Systems For Cancer Therapy And Radionuclide Decorporation, Sameer A. Alshehri

Theses & Dissertations

The main objective of this body of work is to develop polymeric drug delivery systems for cancer radiotherapy and the decorporation of radiological materials. The polymeric systems for radiotherapy were evaluated in vitro and in vivo (in normal, prostate, and ovarian cancer mice models). The polymeric system for radionuclide decorporation was also evaluated in vitro and in a normal mouse model. Due to its attractive properties, the N-(2-Hydroxypropyl) methacrylamide (HPMA) copolymer was utilized as the main carrier for the developed systems.

Chapter 1 provides an overview of prostate and ovarian cancer, targeted radiopharmaceuticals, nanomedicine-based drug delivery for cancer, HPMA copolymers, …

Cardioprotective Roles Of Hydrogen Sulfide Donor Treatment In Diabetic Cardiomyopathy, Sumit Kar

Theses & Dissertations

Diabetes mellitus (DM) increases the risk of heart failure 2-4-fold. Intensive glycemic control does not abate this risk in DM patients, suggesting that DM-induced heart failure is beyond hyperglycemia. DM silently induces cardiac muscle disorder termed diabetic cardiomyopathy (DMCM), which progresses to heart failure. The objective of this dissertation is to understand the mechanistic underpinnings of DMCM to develop new solutions to diagnose and treat heart failure in DM.

The heart pumps blood due to the contraction and relaxation of terminally differentiated cardiomyocytes with limited regenerative capacity. The DM environment of hyperglycemia, hyperlipidemia, and inflammation causes cardiomyocyte death and leads …

Beyond The Eye: The Neural Signature Of Cerebral Visual Processing In Children With Cerebral Palsy, Jacy R. Hannan

Theses & Dissertations

Cerebral palsy (CP) is a permanent, non-progressive neuromuscular disorder diagnosed early in childhood. Frequently the lesion that causes the motor impairments in individuals with CP concurrently disrupts the visual networks, placing them at a high risk of cerebral visual dysfunctions. Cerebral visual impairment (CVI) often remains unrecognized or misdiagnosed in people with CP. Despite the crucial role of visual function in the development of movement and cognition, the neurophysiological basis of the cerebral visual dysfunctions is almost entirely unknown. This investigation aimed to examine the neurophysiological mechanisms underlying cerebral visual dysfunction in children with CP. Specifically, this research used magnetoencephalographic …

Investigating The Relationship Between Unavoidable, Hospital Acquired Pressure Injury And Mortality: Is Unavoidable, Hospital Acquired Pressure Injury A Signal Of Increased One-Year Mortality Risk?, Eileen Jimenez

Theses & Dissertations

The purpose of this dissertation was to explore the strength of the relationship between unavoidable Hospital Acquired Pressure Injury (HAPI) and increased risk of one-year mortality for patients age 55 and older who were admitted to a hospital from 2015 to 2018. A quantitative, retrospective case-control study was designed to compare demographics, comorbid conditions, pressure injury risk, and living situation of those patients that developed unavoidable HAPI and hospitalized adults with similar physiological burdens that remained injury-free. The one-year mortality for the HAPI group was 27 of 48 (56%), and 26 of 47 patients (55%) for the Control group. The …

Outcomes Of Unilateral Alveolar Clefts Grafted Using Recombinant Human Bone Morphogenetic Protein-2: A Retrospective Volumetric Analysis Using Cbct, Landon Robert Peterson

Theses & Dissertations

Purpose of this study is to evaluate the success rates of secondary alveolar grafts using recombinant human bone morphogenetic protein with CBCT and to evaluate the effects of several variables on these outcomes. After our inclusion/exclusion criteria, records of 24 patients receiving secondary alveolar grafts at the University of Nebraska Medical Center were evaluated. Pre-graft and 6-month post-graft cleft volumes were measured using ITK-SNAP 3.8.0 software to determine a percent residual defect following surgery. Of the 24 patients, one was excluded as the graft surgery was deemed a failure. The patients’ gender, age, side of cleft, cleft side canine root …

Perceptions Of Voice Health, Voice Health Care, And Voice Health Education In The Performance Community, Katelyn Nelson

Capstone Experience

There is a medical consensus that proper voice health precautions can protect the voice and decrease the occurrence and severity of voice disorders in vocal performers. Similarly, seeking medical treatment for voice disorders can speed recovery time and preserve the voice. Voice disorders are common in performance students and professionals because of demanding curricula and frequent voice use, but little is known about their voice care needs, preferred voice care resources, and clinical care. The purpose of this study was to add to the research on voice health by interviewing faculty members in the College of Communication, Fine Arts, and …

Effect Of Climate Change On Lyme Disease Cases In 4 New Jersey Counties, Meredith Olson

Capstone Experience

Since its discovery more than 40 years ago, there has been an increasing occurrence of Lyme disease. Lyme disease is a tick-borne illness found predominantly in the Northeastern region of the United States. Studies have shown that environmental factors play an important role on the life cycle of ticks. Due to the complexity of environmental changes as well as the life cycle of different tick species, the variety of factors that could influence the increase in Lyme disease can be different depending on tick species and region. This study compared different regions of New Jersey, a highly Lyme disease endemic …

Developing A Community Innovation Grant In Response To Increasing Rural Critical Incidents In Agricultural Mental Health And Wellbeing, Community Trauma, And Natural Disasters, Chessa S. Quenzer

Capstone Experience

Spink Area Support Network (SASN) is a skilled team of community volunteers that facilitate rural critical incident response services in an effort to prevent a critical incident and offer structured support during the aftermath. SASN was developed in response to identified gaps in rural critical incident response and risk reduction through prevention in Spink County, South Dakota. SASN utilizes a collaborative team approach to fill in gaps between first responder silos and establish community interventions by providing support and resources while utilizing critical incident stress management methods. SASN requires funding to maintain response resources, training, prevention education, and follow-up services. …

Developing A Program Evaluation Plan For Medicaid Prenatal Care Management Programs, Shardae Sims

Capstone Experience

Prenatal care management (PNCM) is an intervention that targets women during the perinatal period to improve birth outcomes. PNCM has the potential to address social determinants of health issues and gaps or barriers to care that could lower incidences of adverse birth outcomes in Nebraska. There is currently a gap in the literature for studies that fully assess the impact of prenatal care management programs and the program’s ability to reach set goals. The purpose of this research is to develop an evaluation plan and potential implementation strategies that can be utilized by the Medicaid PNCM program in Nebraska. The …

Developing A Rabies Prevention Program Based On Rabies Exposure Data In Nebraska, Jill Oatman

Capstone Experience

Eighty-nine percent of Nebraska’s towns are considered rural, with populations of less than 3,000 people and with many towns having less than 1,000 residents. Rural areas consist of crop ground, livestock facilities and regions inhabited by wildlife. Nebraska has two large urban cities, Lincoln and Omaha. Animal and human health in these communities can be greatly impacted by infectious diseases that are transmitted between animals and humans, known as zoonotic diseases. One zoonotic disease of great concern is rabies. Zoonotic diseases not only impact the health of animals and humans, but the social well-being of communities and result in increased …

Assessing Occupational Stress And Preparedness Among Campus Safety Officers And Dental School Employees At An Academic Medical Center During Covid-19, Decature Banker, Lorena Baccaglini, Miriam Mccann, Chandran Achutan

Capstone Experience

Job stress can lead to adverse physical and emotional health effects in employees and is worse during an emergency or pandemic. The complexity of the coronavirus disease 2019 (COVID-19) pandemic is taking a toll on the healthcare systems and their employees. This cross-sectional study looked at two different groups of academic medical center employees, Campus Safety Officers and Dental School employees, who’s work puts them at risk for COVID-19 exposure. We hypothesized that Campus Safety Officers and Dental School employees who felt adequately trained to conduct COVID-19 related work would not feel more stressed during the COVID-19 pandemic than they …

A Preliminary Analysis Of Project Ag Aware: Sbirt In Agricultural Work Settings, Rachel L. Rutt

Capstone Experience

Background: An increasing number of individuals are being negatively affected by substance abuse in the U.S. and Nebraska communities. These communities are seeing immense increases in opioid prescribing rates, especially in rural areas. The aims of this study are to 1) describe the study population of agricultural workers in Nebraska; 2) estimate the prevalence of alcohol misuse, illegal drug use, and anxiety among agricultural workers in Nebraska; and 3) examine factors associated with alcohol misuse among agricultural workers in Nebraska.

Methods: Adult agricultural workers (N=1,206) completed a paper or online survey for Project Ag Aware. Alcohol misuse, illegal drug use, …

Effects Of Climate Change On The Epidemiology Of Flood-Related Waterborne Disease: A Systematic Literature Review, Sarah M. Cadarette

Capstone Experience

Natural disasters, such as flooding related to extreme precipitation, can lead to many adverse health effects (i.e. waterborne disease). Several outbreaks of waterborne disease have been linked to extreme precipitation, and gastrointestinal infection has been shown to increase after floods. Climate change is likely to lead to a higher frequency of waterborne disease through increases in extreme precipitation and associated flooding affecting water and sanitation infrastructure. This review sought to answer 2 research questions: 1. Has the epidemiology of waterborne disease related to floods changed over time? 2. Can this difference be related to climate change? A literature search was …

A Qualitative Analysis Of Omaha Healthy Kids Alliance’S Client Educational Attainment, Shelby Larson

Capstone Experience

Housing and physical health are inextricably linked. Environmental hazards such as lead poisoning, radon, and mold negatively impact the health of a home’s occupants, particularly children. Omaha Healthy Kids Alliance (OHKA) was founded in 2006 to address these environmental hazards through education and construction interventions with the mission “to improve children’s health through healthy homes.” OHKA clients are primarily served through two direct service programs and are evaluated pre- and post-intervention for changes in educational attainment, behavioral outcomes, environmental characteristics, quality of life, and health. A program evaluation was conducted to 1) determine how OHKA clients utilize environmental education post-intervention, …

Non-Emergency Utilization Of Ems: Contributing Factors And Strategies To Promote Effective Care With Appropriate Resources, Jason Jones

Capstone Experience

Non-emergency use of EMS resources can impose a substantial burden on emergency response systems and the communities they serve by reducing the response capacity for time-sensitive and life-threatening situations and through the subsequent diversion of funding that could be used to more effectively address health disparities. National EMS response data suggest that a large proportion of EMS patient encounters are for non-emergent reasons. Despite being a nation-wide issue, inadequate research has been conducted to understand why non-emergency and frequent use occurs and what strategies may be effective in mitigating avoidable use. Community paramedicine (CP), an emerging specialty in EMS that …

Agricultural Injuries Among Central State Region Operators Over A 5-Year Period: Cs-Cash Farm And Ranch Health And Injury Survey 2011-2015, Anthony Johnson Jr

Capstone Experience

Background The high risk of occupational fatalities in agriculture is well documented, but information on non-fatal injuries is lacking due to challenges in injury surveillance. This surveillance study explored the frequency, characteristics, and risk factors for non-fatal injuries among farmers and ranchers in the central United States.

Methods The Central States Center for Agricultural Safety and Health (CS-CASH), in collaboration with the USDA National Agricultural Statistics Service (NASS), conducted annual surveys (n=34,777 sent) during 2011-2015 covering a seven-state region (Iowa, Kansas, Minnesota, Missouri, North Dakota, Nebraska, and South Dakota).

Results The average response rate was 32% in the five consecutive …

Development Of A Web-Based Agriculture Health Risk Assessment Tool For Military Veteran Farmers And Ranchers, Alyssa Damke

Capstone Experience

In the U.S., significant health disparities exist among rural populations compared to their urban counterparts. These disparities can be compounded in agricultural workers due to the dangerous and unpredictable nature of their work. Agricultural producers who are also military Veterans may experience additional health pressures that are often overlooked in the healthcare setting. Over 2.5 million Veteran Health Administration (VHA) patients reside in rural areas and the healthcare infrastructure to care for these Veterans may not include an agricultural occupational approach. To address healthcare disparities in Veteran farmers and ranchers, this study, in collaboration with AgriSafe Network, will be used …

Multiquantal Glutamate Release From Rod Photoreceptors, Cassandra L. Hays

Theses & Dissertations

Neurons communicate via Ca²⁺-dependent release of neurotransmitters packaged into vesicles (quanta). Some CNS neurons, especially sensory synapses, can release multiple vesicles at a time, increasing information transmission and overcoming the unreliability of a stochastic process. Ribbon-bearing neurons, including retinal photoreceptors, face the challenge of encoding sensory receptor potentials into an ever-changing train of vesicle release events. We studied release of glutamate using voltage clamp to measure anion currents activated during glutamate reuptake into presynaptic terminals (I_A(glu)) of salamander and mouse rods, finding that each employ distinct mechanisms for multiquantal release. In amphibian rods, we found that …

Ligand-Installed Polymeric Nanocarriers For Combination Chemotherapy, Xinyuan Xi

Theses & Dissertations

Combination chemotherapy remains the mainstay of cancer treatment because such strategy targets different cell signaling pathways to decrease the likelihood of developing protective mechanisms by cancer cells, thereby delaying the onset of recurrence and prolonging the survival. The co-delivery of binary drug combination via a single nanocarrier provides benefits in reducing dose-limiting toxicities, improving the pharmacokinetic properties of the cargo, spatial-temporal synchronization of drug exposure, and synergistic therapeutic effects. Rational design of such regimen is crucial for maximizing the therapeutic effects since only certain drug ratios exposed to the target might be synergistic while other ratios exert additive or even …

Development Of Cholesterol Modified Rnai Polyplexes For Breast Cancer Therapy, Zhen Ye

Theses & Dissertations

Not available.

Utilization Of Nurse Practitioners In States With Full Practice Authority: Does Geography Matter?, Jana Zwilling

Theses & Dissertations

Background: Over 80 million Americans reside in or are part of a population designated as Health Professional Shortage Areas (HPSAs). Of the primary medical HPSA areas designated in the U.S., 66.74% are located in rural or partially rural areas (HRSA, 2020). To combat this shortage, 23* states and Washington, D.C. have enacted full practice authority laws for nurse practitioners (NP). Over 60% of NPs work in communities of less than 250,000.

Problem: The variability and extent of utilization of NPs in states with full practice authority (FPA) is unknown. To ensure access to quality healthcare, nurse practitioners need to be …