Digital Commons Network^™

Role Of E3 Ubiquitin Ligase Ubr5 In B Cell Development And Mantle Cell Lymphoma, Tyler J. Gilbreath

Theses & Dissertations

UBR5 is part of the ubiquitin proteasome system (UPS), most well-known as a degradation and recycling pathway in which proteins are tagged with a chain of ubiquitin protein and degraded by the proteasome. However, the UPS is multifunctional and other important roles include tagging protein with ubiquitin for cell signaling purposes. UBR5 is a homologous to the E6AP C-terminus (HECT) E3 ubiquitin ligase, meaning ubiquitin is transferred to UBR5 on a cysteine residue within the HECT domain and then onto a target substrate. UBR5 has mutations in many types of cancers: breast, ovarian, liver, and lymphomas. Recently published data shows …

Gender Differences In Breast Cancer Treatment Decisions And Related Survival: A Study Using The National Cancer Database, Shamim Shahi

Theses & Dissertations

Despite increasing incidence, male breast cancer (MBC) remains understudied in almost all aspects of disease management. MBC patients are more likely to be diagnosed with larger tumors, at an advanced stage, and to experience poorer survival than female patients. There is a need to identify modifiable factors that can improve MBC patients’ survival.

This dissertation aimed to investigate whether there was a difference in the refusal of recommended treatments and related survival, by gender, in breast cancer patients enrolled in the National Cancer Database. Specifically, we conducted separate analyses for four treatments: hormone therapy, chemotherapy, radiation therapy, and surgery. Then, …

A Study To Determine The Most Important Leadership Skills For Entry-Level Public Health Practitioners, Taelyr Weekly

Theses & Dissertations

Objective: This study 1) identifies the top leadership skills needed for entry-level local public health department employees, 2) provides employee self-assessment ratings in importance, preparation, and proficiency of select leadership skills, and 3) compares the self-assessment and supervisor ratings of select leadership skills to assess how prepared and proficient employees are. Participants: A sample of positional leaders (n=15) from Nebraska’s local health departments provided results for the top leadership skills for entry-level local public health department employees. Employee self-assessment ratings (n=18) and paired samples of employees and supervisors (n=12) produced results on the importance, preparation, and proficiency of …

Frailty Determination And Responsiveness In Left Ventricular Assist Devices, Sarah Schroeder

Theses & Dissertations

Frailty, the state of being vulnerable with susceptibility to decreased age-related physical reserve, is found in 56-79% of adults with end-stage HF receiving durable left ventricular assist device (dLVAD) therapy. Frailty increases risk of adverse events, including increased mortality in the dLVAD population, but less is known about depression, quality of life (QOL), cognition and frailty responsiveness. Therefore, we aimed to describe and compare frailty (5-Meter Walk Test, 5MWT), depression (Patient Health Questionnaire-9, PHQ-9), quality of life (EQ5D Visual Analog Scale, EQ-5D VAS) and cognition (Trailmaking B) from pre- to 12-months post-dLVAD We also compared demographics, clinical characteristics, and post-dLVAD …

Exploring The Influence Of Contextual Factors And The Caregiving Process On Burden, Quality Of Life, And Outcomes Of Heart Failure (Hf) Dyads After A Hospital Discharge Guided By The Individual And Family Self-Management Theory (Ifsmt): A Mixed Method Study, Tamara Bernard

Theses & Dissertations

ABSTRACT The purpose of this study is to explore the influence of contextual factors and caregiving process characteristics on proximal outcomes of the patient and caregiver after discharge from the hospital. The long-term goal of this research is to reduce caregiver burden and improve patient outcomes. Heart failure (HF) is an increasingly common chronic illness with unique caregiving needs and a high rate of hospital readmissions. Caregiver burden has been researched extensively in other areas of medicine such as oncology and dementia and has been reported for stable chronic HF patients in an outpatient setting. However, there is little research …

An Analysis Of The Genetic And Environmental Mechanisms Behind Aortic Aneurysm Development And Inhibition, Kathryn E. Jespersen

Theses & Dissertations

Aortic aneurysm is a widespread condition, characterized by dilation and weakening of the aortic vessel wall. Dissection and rupture of the aorta due to uncontrolled aneurysm progression carries a high risk of death. Although both thoracic aortic aneurysms (TAA) and abdominal aortic aneurysms (AAA) share similar risks of rupture and mortality, the pathophysiology of each disease is unique. TAA is a hallmark feature of Marfan syndrome (MFS), a connective tissue disorder characterized by malformation of functional elastic fibers in the aortic extracellular matrix (ECM). This malformation of elastic fibers is attributed to mutation of the gene encoding the fibrillin-1 protein, …

Depression And Parenting: A Mixed Method Analysis Of Some Protective Factors For Depression Among African American Fathers Using A Community-Based Participatory Research Approach, Tatiana Tchouankam

Theses & Dissertations

In the United States (US), African American (AA) men often face oppression, discrimination, negative interactions with the justice system, and significant economic, neighborhood, and social hardships over their life course. These challenges increase the risk of chronic exposure to stressful events with negative mental health outcomes, such as depression. Most of the research on parenting and parental depression has focused on mothers based on the premise that women are more often primary caregivers for their children, especially during early childhood. However, a growing number of fathers take on childcare responsibilities. Despite dealing with different life stressors and negative circumstances, AA …

Characterization Of Metastatic Cutaneous Squamous Cell Carcinoma In The Immunosuppressed Patient, Megan E. Wackel

Theses & Dissertations

Patients who are immunosuppressed, such as solid organ transplant recipients (SOTRs), are known to have a higher risk of developing cutaneous squamous cell carcinoma (cSCC). This population is at a higher risk of metastasis and worse disease-specific survival, with over 1 million cases and an estimated 3,932 to 8,791 deaths each year in the United States. Large cancer genomic databases have reported on genomic drivers for many cancer subtypes, yet cSCC has not been included. The immunosuppressed population is generally ineligible to receive immunotherapy which poses a challenge for treatment options in cases that develop metastasis. After we performed a …

Assessing The Methodology, Prevalence, And Associated Factors For Adverse Childhood Experiences (Aces) Among Children And Adolescents In The United States, Kiara L. Lyons

Theses & Dissertations

To comprehensively capture the risk and protective factors of ACE exposure and ACE-related outcomes, we propose to consider a social-ecological model framework. The concept of the Social-Ecological Model was originally introduced in the 1970s by psychologist Urie Bronfenbrenner and designed to theoretically capture the multifaceted influence different personal, social, and environmental factors have on health behaviors and outcomes. Additionally, this would help to determine what prevention and intervention methods would be more appropriate to implement. This conceptual framework had five system levels: microsystem (individual), mesosystem (interpersonal), exosystem (community context), macrosystem (societal and cultural influences), and chronosystem (internal and external elements …

Metoprolol Disrupts Sterol Biosynthesis Through Inhibition Of 7-Dehydrocholesterol Reductase (Dhcr7), Luke B. Allen

Theses & Dissertations

Cholesterol is essential for life. It is particularly important in the brain as it relies on de novo synthesis of cholesterol following the formation of the blood brain barrier (BBB). As such, disrupting sterol biosynthesis during neurodevelopment can have devastating outcomes. The most common post-lanosterol sterol biosynthesis disorder, Smith-Lemli-Opitz Syndrome, arises from a faulty DHCR7 enzyme. DHCR7 has also been shown to be inhibited by several psychotropic medications. Here we assess six beta-blockers and their effects on sterol biosynthesis in vitro. Two beta-blockers, metoprolol and nebivolol strongly inhibit DHCR7 in four separate in vitro models of both mouse and …

Structural And Inhibitory Studies On (I)Two Mycobacterium Tuberculosis Enzymes Essential For Capsular Glucan Biosynthesis And Mrna Degradation: (Ii) Hantann Virus L-Protein Endonuclease Domain, Hettiarachchige Thilina D. Jayasinghe

Theses & Dissertations

Mycobacterium tuberculosis (Mtb) is the pathogenic bacterium species that causes Tuberculosis (TB). Understanding the major biosynthetic pathways responsible for cell viability is essential in developing new drugs against Mtb. The first two projects will reflect our approach in identifying inhibitors against Mtb GlgE, Mtb GpsI, and characterization of protein inhibitor interactions using X-ray crystallography.

The enzyme GlgE plays an essential role in the α-glucan biosynthesis pathway in Mtb cells. These α-glucans are one of the major structural units in the Mtb capsule. GlgE catalyzes the elongation of α-glucan by transferring maltose from maltose-1-phosphate (M1P) to the non-reducing end …

Structural And Biochemical Studies Of Three Enzymes Involved In Amino Acid Metabolism To Develop Novel Drugs, Yahani Pankaja Jayasinghe Arachchige

Theses & Dissertations

Intrinsic drug resistance in bacteria predates the clinical use of antibiotics. Additionally, heterogeneous metabolic states and the ability of many bacteria to form biofilms further enhances bacterial survival during infection and exacerbates treatment challenges. This necessitates the identification of novel drugs against new drug targets. These studies focus on the development of compounds targeting enzymes in Mycobacterium tuberculosis (Mtb) and Staphylococcus aureus that avoid intrinsic antibiotic defenses. The Mtb-encoded homoserine transacetylase enzyme (HTA) catalyzes the first step of the methionine biosynthesis pathway that produces methionine and S-adenosyl methionine. These compounds are shown to be essential for both dormant …

The Impact Of Antecedent Physical Exercises On Increasing On-Task Behaviors And Decreasing Restricted And Repetitive Behaviors In Elementary Students With High Functioning Autism Spectrum Disorder In Saudi Arabia, Shadi Albadawi

Electronic Theses and Dissertations

Physical exercises (PEs) are one of the most used approaches by researchers to treat restricted and repetitive behaviors (RRBs) and enhance on-task behaviors in students with high-functioning Autism spectrum disorders (ASD). Although PEs is recognized as Evidence-based Practices (EBPs) for students with ASD in the United States of America (USA) that are based on moderate evidence, it is important to conduct more empirical studies to explore its effects on individuals with ASD from different populations in the KSA. The current study used a single-subject, multiple baseline design across subjects to examine the effect of antecedent structured physical exercises (teaching soccer …

Differential Role Of Type 2 Diabetes As A Risk Factor For Tuberculosis In The Elderly Versus Younger Adults, Blanca I. Restrepo, Julia M. Scordo, Genesis P. Aguillón-Durán, Doris Ayala, Ana P. Quirino-Cerrillo, Raúl Loera-Salazar, America Cruz-González, Jose A. Caso, Mateo Joya-Ayala, Esperanza M. García-Oropesa, Alejandra B. Salinas

School of Medicine Publications

The elderly are understudied despite their high risk of tuberculosis (TB). We sought to identify factors underlying the lack of an association between TB and type 2 diabetes (T2D) in the elderly, but not adults. We conducted a case–control study in elderly (≥65 years old; ELD) vs. younger adults (young/middle-aged adults (18–44/45–64 years old; YA|MAA) stratified by TB and T2D, using a research study population (n = 1160) and TB surveillance data (n = 8783). In the research study population the adjusted odds ratio (AOR) of TB in T2D was highest in young adults (AOR 6.48) but waned with age …

Open-Source Flight Data: Free, But At What Cost?, James Norman

Aviation Faculty Publications

The proliferation of open-source flight data has been heralded throughout the aviation industry, from air traffic service providers seeking efficiencies to the voyeuristic tracking of celebrity aircraft movements. However, the rise of open-source data presents challenges when juxtaposed against the traditional safety management systems that have sustained commercial aviation until now. Open-source data are not protected legally to the same extent as traditional flight data, and data from open-source platforms are not subject to the same validation standards as traditional flight data. Pilots are now able to interface with their own flight data, which diverges from the original aggregate intent …

Annual Financial Report, Williamson County, Tennessee For The Year Ended June 30, 2022, Tennessee. Comptroller Of The Treasury.

Tennessee County Audit Reports

No abstract provided.

The Art Of Branding: Rebranding The Habit, Allison Willrich

Whittier Scholars Program

The world is more visual-oriented than ever before, making a company’s logo a crucial factor in the success of branding as the logo serves as the first impression and visual indicator of the experience and value the brand will deliver. The purpose of this project is to better understand how people respond to brand design, and more specifically make judgments about the company based on the first impression they get from a logo. The brand of focus is The Habit, an American restaurant chain recognized for its excellence in product quality, but also has weaknesses in its overall brand negatively …

Estimating Vehicle Infrastructure: Downtown Albuquerque, New Mexico, Zachery Phillip Baiamonte

Architecture and Planning ETDs

Cities have little knowledge about their parking infrastructure despite clear evidence that abundant parking has environmental, economic, and transportation consequences. The objective of this thesis is to illustrate the need to accurately estimate the area dedicated to vehicle infrastructure (parking lots and streets) within urban areas. I focused on a method that estimated the vehicle infrastructure area within the Downtown Core of Albuquerque, New Mexico, by cross-referencing geospatial cadastral data with minimum parking requirements. Three parking space types were identified: 1) parking in structures; 2) surface parking (parking lots and residential driveways); and 3) on-street parking. To illustrate the need …

Person-Centred Care And Health Justice In A Multicultural World: Holistic Perspectives From Context, Care, And Capabilities, Asmat Ara Islam

Electronic Theses and Dissertations

Medical ethicists debate whether “one-approach-fits-all” is specifically a problem for disease-oriented paradigms. In developed countries, health systems have adopted limited person-centred care (PCC) paradigms, most of which focus only on patient autonomy. However, these models neither adequately respond to a nexus of relevant aspects, including patients’ vulnerability, needs, and capabilities, nor provide adequate justification that PCC is related to social justice. The central question of this dissertation is: how does a PCC framework that is based on the capabilities approach justify a shift in the current health system toward PCC so that health systems can address health injustices in a …

The Antiregulatory Arsenal, Antidemocratic Can(N)Ons, And The Waters Wars, William W. Buzbee

Georgetown Law Faculty Publications and Other Works

The Clean Water Act has become a centerpiece in an enduring multifront battle against both environmental regulation and federal regulatory power in all of its settings. This Article focuses on the emergence, elements, and linked uses of an antiregulatory arsenal now central to battles over what are federally protected “waters of the United States.” This is the key jurisdictional hook for CWA jurisdiction, and hence, logically, has become the heart of CWA contestation. The multi-decade battle over Waters protections has both drawn on emergent antiregulatory moves and generated new weapons in this increasingly prevalent and powerful antiregulatory arsenal. This array …

An Implementation Roadmap For Establishing Remote Infectious Disease Specialist Support For Consultation And Antibiotic Stewardship In Resource-Limited Settings, Robin L.P. Jump

Faculty Scholarship

Infectious Disease (ID)-trained specialists, defined as ID pharmacists and ID physicians, improve hospital care by providing consultations to patients with complicated infections and by leading programs that monitor and improve antibiotic prescribing. However, many hospitals and nursing homes lack access to ID specialists. Telehealth is an effective tool to deliver ID specialist expertise to resource-limited settings. Telehealth services are most useful when they are adapted to meet the needs and resources of the local setting. In this step-by-step guide, we describe how a tailored telehealth program can be implemented to provide remote ID specialist support for direct patient consultation and …

Curating The Agenda: A Review Of The Tenement Museum’S Twitter, Taylor Carpenter

Theses

Most museums have established strong online presences, due in part to the effects of the COVID-19 pandemic. To stay relevant in the social media sphere, museums must keep up with the speed at which the internet operates. One way of doing this is to follow the current trends and events that are already piquing the interest of those on the internet. However, is it the museum account that follows the current events, or are current events influenced by the museum’s presence? By examining the Tenement Museum’s Twitter account through the agenda-setting and agenda-melding theories, this paper seeks to answer the …

2021 Tennessee Census Of Fatal Occupational Injuries, The Survey Of Occupational Injuries And Illnesses, Tennessee. Department Of Labor & Workforce Development.

Occupational Injuries

No abstract provided.

Engagement Journalism In Action: Supporting New Yorkers With Long Covid, Sarah Luft

Capstones

What do asthma and long COVID have in common? 1 in 13 U.S. adults are living with them. This report is a recap of my efforts to address the information needs of New Yorkers with long COVID as a student in CUNY's Craig Newmark Graduate School of Journalism engagement program. For my final project, I partnered with THE CITY, a nonprofit news outlet serving New Yorkers, to expand the MISSING THEM project. The report details the what, why, and how of my engagement reporting process, including a community engagement framework, a service journalism series, and lessons to carry forward. You …

Careers Lost To Long Covid, Emily Sauchelli

Capstones

Americans have had to adjust to new lifestyles as a result of the lingering symptoms associated with long COVID. Many have had no choice but to leave the workforce. Those with long COVID are putting the career paths they intended for themselves behind them, due to their inability to keep up with their jobs as a result of their lingering symptoms. Accommodations and resources on how those with long COVID can reenter back into the workforce are coming at a slow pace, as employers are not recognizing how to help those with long COVID stay and thrive in the workplace. …

Empowering Nurses To Recognize Post-Stroke Depression In The African American Community, Deidra Frisbie, Robin Simon

Doctor of Nursing Practice Projects

African Americans (AA) have the highest prevalence of stroke and death compared to other racial groups in the United States. Post-stroke depression (PSD) affects approximately 1/3 of all stroke patients and is underdiagnosed in the African American community.

Aim: By using a mHealth mobile app and a Psychiatry provider list at discharge, PSD can be identified, and interventions initiated, thus decreasing the sequela of PSD in AA.

Methods: Nurses were provided education on PSD, expressions of depression in African-Americans, cultural humility, implicit bias, and the importance of the nurse's role in developing a therapeutic relationship.

Results: Quantitative analysis revealed the …

Implementation Of Enhanced Recovery After Surgery For Adult Cervical Spine Fusion Patients: A Quality Improvement Project, Ashley Darin-Messmer

Doctor of Nursing Practice Projects

Spinal surgeries can lead to an increase in costs and complications for patients and hospital organizations. Complications following spine surgery have been identified in 16.4% to 80% of cases for spine surgeries. An Enhanced Recovery after Surgery (ERAS) protocol is a set of guidelines with the goal of improving surgical outcomes and improving a patient’s quality of life. The purpose of this quality improvement project was to implement an ERAS protocol for adult cervical spine surgery patients at a tertiary care teaching center with the goal to reduce hospital length of stay and readmissions. Inclusion criteria included adult patients undergoing …

Increasing Hpv Vaccination In Adolescents, Emily Martin, Emily Hartmann

Doctor of Nursing Practice Projects

Human papillomavirus virus (HPV) is a sexually transmitted disease that can negatively affect both males and females by leading to cervical, vaginal, vulvar, anal, penile, and oropharyngeal cancer. Vaccinating against HPV using the Gardasil vaccine is an effective method to prevent HPV, however, vaccination rates are still unacceptably low in adolescents ages 11 to 14. Pediatric providers should encourage and strongly recommend HPV vaccines to all adolescents. Addressing and easing parental hesitancy is a key component to improving vaccine acceptance. The setting for the project was a rural pediatric office in southern Illinois where HPV vaccination rates are lower than …

Retention Of New Nurses In The Cardiovascular Operating Room, Hannah Shufeldt

Doctor of Nursing Practice Projects

Background

In January of 2020, a hospital in Springfield, Illinois started the year with seven full-time circulating nurses in the cardiovascular operating room (CVOR). Three of those nurses left before the end of the year and an additional four nurses were hired. In January of 2021, the CVOR began the year with eight nurses. Five of these nurses left by the end of the year and seven more were hired, one of which left before the end of 2021. This department has struggled to retain nurses, with a turnover rate of 42.9% in 2020 and 62.5% in 2021.

Purpose

The …

Implementation Of Written Discharge Instructions For Common Diagnoses In The Urgent Care Setting, Melissa Kulp, Kristin Elmore

Doctor of Nursing Practice Projects

Abstract

Discharge instructions are an important tool providers use to communicate information to patients about their medical diagnosis after they return to their home environments. When patients understand and follow discharge instructions there are improved outcomes, fewer callbacks, and decreased return visits. The purpose of this quality improvement project were (a) to develop and distribute discharge instructions at or below a sixth-grade reading level, (b) on common diagnoses appropriate for a rural community, (c) decreased the need for subsequent office visits, and (d) decreased call volumes at a rural walk-in clinic. A large-scale literature review was conducted to determine the …