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Approaches To Fracture Healing Under Inflammatory Conditions: Infection And Diabetes, Sean Vincent Cahill

Yale Medicine Thesis Digital Library

Non-union is a devastating complication of fracture and can be precipitated by abnormal

inflammatory states including infection and diabetes.

This thesis focuses on four related research problems that are addressed through original

scientific investigation and literature review. In addressing these questions, this dissertation

presents evidence for the following conclusions through in vivo animal models and using methods

including bacterial cell culture and counting, histology, radiography, and micro-computed

tomography:

1. Rifampin-loaded hydrogels decrease bacterial load and improve fracture healing in

a MRSA-infected open fracture model.

2. MRSA-infected nonunion is characterized by impaired chondrocyte maturation and

is associated with IL-1 and NF-KB …

Uncovering Intratumoral And Intertumoral Heterogeneity Among Single-Cell Cancer Specimens, William Shelton Chen

Yale Medicine Thesis Digital Library

While several tools have been developed to map axes of variation among individual cells, no analogous approaches exist for identifying axes of variation among multicellular biospecimens profiled at single-cell resolution. Developing such an approach is of great translational relevance and interest, as single-cell expression data are now often collected across numerous experimental conditions (e.g., representing different drug perturbation conditions, CRISPR knockdowns, or patients undergoing clinical trials) that need to be compared. In this work, “Phenotypic Earth Mover's Distance” (PhEMD) is presented as a solution to this problem. PhEMD is a general method for embedding a “manifold of manifolds,” in which …

Natural History Of Thoracic Aortic Aneurysm Associated With Bicuspid Aortic Valve, Thais Faggion Vinholo

Yale Medicine Thesis Digital Library

Hypothesis: Thoracic aortic aneurysm (TAA) is a silent but virulent disease. Bicuspid aortic valve (BAV) is the most common congenital heart disease. The association between BAV and ascending TAA (ATAA) is well described. However, the guidelines for surgical management to treat patients with thoracic aortic aneurysms associated with bicuspid aortic valve (ATAA-BAV) remains controversial. We hypothesized that the surgical management of patients with ATAA-BAV should not differ from the management of those who have ATAA with a trileaflet aortic valve (TAV). Additionally, we suspected that BAVs that are free of stenosis and regurgitation can be spared in the setting of …

Aging With Hiv: Biomarkers Of Inflammation And Incident Rheumatologic Disease, Jennifer Leslie Simon Hanberg

Yale Medicine Thesis Digital Library

Chronic Human Immunodeficiency Virus (HIV) infection results in multimorbidity and shortened lifespan. Inflammation and immune dysfunction contribute to these outcomes. The aim of this thesis is (1) to investigate the utility of two inflammatory biomarkers evaluated in other settings (neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR)) for prognostication in patients living with HIV (PLWH) and comorbid inflammatory states; and (2) to compare the frequency and severity with which rheumatologic disease states occur in PLWH to demographically and behaviorally similar uninfected individuals (“controls”).

Three cohorts were created from the Veterans Aging Cohort Study. In each cohort, patients were stratified by presence …

Acute And Chronic Liver Disease: Lessons Learned From Retrospective Cohort Studies, Ysabel C. Ilagan-Ying

Yale Medicine Thesis Digital Library

Current trends in liver disease are changing due to increased access to pharmacotherapies and the worsening burden of obesity. Large, observational cohort studies are a common tool in clinical and epidemiological research to determine risk for patients that may have experienced an exposure of interest. Past studies have largely examined risk factors for liver disease in patients with cirrhosis or fatty liver disease. We utilized retrospective cohort studies in a disease-agnostic approach and aimed to characterize risk for two increasingly prevalent populations: patients with severe acute liver injury and those with liver fibrosis progressing to hepatocellular carcinoma (HCC).

First, we …

Reversal Of Warfarin-Associated Coagulopathy: Prothrombin Complex Concentrates Versus Fresh Frozen Plasma In Elderly Patients Presenting With Intracranial Hemorrhage, Shunella Grace Lumas

Yale Medicine Thesis Digital Library

Background: Patients on warfarin with traumatic intracranial hemorrhage (ICH) often require pharmacological reversal of warfarin-induced coagulopathy. We compared outcomes among patients who received 4-factor prothrombin complex concentrate (PCC), fresh frozen plasma (FFP) or no reversal to assess the real-world impact of PCC on elderly patients with traumatic intracranial hemorrhage on warfarin.

Study Design: This was a retrospective analysis of 150 patients on preinjury warfarin. Data was abstracted from the electronic medical record (EMR) of an academic level 1 trauma center for patients age 65 years and greater on warfarin therapy admitted with a traumatic ICH between January 2013 and December …

Differential Response To Rituximab In Anti-Achr And Anti-Musk Positive Myasthenia Gravis Patients, Tess Litchman

Yale Medicine Thesis Digital Library

Response to immunomodulatory therapies in myasthenia gravis (MG) can be variable. A subset of MG patients remains refractory to conventional agents. B-cell targeted therapy with rituximab has demonstrated a durable response in treating refractory myasthenia gravis (MG). This study compares the response to rituximab between patients with acetylcholine receptor autoantibody positive (AChR+) and muscle-specific kinase autoantibody positive (MuSK+) MG.

This retrospective study included 33 patients with either AChR+ or MuSK+ MG who were treated with rituximab from 05/31/2003 to 05/31/2017. Pretreatment and post-treatment immunotherapy regimens, clinical symptoms, and examination findings were evaluated.

Median MGFA Class of II at baseline improved …

Lifestyle Factors Associated With Neoadjuvant Chemotherapy Outcomes In Breast Cancer, Ilana Usiskin

Yale Medicine Thesis Digital Library

Lifestyle factors such as lower BMI, higher levels of physical activity, and increased fruit and vegetable intake, have been shown to benefit breast cancer survival, but the association between these factors and the pathologic complete response (pCR) to chemotherapy, has not been studied. We investigated whether lifestyle factors including BMI, physical activity, diet and alcohol use are associated with pCR from neoadjuvant chemotherapy for breast cancer treatment. Secondarily, we assessed whether the relative dose intensity (RDI) of neoadjuvant chemotherapy is associated with pCR.

We conducted a retrospective study of women treated with neoadjuvant chemotherapy for stage I-III breast cancer between …

The Development And Validation Of A Novel Ichthyosis Severity Assessment Instrument, Qisi Sun

Yale Medicine Thesis Digital Library

Abstract: THE DEVELOPMENT AND VALIDATON OF A NOVEL ICHTHYOSIS SEVERITY ASSESSMENT INSTRUMENT. Qisi Sun, Amy Paller, Keith A. Choate. Department of Dermatology, Genetics & Pathology, Yale University School of Medicine, New Haven, CT.

Ichthyosis clinical trials require reliable, validated severity assessments to identify appropriate subjects and quantify treatment outcomes. There is no validated scale to measure ichthyosis severity across the entire body. We aim to create and validate a comprehensive and user-friendly instrument to measure total body ichthyosis severity in adults and children.We divided the body into 10 regions to score special regions of interest. Likert scales (0-4) were established …

Forecast, 2020, Illinois State University, College Of Applied Science And Technology

foreCAST

Magazine of the Illinois State University College of Applied Science and Technology

Trypanosomatids Detected In The Invasive Avian Parasite Philornis Downsi (Diptera: Muscidae) In The Galapagos Islands, Patricia Parker, Courtney Pike, María Piedad Lincango, Charlotte Causton

Biology Department Faculty Works

Alien insect species may present a multifaceted threat to ecosystems into which they are introduced. In addition to the direct damage they may cause, they may also bring novel diseases and parasites and/or have the capacity to vector microorganisms that are already established in the ecosystem and are causing harm. Damage caused by ectoparasitic larvae of the invasive fly, Philornis downsi (Dodge and Aitken) to nestlings of endemic birds in the Galapagos Islands is well documented, but nothing is known about whether this fly is itself associated with parasites or pathogens. In this study, diagnostic molecular methods indicated the presence …

First Report Of The Broad-Toothed Tailless Bat, Anoura Latidens Handley, 1984 (Chiroptera, Phyllostomidae), In Bolivia, Camilo Calderón-Acevedo, Nathan Muchhala

Biology Department Faculty Works

Anoura latidens Handley, 1984 is a nectarivorous bat with a wide elevational and latitudinal distribution, from Venezuela and Guyana to southeastern Peru. We reviewed mammal collections of the genus Anoura Gray, 1838 and identified two individuals previously attributed to A. caudifer (É. Geoffroy Saint-Hilaire, 1818) as A. latidens based on their premolar morphology and morphological measurements. In this note we report the first record of A. latidens in the Yungas forests of Bolivia, which extends its geographic range by 1,006 km southeast of its previous southernmost record in Peru.

Nuclear Moonlighting Of Cytosolic Glyceraldehyde-3-Phosphate Dehydrogenase Regulates Arabidopsis Response To Heat Stress, Sang-Chul Kim, Liang Guo, Xuemin Wang

Biology Department Faculty Works

Various stress conditions induce the nuclear translocation of cytosolic glyceraldehyde-3-phosphate dehydrogenase (GAPC), but its nuclear function in plant stress responses remains elusive. Here we show that GAPC interacts with a transcription factor to promote the expression of heat-inducible genes and heat tolerance in Arabidopsis. GAPC accumulates in the nucleus under heat stress. Overexpression of GAPC enhances heat tolerance of seedlings and the expression of heat-inducible genes whereas knockout of GAPCs has opposite effects. Screening of Arabidopsis transcription factors identifies nuclear factor Y subunit C10 (NF-YC10) as a GAPC-binding protein. The effects of GAPC overexpression are abolished when NF-YC10 is deficient, …

School Of Biological Sciences News, 2020-2021, School Of Biological Sciences

School of Biological Sciences News

Alumni newsletter of Illinois State University's School of Biological Sciences.

Gender Quota Policy Plans And Female Members Of The Board Of Directors, Saidah Muhammad Traish

Walden Dissertations and Doctoral Studies

The present study explored how gender quota policy plans hindered and supported the access of female board members serving on the board of directors of their nonprofit organizations. The gender organizational theory guided the theoretical framework of this study by exploring how gendering organizational processes replicated, challenged, and reproduced gender perceptions of women in caregiving roles rather than leadership roles. The qualitative phenomenological approach explored the lived experiences of 6 female board members from 6 different nonprofit organizations on gender quota policy plans. The results of the analysis revealed succession planning, the inclusiveness of the mission and vision statements, and …

Risks For Hiv Infection Among Adolescent Girls And Young Women In Mozambique, Isabelle Casavant

Walden Dissertations and Doctoral Studies

Adolescent girls and young women (AGYW) living in Sub-Saharan African countries constitute 17% of the population, yet they account for one third of all new human immunodeficiency virus (HIV) infections. To prevent HIV infections among AGYW, it is necessary to understand why they are disproportionally infected. The purpose of the dissertation was to identify risk for HIV among AGYW living in a southern district of Mozambique. The analysis was driven by the Modified Socio Ecological Model and performed using a quantitative dataset collected for the Chokwe Combination Prevention of HIV (N=3354). Logistic regression analysis was conducted to assess whether an …

Sex Bias In The Diagnosis Of Chronic Obstructive Pulmonary Disease, Olga Ivan Belitchenko Ryan

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, disability, and cost globally and in the United States. Various sources point to women experiencing greater morbidity, increased health care resource use and higher incidence of mortality resultant from COPD. While exact causality is not fully understood, it is possible that social bias towards COPD in women impacting screening and timely diagnosis may be a contributing factor. This current investigation involved the social ecological model. In this cross-sectional secondary analysis of Behavioral Risk Factor Surveillance System, 2017 data, differences in screening through use of breathing testing among 6334 …

Comparison Of Gpa And Act Reading And Math Scores For African American Males In Afrocentric Versus Mainstream High Schools, Marissa Irene Prince

Walden Dissertations and Doctoral Studies

In the United States, the academic achievement of African American males is not at the same level as their peers from other ethnic backgrounds. There are negative social and financial implications for African American males who do not experience positive educational outcomes. The purpose of this quantitative study, based on critical race theory, was to compare the effectiveness of traditional high school education and Afrocentric high school education on the educational outcomes of African American males. Three measures of educational outcomes were examined: GPA at graduation, ACT reading score, and ACT math scores. The participants were 143 African American males, …

Health Behaviors Of Fruit And Vegetable Consumption, Physical Activity, And Breast Cancer Among African American Women, Nicole Ekoue

Walden Dissertations and Doctoral Studies

Breast cancer incidence is suddenly increasing among African American women. Recent studies indicate that health behaviors are thought to confer important health benefits and have the potential to lowering breast cancer incidence. Guided by the social ecological model, the purpose of this quantitative, cross-sectional study was to investigate the association between health behaviors of fruit consumption, vegetable consumption, and physical activity and breast cancer after adjusting for age, body mass index, and smoker status. Social support and income level were assessed as modifiers. Using the 2012 to 2017 Health Information and National Trends Survey data, this study was conducted with …

Association Between Maoa U Vntr Genetic Polymorphism And Aggression, Gender, And Race In Adolescents, Almaz Adair Johnson

Walden Dissertations and Doctoral Studies

A genetic polymorphism found in the upstream region of the monoamine oxidase A (MAOA) gene upstream variable number tandem repeat (u VNTR) has been shown to have an influence on aggression with mixed results. The purpose of this quantitative study was to examine the association between the u VNTR genetic polymorphism of the MAOA gene and aggression in an adolescent population 13–18 years of age. The conceptual framework was based on the biosocial model of antisocial behavior that indicates genes can influence aggressive behaviors with or without environmental influences. Data (N = 2506) from the National Longitudinal Adolescents and Adult …

Pharmacy Manager Strategies For Reducing Financial Losses From Adverse Drug Events By Polypharmacy Patients, Francis Rudden

Walden Dissertations and Doctoral Studies

Every year over 100,000 deaths occur in the U.S. from adverse drug events derived from medication errors. Medication errors account for an annual cost of $100 to $200 billion. Healthcare pharmacists lack strategies to reduce adverse drug events and medication errors from taking place. Grounded in complex adaptive system theory, the purpose of this qualitative multiple case study was to explore strategies to reduce advere drug events and medication errors. The participants were 5 pharmacist managers in a county in central Florida. These pharmacists were from different community pharmacies, and each had a minimum of 5 years’ experience in the …

Tool Kit To Address Communication On A Mental Health Unit, Carol L. Barclay

Walden Dissertations and Doctoral Studies

Effective communication by newly graduated, hired nursing staff is a significant issue affecting patient care on mental health units. The rising prevalence of mental illness in the United States has not only increased the healthcare burden, but has also affected the overall economy. The lack of training of new nursing staff regarding communication diminishes the effective recovery rate of patients, further increasing the burden to the healthcare field and the economy. A tool kit for newly graduated mental health nurses working on mental health units may help to improve communication skills and enhance patient safety and quality of care. Therefore, …

Effective Strategies Nonprofit U.S. Leaders Use To Assess And Mitigate Occupational Fraud, Fahim Mazumdar

Walden Dissertations and Doctoral Studies

A lack of effective strategies to assess and mitigate occupational fraud can negatively impact nonprofit organizations. Nonprofit organizational leaders in the United States who lack the strategies to assess and mitigate occupational fraud are at high risk of incurring loss due to fraud. Grounded in Cressey’s fraud triangle theory, the purpose of this qualitative single case study was to explore strategies nonprofit officers use to assess and mitigate occupational fraud in a nonprofit organization. The participants comprised 2 internal auditors in the northeast region of the United States who effectively used strategies to assess and mitigate occupational fraud in the …

Identifying What Hinders Effective Interactions Between Correctional Staff And Transgender Juvenile Offenders, Tawanda Walker

Walden Dissertations and Doctoral Studies

Communication serves as an avenue for individuals to introduce themselves to others and the world, but communication for individuals who identify as lesbian, gay, bisexual, transgender, questioning/queer, or intersex (LGBTQI) creates an opportunity discrimination, bias, and mistreatment. Research has been conducted to address the issues of discrimination, bias, and mistreatment among LGBTQI youth in juvenile detention centers; however, a gap exists in the literature exploring correctional staff members’ beliefs, attitudes, and understandings of transgender juvenile offenders. The purpose of this action research, quasi-experimental, mixed-method study was to explore if correctional staff members’ religious beliefs, lack of LGBTQI training, and inadequate …

Faculty Perceptions Of The Use Of Virtual Learning Environments In Introductory Biology Courses, Whitley Shaina Webb

Walden Dissertations and Doctoral Studies

Blended learning (BL) and virtual learning environments (VLEs) are innovative approaches that many higher education instructors are using to promote student success and learning in introductory biology courses. However, research does not provide insight into whether specific VLEs such as Mastering Biology (MB), are useful or effective in increasing student success. The purpose of this basic qualitative research study was to explore the experiences and perceptions of higher education introductory biology instructors regarding the use of BL and MB to promote student success and learning. The theoretical framework for this study was connectivism, based on the work of Siemens. Research …

Strategies For Teaching New Mothers The Importance Of Vaccination, Halimat Akojie

Walden Dissertations and Doctoral Studies

Vaccinations provide protection against a number of severe childhood communicable diseases, such as polio, measles, and pertussis. However, not all parents follow the recommended immunization schedules for their young children, a decision which could lead to increased disease incidence and prevalence. The purpose of this DNP project was to address the gap-in-practice related to ineffective strategies to reduce vaccination refusal among parents. This systematic review sought to understand strategies effective at teaching new mothers the importance of vaccinating their children. The theoretical foundation for addressing this question is Rogers’ protection motivation theory, which explains that sources of information, mediating cognitive …

Hiv/Sti Screening, Testing, And Prophylaxis Among Sexual Assault Survivors In U. S. Emergency Departments, Elizabeth A. Cita

Walden Dissertations and Doctoral Studies

Use of HIV screening/testing and prophylaxis has been found to be low in the general emergency department (ED) population. Less is known about the use of HIV/sexually transmitted infection (STI) screening, testing, and prophylaxis among sexual assault survivors who present to EDs. The main research questions asked whether there was a relationship between race, socioeconomic status (SES), geographic region, or age, HIV/STI, treatment, and prophylaxis among sexual assault survivors that present to U.S. EDs. This study was a secondary analysis of data collected in the NHAMCS years 2010 to 2016 and included 112 geographic primary sampling units, about 480 hospitals. …

Job Satisfaction And Retention Of Middle School Teachers, Rebecca Jane Gault

Walden Dissertations and Doctoral Studies

The problem investigated in this study was the high turnover rates of experienced, quality, and highly effective middle school teachers, which has a negative effect on student learning and achievement. The purpose of this qualitative study was to discover what specific support and professional development middle school teachers need to remain teaching. The conceptual framework that grounded this study was Herzberg’s two-factor theory of motivation. The research questions explored what experienced middle school teachers need in terms of support and professional development in order to improve their job satisfaction and increase their retention. Nine teachers, one from each middle school …

The Influence Of Age And A Self-Actualizing Workshop On Adult Self-Actualization Scores, Tami Amelia Michelle Harris

Walden Dissertations and Doctoral Studies

Seeking self-fulfillment is a relevant goal among many adults but one that is often not attained. Existing literature includes research on programs that enhance the well-being of participants but does not teach how core self-actualization attributes are significant in developing self-fulfillment. The main theoretical framework for this study was Maslow’s hierarchy of needs concentrating on the internal and external schemas of self-actualizing attributes. Using a snowball sample, the total number of qualified participants for this study was 80; the study was a cross-section sample of adults using a between group, single group, pre-/posttest, quantitative design. The 10 items of the …

Evaluation Of The Impact Of Virginia’S Senate Bill 1294 On Crisis Intervention Team Cooperation, Dennis Ray Martin

Walden Dissertations and Doctoral Studies

In 2009, the Commonwealth of Virginia passed Senate Bill (SB) 1294 that directly involved the Department of Criminal Justice Services and the Department of Behavioral Health and Developmental Services in the spread of the Crisis Intervention Team (CIT) program statewide. The purpose of this mixed-method study was to explore how the passage of SB 1294 affected the level of stakeholder cooperation within Virginia’s statewide CIT program, through 11 interviews with Virginian CIT leaders and by the completion of 115 questionnaires by CIT members in a region of central Virginia. Findings indicated the most common way that SB 1294 affected CIT …