Digital Commons Network^™

Protecting And Serving Yourself: The Mental Health Of Police Officers In Kaukauna, Wisconsin, Caina Weiner

Capstone Experience: Master of Public Health

The service learning hours performed at the Kaukauna Police Department served as a valuable learning experience to better understand an organization that is involved in public health. Although some may view this as non-traditional, the police department is quite involved in the community’s health. They work closely with public health officials and are also involved in certain public health programs, such as drug and alcohol programs. The health of a police officer must also be considered as a public health topic. A police officer is part of a vulnerable population of individuals that are “first responders.” These individuals are at …

Elucidation Of The Functions Of Neuropilin 2 In Osteoclasts In Promoting Prostate Cancer Bone Metastasis., Navatha S. Polavaram

Theses & Dissertations

Bone metastasis is one of the major clinical concerns that causes skeletal related malignancies and increased mortality. Bone is one of the preferred sites for metastatic prostate cancer. The metastatic prostate cancer cells interact with bone cells (osteoblasts and osteoclasts) resulting in an imbalance in the bone homeostasis leading to increased activation of osteoblasts over osteoclasts. Our preliminary data indicated a non-tyrosine kinase receptor Neuropilin 2 (NRP2) is expressed in osteoclasts induced by metastatic prostate cancer cells and acts as a negative regulator of osteoclast differentiation and function. We hypothesize that prostate cancer -induced NRP2 expression in osteoclasts is necessary …

Pandemic Planning: Estimating Disease Burden Of Pandemic Influenza To Guide Preparedness Planning Decisions For Nebraska Medicine, Angelia Wimberly

Theses & Dissertations

This year marks the 100^th anniversary of the 1918 “Spanish Flu” outbreak that killed 50-100 million people worldwide. If a pandemic of this proportion happened today, the federal pandemic influenza plan predicts that 30 percent of the population could become infected with up to 50 percent seeking outpatient care. With Nebraska Medicine currently operating at nearly full capacity (95-97%), surge capacity for hospital space, staff, and supplies would be in severe demand and would quickly overwhelm the organization. To assess the impact of pandemic influenza in Douglas County Nebraska and Nebraska Medicine, pandemic modeling tool FluAid and FluSurge 2.0 …

Microrna Expression And Disease Correlation In A Hispanic Lupus Cohort, Thandiwe Jere

Theses & Dissertations

Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease with varying clinical presentation and severity in different ethnicities/races. Micro-RNAs (miRNAs) modulate the immune system, and there is a growing interest in their role in SLE pathogenesis and disease presentation. Studies on miRNAs expression in SLE have been done in Caucasians and Asians but no comprehensive profiling has been done in Hispanics. This cross-sectional study of a Hispanic cohort of SLE patients (n =185) and healthy controls (HC) (n =185) from the Dominican Republic determined the expression of 10 selected miRNAs and their correlation to inflammatory markers and auto-antibody production in …

An Assessment Of Nontuberculous Mycobacteria In Nebraska, Molly Hoffman

Capstone Experience: Master of Public Health

Background. Nontuberculous mycobacteria (NTM) are an important cause of morbidity and mortality in the U.S., yet not much is known about the prevalence and risk factors. It is thought to be increasing and most commonly found in women and older adults. The objectives of this project were to estimate the burden of NTM in Nebraska and to describe the patterns of NTM infection including location, species, specimen source, and patient demographic characteristics.

Methods. The National Electronic Disease Surveillance System was searched for all NTM infections reported from 2012-2017. Cases were classified as either pulmonary or nonpulmonary and available information was …

Occupational Health Challenges In Research, Anthony Blake

Capstone Experience: Master of Public Health

ABSTRACT

Introduction: Employees working in universities and hospitals are faced with common and unique health and safety challenges. Usually, the campus Department of Health and Safety is tasked with reducing employee exposure through risk assessments. Purpose: In this study, we present a unique risk assessment case study related to a research project undertaken by the campus Department of Health and Safety (DHES). This project also describes the activities done by DHES to improve campus safety. We hypothesized that carbon monoxide, particulate matter, formaldehyde, and VOCs emitted from burning wood chips in a closed laboratory space will exceed …

Sooty Mangabey Genome Sequence Provides Insight Into Aids Resistance In A Natural Siv Host, David Palesch, Steven E. Bosinger, Gregory K. Tharp, Thomas H. Vanderford, Mirko Paiardini, Ann Chahroudi, Zachary P. Johnson, Frank Kirchhoff, Beatrice H. Hahn, Robert B. Norgren, Nirav B. Patel, Donald L. Sodora, Reem A. Dawoud, Caro-Beth Stewart, Sara M. Seepo, R. Alan Harris, Yue Liu, Muthuswamy Raveendran, Yi Han, Adam English, Gregg W.C. Thomas, Matthew W. Hahn, Lenore Pipes, Christopher E. Mason, Donna M. Muzny, Richard A. Gibbs, Daniel Sauter, Kim Worley, Jeffrey Rogers, Guido Silvestri

Journal Articles: Genetics, Cell Biology & Anatomy

In contrast to infections with human immunodeficiency virus (HIV) in humans and simian immunodeficiency virus (SIV) in macaques, SIV infection of a natural host, sooty mangabeys (Cercocebus atys), is non-pathogenic despite high viraemia. Here we sequenced and assembled the genome of a captive sooty mangabey. We conducted genome-wide comparative analyses of transcript assemblies from C. atys and AIDS-susceptible species, such as humans and macaques, to identify candidates for host genetic factors that influence susceptibility. We identified several immune-related genes in the genome of C. atys that show substantial sequence divergence from macaques or humans. One of these sequence divergences, a …

Clinical Features Of Guillain-Barré Syndrome With Vs Without Zika Virus Infection, Puerto Rico, 2016, Emilio Dirlikov, Chelsea G. Major, Nicole A. Medina, Roberta Lugo-Robles, Desiree Matos, Jorge L. Muñoz-Jordan, Candimar Colon-Sanchez, Myriam Garcia, Marangely Olivero-Segarra, Graciela Malave, Gloria M. Rodríguez-Vega, Dana L. Thomas, Stephen H. Waterman, James J. Sejvar, Carlos A. Luciano, Tyler M. Sharp, Brenda Rivera-García

Journal Articles: Epidemiology

Importance: The pathophysiologic mechanisms of Guillain-Barré syndrome (GBS) associated with Zika virus (ZIKV) infection may be indicated by differences in clinical features.

Objective: To identify specific clinical features of GBS associated with ZIKV infection.

Design, Setting, and Participants: During the ZIKV epidemic in Puerto Rico, prospective and retrospective strategies were used to identify patients with GBS who had neurologic illness onset in 2016 and were hospitalized at all 57 nonspecialized hospitals and 2 rehabilitation centers in Puerto Rico. Guillain-Barré syndrome diagnosis was confirmed via medical record review using the Brighton Collaboration criteria. Specimens (serum, urine, cerebrospinal fluid, and saliva) from …

Evidence-Based Guidelines For Supportive Care Of Patients With Ebola Virus Disease, François Lamontagne, Robert A. Fowler, Neill K. Adhikari, Srinivas Murthy, David Brett-Major, Michael Jacobs, Timothy M. Uyeki, Constanza Vallenas, Susan L. Norris, William A. Fischer, Thomas E. Fletcher, Adam C. Levine, Paul Reed, Daniel G. Bausch, Sandy Gove, Andrew Hall, Susan Shepherd, Reed A. Siemieniuk, Marie-Claude Lamah, Rashida Kamara, Phiona Nakyeyune, Moses J. Soka, Ama Edwin, Afeez A. Hazzan, Shevin T. Jacob, Mubarak Mustafa Elkarsany, Takuya Adachi, Lynda Benhadj, Christophe Clément, Ian Crozier, Armando Garcia, Steven J. Hoffman, Gordon H. Guyatt

Journal Articles: Epidemiology

The 2013-16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive …

Use Of A 4-Week Up-Titration Regimen Of Roflumilast In Patients With Severe Copd, Henrik Watz, Nitin Bagul, Klaus F. Rabe, Stephen I. Rennard, Vijay Kt Alagappan, Jonas Román, Axel Facius, Peter Ma Calverley

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: The oral selective phosphodiesterase-4 inhibitor roflumilast (ROF) reduces exacerbations in patients with severe COPD. Adverse events (AEs) can cause early ROF discontinuation. Alternative dosing strategies may help patients continue their therapy.

METHODS: In this multicenter, double-blind trial, 1,321 patients with severe COPD were randomized 1:1:1 to 4 weeks' treatment with ROF 250 µg once daily (OD), 500 µg every other day (EOD), or 500 µg OD, each followed by ROF 500 µg OD for 8 weeks, plus standard therapy. The primary end point was the percentage of patients prematurely discontinuing study treatment.

RESULTS: Patients in the 250 µg OD/500 …

Variation In Competence For Zikv Transmission By Aedes Aegypti And Aedes Albopictus In Mexico, Selene M. Garcia-Luna, James Weger-Lucarelli, Claudia Rückert, Reyes A. Murrieta, Michael C. Young, Alex D. Byas, Joseph R. Fauver, Rushika Perera, Adriana E. Flores-Suarez, Gustavo Ponce-Garcia, Americo D. Rodriguez, Gregory D. Ebel, William C. Black

Journal Articles: Epidemiology

BACKGROUND: ZIKV is a new addition to the arboviruses circulating in the New World, with more than 1 million cases since its introduction in 2015. A growing number of studies have reported vector competence (VC) of Aedes mosquitoes from several areas of the world for ZIKV transmission. Some studies have used New World mosquitoes from disparate regions and concluded that these have a variable but relatively low competence for the Asian lineage of ZIKV.

METHODOLOGY/PRINCIPAL FINDINGS: Ten Aedes aegypti (L) and three Ae. albopictus (Skuse) collections made in 2016 from throughout Mexico were analyzed for ZIKV (PRVABC59-Asian lineage) VC. Mexican …

Adherence And Perceived Barriers To Oral Antiviral Therapy For Chronic Hepatitis B, Kerui Xu, Li-Ming Liu, Evi A. Farazi, Hongmei Wang, Fedja A. Rochling, Shinobu Watanabe-Galloway, Jian-Jun Zhang

Journal Articles: Epidemiology

BACKGROUND: Globally, of the 248 million people chronically infected with the hepatitis B virus (HBV), 74 million reside in China. Five oral nucleot(s)ide analogs (NUCs) have been approved for the treatment of chronic hepatitis B (CHB) in China.

OBJECTIVES: The aims of this study were to determine rates of adherence to NUC therapy in patients with CHB, to identify the self-perceived barriers to adherence, and to examine the factors associated with adherence.

METHODS: Questionnaire-based interviews were administered among Chinese patients with CHB at hepatology clinics of a tertiary hospital in the city of Wuhan, China. Adults aged 18 years or …

Implementation And Evaluation Of Guillain-Barré Syndrome Surveillance In Puerto Rico During The 2016 Zika Virus Epidemic, Chelsea G. Major, Emilio Dirlikov, Nicole A. Medina, Roberta Lugo-Robles, Desiree Matos, Jorge Muñoz-Jordán, Candimar Colón-Sánchez, Myriam García-Negrón, Marangely Olivero-Segarra, Graciela Malavé-González, Dana L. Thomas, Carlos A. Luciano, Stephen H. Waterman, James Sejvar, Tyler M. Sharp, Brenda Rivera-García

Journal Articles: Epidemiology

OBJECTIVE: Guillain-Barré syndrome (GBS) is an uncommon autoimmune disorder that follows infection or vaccination, and increased incidence has been reported during Zika virus (ZIKV) transmission. During the 2016 ZIKV epidemic, the Puerto Rico Department of Health (PRDH) implemented the Enhanced GBS Surveillance System (EGBSSS). Here, we describe EGBSSS implementation and evaluate completeness, validity, and timeliness.

METHODS: GBS cases were identified using passive surveillance and discharge diagnostic code for GBS. Completeness was evaluated by capture-recapture methods. Sensitivity and positive predictive value (PPV) for confirmed GBS cases were calculated for both case identification methods. Median time to completion of key time steps …

Schistosoma Mansoni And Other Intestinal Parasitic Infections In Schoolchildren And Vervet Monkeys In Lake Ziway Area, Ethiopia, Dejene Teklemariam, Mengistu Legesse, Abraham Degarege, Song Liang, Berhanu Erko

Journal Articles: Epidemiology

OBJECTIVE: To assess Schistosoma mansoni and other intestinal parasitic infections in schoolchildren and vervet monkeys (Chlorocebus aethiops) in Bochessa Village, Ziway, Ethiopia.

RESULTS: Fecal specimens from selected schoolchildren and droppings of the vervet monkeys were collected and microscopically examined for intestinal parasites using the Kato-Katz thick smear and formol-ether concentration techniques. The prevalences of S. mansoni, Trichuris trichiura, Ascaris lumbricoides, Enterobius vermicularis, hookworms, Hymenolepis nana and Taenia species among the children were 35.7, 26.9, 24.1, 2.1, 2.1, 1.07 and 2.1%, respectively (by Kato-Katz) and 39.3, 36.1, 35.6, 2.9, 10.0, 4.3, and 2.9%, respectively (by formol-ether concentration). Prevalence of S. mansoni …

Catching Chances: The Movement To Be On The Ground And Research Ready Before An Outbreak, David Brett-Major, James V. Lawler

Journal Articles: Epidemiology

After more than 28,000 Ebola virus disease cases and at least 11,000 deaths in West Africa during the 2014⁻2016 epidemic, the world remains without a licensed vaccine or therapeutic broadly available and demonstrated to alleviate suffering. This deficiency has been felt acutely in the two, short, following years with two Ebola virus outbreaks in the Democratic Republic of Congo (DRC), and a Marburg virus outbreak in Uganda. Despite billions of U.S. dollars invested in developing medical countermeasures for filoviruses in the antecedent decades, resulting in an array of preventative, diagnostic, and therapeutic products, none are available on commercial shelves. This …

Midwest Pharmacists' Familiarity, Experience, And Willingness To Provide Pre-Exposure Prophylaxis (Prep) For Hiv, Jordan M. Broekhuis, Kimberly K. Scarsi, Harlan R. Sayles, Donald G. Klepser, Joshua P. Havens, Susan Swindells, Sara H. Bares

Journal Articles: Internal Medicine

INTRODUCTION: Pharmacist provision of pre-exposure prophylaxis (PrEP) through collaborative practice agreements with physicians could expand access to people at risk for HIV. We characterized pharmacists' familiarity with and willingness to provide PrEP services in Nebraska and Iowa.

METHODS: An invitation to complete an 18-question survey was emailed to 1,140 pharmacists in Nebraska and Iowa in June and July of 2016. Descriptive analyses and Pearson chi-square tests were used to determine to what extent demographics, familiarity and experience were associated with respondent willingness to provide PrEP. Wilcoxon rank-sum tests compared ages and years of experience between groups of respondents.

RESULTS: One …

Common Diagnoses Among Refugee Populations: Linked Results With Statewide Hospital Discharge Database, Kerui Xu, Shinobu Watanabe-Galloway, Ming Qu, Brandon Grimm, Jungyoon Kim

Journal Articles: Epidemiology

BACKGROUND: According to the U.S. State Department's Refugee Processing Center and the U.S. Census Bureau, in the fiscal year 2016, among all states in the United States, Nebraska resettled the highest number of refugees per capita.

OBJECTIVES: The objectives of this study were to determine the most common reasons for refugees utilizing hospital services in Nebraska between January 2011 and September 2015, and to examine whether refugee patients had increased risks for adverse health conditions compared to non-refugee patients.

METHODS: Statewide linkage was performed between Nebraska Medicaid Program's immigration data, and 2011-2015 Nebraska hospital discharge data inpatient and outpatient files. …

Interprofessional Education At Unmc: 2018 Annual Report, University Of Nebraska Medical Center

Annual Reports: Interprofessional Education

No abstract provided.

A Pharmacist-Led Medication Switch Protocol In An Academic Hiv Clinic: Patient Knowledge And Satisfaction, Sarah S. Lee, Joshua P. Havens, Harlan R. Sayles, Jennifer L. O'Neill, Anthony T. Podany, Susan Swindells, Kimberly K. Scarsi, Sara H. Bares

Journal Articles: Infectious Diseases

BACKGROUND: Tenofovir alafenamide (TAF) is associated with less renal and bone toxicity compared with tenofovir disoproxil (TDF). TAF's recent FDA approval has spurred HIV providers to consider switching antiretroviral therapy (ART) regimens containing TDF to TAF to minimize long term risks. Patient views on the process of such medication switches have not been explored.

METHODS: Patients taking elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (E/C/F/TDF) following the Food and Drug Administration's (FDA) approval of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) received medication education from an HIV pharmacist prior to switching to the tenofovir alafenamide (TAF) formulation. Patients were asked to complete a cross-sectional survey assessing satisfaction with …

Determinants Of Facilitated Health Insurance Enrollment For Patients With Hiv Disease, And Impact Of Insurance Enrollment On Targeted Health Outcomes., Renae Furl, Shinobu Watanabe-Galloway, Elizabeth Lyden, Susan Swindells

Journal Articles: Infectious Diseases

BACKGROUND: The introduction of the Affordable Care Act (ACA) has provided unprecedented opportunities for uninsured people with HIV infection to access health insurance, and to examine the impact of this change in access. AIDS Drug Assistance Programs (ADAPs) have been directed to pursue uninsured individuals to enroll in the ACA as both a cost-saving strategy and to increase patient access to care. We evaluated the impact of ADAP-facilitated health insurance enrollment on health outcomes, and demographic and clinical factors that influenced whether or not eligible patients enrolled.

METHODS: During the inaugural open enrollment period for the ACA, 284 Nebraska ADAP …

Evaluation Of Immune-Modulating Therapies For Parkinson's Disease, Katherine E. Olson

Theses & Dissertations

Parkinson’s disease (PD) is the second most common neurodegenerative

disorder, second only to Alzheimer’s disease (AD). It is characterized by a

progressive loss of dopaminergic neurons along the nigrostriatal axis and the

formation of proteinaceous inclusions of alpha-synuclein (α-syn). Secondary to

the loss of dopaminergic neurons is a progression in motor and non-motor

symptoms. Motor symptoms are characterized by slowness in movement,

stiffness and tremor. Non-motor symptoms include depression, constipation,

sleep abnormalities and loss of sense of smell. The cause of disease remains

incompletely understood. However, age, genetics, environment, viral infection,

and interplay between the innate and adaptive immune system …

Defining The Role Of Neuropilin-2 In Macrophages: Implications In Tumor Associated Macrophages In Pancreatic Cancer, Sohini Roy

Theses & Dissertations

Macrophages are extremely heterogeneous and highly plastic hematopoietic cells that reside in all tissues and act as a bridge between the innate and adaptive arms of the immune responses. Besides, they undertake a wide array of housekeeping functions like, clearance of cellular debris that arise due to regular turnover in tissues, iron homeostasis, immune surveillance as well as tissue repair processes post inflammation. They are also causally associated with several clinical conditions, including cancer where the infiltration of macrophages contribute to disease progression, metastasis and therapy resistance, and thereby poor clinical outcome.

Neuropilins (NRPs) are non-tyrosine kinase cell surface glycoproteins …

Effects Of Gm-Csf On Dendritic Cells And Regulatory T Cells In Parkinson’S Disease Patients And Models Of Parkinson’S Disease, Charles Schutt

Theses & Dissertations

Parkinson’s disease (PD) is the most common neurodegenerative movement disorder. Pathologically, loss of nigrostriatal neurons and dopamine released by these neurons are responsible for PD motor symptoms. During PD, activation of resident microglia and infiltrating lymphocytes leads to progressive neuroinflammation and reduction in the number and function of regulatory immune cells. Neuroinflammation contributes to progressive neurodegeneration and declining motor function. Reducing neuroinflammation is the target for novel PD therapeutics. Our goal is to increase the number and function of regulatory T cells (Tregs) in PD patients to decrease neuroinflammation and reduce PD symptoms. One potential therapy is granulocyte-macrophage colony stimulating …

Relationships Between Complex Pediatric Health Conditions And The Built, Physical And Social Environments, Brittany Corley

Theses & Dissertations

The relationship between human health and the environment is complex and overall poorly understood. The environment has a lasting impact on health, and the processes appear to start at conception. Thus, this dissertation examines the potential relationship between pediatric health and the environment.

The first relationship examined was between the built environment and comorbid Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder. Many publications have reported the relationship between socioeconomic disadvantage, Attention Deficient Hyperactivity Disorder, and Autism Spectrum Disorder. However, the link between the built environment and Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder symptom severity is poorly understood. …

The Use Of Electronic Health Records Data For Public Health: A Snapshot Of Current Practices In Nebraska’S Local Health Departments, Kushal Karan

Capstone Experience: Master of Public Health

Background: Public health issues are constantly changing and require local health departments (LHDs) to continually evolve in their approaches to address these issues. Advancements in health information technology (HIT), such as electronic health records (EHRs), play an important role in the collection of data that can be used to improve population health.

Objective: The purpose of this project was to assess the current use of electronic health records data by Nebraska’s local health departments and identify the data or tools they are using to address the health needs of the populations they serve.

Methods: In this study, a Mixed-Methods approach …

Frequently Identified Gaps In Antibiotic Stewardship Programs In Critical Access Hospitals, Philip Chung, Regina Nailon, Kate Tyner, Sue Beach, Scott Bergman, Margaret Drake, Teresa Fitzgerald, Elizabeth Lyden, Mark Rupp, Michelle Schwedhelm, Maureen Tierney-Brenran, Trevor Van Schooneveld, Muhammad Salman Ashraf

Posters and Presentations: Nebraska ASAP

Background: Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) is a CDC funded project. ICAP team works in collaboration with NE Department of Health and Human Services (NEDHHS) to assess and improve infection prevention and control programs (IPCP) in various health care settings including resource limited settings like critical access hospitals (CAH). Little is known about the existing gaps in antimicrobial stewardship programs (ASP) of CAH. Hence, we decided to study the current level of ASP activities and factors associated with these activities in CAH.

Methods: NE ICAP conducted on-site surveys in 36 CAH from October 2015 to February …

Development Of C5ar-Targeted Nanoparticles For Delivery Of Vaccines, Shailendra Bharadwaj Tallapaka Venkata Sesha

Theses & Dissertations

Since the early attempts of Benjamin Jesty at inducing immunity against smallpox and the pioneering work of Edward Jenner, vaccination has been, and continues to remain, the principal method of protection from diseases. However, most of the successful vaccines have been against pathogens that do not have major mechanisms to evade the immune system. So far, many life-threatening diseases like hepatitis C, HIV infection, malaria etc., have been resistant to existing vaccination strategies. Thus, there is an urgent need to develop new vaccination strategies that can generate long-lived protective immunity against such pathogens.

The purpose of this thesis is to …

Redirection Of The Immune Response To Staphylococcus Aureus Biofilm Infection, Anna G. Staudacher

Theses & Dissertations

Staphylococcus aureus (S. aureus) is a leading cause of community- and healthcare-associated infections and has a propensity to form biofilms. Biofilm infections are recalcitrant to host immune-mediated clearance as well as antibiotics, making them exceptionally difficult to eradicate. The biofilm environment has been shown to skew the host immune response towards an anti-inflammatory phenotype, characterized by alternatively activated macrophages, recruitment of myeloid-derived suppressor cells (MDSCs), and minimal neutrophil and T cell infiltrates. Our laboratory has attempted to redirect the host immune response towards one that would favor bacterial clearance by employing strategies to augment pro-inflammatory mechanisms. One such …

Patient-Centered Medical Home Adoption In School-Based Health Centers, Abbey Gregg

Theses & Dissertations

The patient-centered medical home (PCMH) is promoted as a primary care delivery design that can improve health care quality and patient outcomes while controlling health care costs. To achieve PCMH recognition, primary care providers must implement practice-level changes in order to deliver care that is comprehensive, coordinated, accessible, high quality, and whole-person oriented. This practice transformation requires advanced use of health information technology, staff investment in quality improvement and care coordination, and significant investments of both financial and human resources to support these activities. As a safety-net provider, school-based health centers (SBHCs) serve vulnerable children that typically experience barriers to …

Requirement Of Ehd Family Of Endocytic Recycling Regulators For T-Cell Functions, Fany M. Iseka

Theses & Dissertations

T-cells use the endocytic pathway for key cell biological functions, including receptor turn-over and maintenance of the immunological synapse. Some of the established players include the Rab GTPases, SNARE complex proteins, and others which in non-T-cell systems function together with Eps15 Homology Domain-containing (EHD) proteins. To date, the role of the EHD protein family in T-cell function remains unexplored. We generated conditional EHD1/3/4 knockout mice using CD4-Cre and crossed these with mice bearing a myelin oligodendrocyte glycoprotein (MOG)-specific TCR transgene. We found that CD4⁺ T-cells from these mice exhibited a reduced antigen-driven cell proliferation and IL-2 secretion in vitro. …