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Evaluation Of The Effectiveness Of Anisotropic Analytical Algorithm In Flattened And Flattening-Filter-Free Beams For High Energy Lung Dose Delivery Using The Radiological Physics Center Lung Phantom, Roman Repchak, David Scott Followill

Dissertations and Theses (Open Access)

The effectiveness of the Anisotropic Analytical Algorithm (AAA) implemented in the Eclipse treatment planning system (TPS) was evaluated using theRadiologicalPhysicsCenteranthropomorphic lung phantom using both flattened and flattening-filter-free high energy beams. Radiation treatment plans were developed following the Radiation Therapy Oncology Group and theRadiologicalPhysicsCenterguidelines for lung treatment using Stereotactic Radiation Body Therapy. The tumor was covered such that at least 95% of Planning Target Volume (PTV) received 100% of the prescribed dose while ensuring that normal tissue constraints were followed as well. Calculated doses were exported from the Eclipse TPS and compared with the experimental data as measured using thermoluminescence detectors …

Understanding The Influence Of Photon Energy On 6mv Non Reference Dosimetry And Ct Dosimetry Using Tld And Osld, Sarah B. Scarboro

Dissertations and Theses (Open Access)

Measurement of the absorbed dose from ionizing radiation in medical applications is an essential component to providing safe and reproducible patient care. There are a wide variety of tools available for measuring radiation dose; this work focuses on the characterization of two common, solid-state dosimeters in medical applications: thermoluminescent dosimeters (TLD) and optically stimulated luminescent dosimeters (OSLD).

There were two main objectives to this work. The first objective was to evaluate the energy dependence of TLD and OSLD for non-reference measurement conditions in a radiotherapy environment. The second objective was to fully characterize the OSLD nanoDot in a CT environment, …

The New Role Of Proprotein Convertase Subtilisin/Kexin Type 9: A Connection Of Proprotein Convertase Subtilisin/Kexin Type 9, Apolipoprotein B, And Autophagy, Hua Sun

Dissertations and Theses (Open Access)

Plasma low-density lipoprotein (LDL) levels are positively correlated with the incidence of coronary artery disease. In the circulation, the plasma LDL clearance is mainly achieved by the uptake via LDL receptor (LDLR). Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a newly discovered gene, playing an important role in LDL metabolism. Gain-of-function mutations of PCSK9 lead to hypercholesterolemia and loss-of-function mutations of PCSK9 are associated with decrease of LDL cholesterol. The effects of PCSK9 on cholesterol levels are the consequence of a strong interaction between the catalytic domain of PCSK9 and epidermal growth factor-like repeat A (EGF-A) domain of …

Development And Implementation Of The Use Of Optically Stimulated Luminescent Detectors In The Radiological Physics Center Anthropomorphic Quality Assurance Phantoms, Jennelle Bergene

Dissertations and Theses (Open Access)

The Radiological Physics Center (RPC) uses both on-site and remote reviews to credential institutions for participation in clinical trials. Anthropomorphic quality assurance (QA) phantoms are one tool the RPC uses to remotely audit institutions, which include thermoluminescent dosimeters (TLDs) and radiochromic film. The RPC desires to switch from TLD as the absolute dosimeter in the phantoms, to optically stimulated luminescent dosimeters (OSLDs), but a problem lies in the angular dependence exhibited by the OSLD. The purpose of this study was to characterize the angular dependence of OSLD and establish a correction factor if necessary, to provide accurate dosimetric measurements as …

The Regulation Of Mtorc2 Kinase Activity And Complex Integrity, Chien-Hung Chen

Dissertations and Theses (Open Access)

Growth factor signaling promotes anabolic processes via activation of the

PI3K-Akt kinase cascade. Deregulation of the growth factor-dependent PI3K-Akt

pathway was implicated in tumorigenesis. Akt is an essential serine/threonine

protein kinase that controls multiple physiological functions such as cell growth,

proliferation, and survival to maintain cellular homeostasis. Recently, the

mammalian Target of Rapamycin Complex 2 (mTORC2) was identified as the

main Akt Ser-473 kinase, and Ser-473 phosphorylation is required for Akt

hyperactivation. However, the detailed mechanism of mTORC2 regulation in

response to growth factor stimulation or cellular stresses is not well understood.

In the first project, we studied the regulation …

Low Reactive Oxygen Species And High Glycolysis In Glioblastoma Stem Cells:Mechanisms And Therapeutic Implications, Feng Wang

Dissertations and Theses (Open Access)

Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor with poor prognosis due in part to drug resistance and high incidence of tumor recurrence. The drug resistant and cancer recurrence phenotype may be ascribed to the presence of glioblastoma stem cells (GSCs), which seem to reside in special stem-cell niches in vivo and require special culture conditions including certain growth factors and serum-free medium to maintain their stemness in vitro. Exposure of GSCs to fetal bovine serum (FBS) can cause their differentiation, the underlying mechanism of which remains unknown. Reactive oxygen species (ROS) play an important role …

Role Of Stat3 In Keratinocyte Stem Cells During Skin Tumorigenesis, Dharanija Rao

Dissertations and Theses (Open Access)

STATs play crucial roles in a wide variety of biological functions, including development, proliferation, differentiation, migration and in cancer development. In the present study, we examined the impact of Stat3 deletion or activation on behavior of keratinocytes, including keratinocyte stem cells (KSCs). Deletion of Stat3 specifically in the bulge region of the hair follicle using K15.CrePR1 X Stat3^fl/fl mice led to decreased tumor development by altering survival of bulge region KSCs. To further understand the role of KSCs in skin tumorigenesis, K5.Stat3C transgenic (Tg) mice which express a constitutively active/dimerized form of Stat3 called Stat3C via the bovine keratin …

Transcriptional And Post-Translational Mechanisms Contribute To Maintenance Of Rest In Neural Tumors, Akanksha Singh

Dissertations and Theses (Open Access)

The RE-1 silencing transcription factor (REST) is an important regulator of normal nervous system development. It negatively regulates neuronal lineage specification in neural progenitors by binding to its consensus RE-1 element(s) located in the regulatory region of its target neuronal differentiation genes. The developmentally coordinated down-regulation of REST mRNA and protein in neural progenitors triggers terminal neurogenesis.

REST is overexpressed in pediatric neural tumors such as medulloblastoma and neuroblastoma and is associated with poor neuronal differentiation. High REST protein correlate with poor prognosis for patients with medulloblastoma, however similar studies have not been done with neuroblastoma patients. Mechanism(s) underlying elevated …

Targeting Akt/Mtor Signaling Pathways During Murine Skin Tumor Promotion And The Impact Of Dietary Energy Balance Manipulation, Laura A. Checkley

Dissertations and Theses (Open Access)

The prevalence of obesity has continued to rise over the last several decades in the United States lending to overall increases in risk for chronic diseases including many types of cancer. In contrast, reduction in energy consumption via calorie restriction (CR) has been shown to be a potent inhibitor of carcinogenesis across a broad range of species and tumor types. Previous data has demonstrated differential signaling through Akt and mTOR via the IGF-1R and other growth factor receptors across the diet-induced obesity (DIO)/CR spectrum. Furthermore, mTORC1 is known to be regulated directly via nutrient availability, supporting its role in the …

The Functional Organization Of Synaptic Vesicle Pools In A Retinal Bipolar Neuron, Proleta Datta

Dissertations and Theses (Open Access)

Ribbon synapses are found in sensory systems and are characterized by ‘ribbon-like’ organelles that tether synaptic vesicles. The synaptic ribbons co-localize with sites of calcium entry and vesicle fusion, forming ribbon-style active zones. The ability of ribbon synapses to maintain rapid and sustained neurotransmission is critical for vision, hearing and balance. At retinal ribbon synapses, three vesicle pools have been proposed. A rapid pool of vesicles that are docked at the plasma membrane, and whose fusion is limited only by calcium entry, a releasable pool of ATP-primed vesicles whose size also correlates with the number of ribbon-tethered vesicles, and a …

Targeting Traf6 For Cancer Therapeutical Development, John K. Morrow

Dissertations and Theses (Open Access)

Tumor necrosis factor (TNF)-Receptor Associated Factors (TRAFs) are a family of signal transducer proteins. TRAF6 is a unique member of this family in that it is involved in not only the TNF superfamily, but the toll-like receptor (TLR)/IL-1R (TIR) superfamily. The formation of the complex consisting of Receptor Activator of Nuclear Factor κ B (RANK), with its ligand (RANKL) results in the recruitment of TRAF6, which activates NF-κB, JNK and MAP kinase pathways. TRAF6 is critical in signaling with leading to release of various growth factors in bone, and promotes osteoclastogenesis. TRAF6 has also been implicated as an oncogene in …

Phenothiazines Induce Abortive Autophagy Leading To Cancer Cell Death, Catherine T. Charles

Dissertations and Theses (Open Access)

Autophagy is an evolutionarily conserved process that functions to maintain homeostasis and provides energy during nutrient deprivation and environmental stresses for the survival of cells by delivering cytoplasmic contents to the lysosomes for recycling and energy generation. Dysregulation of this process has been linked to human diseases including immune disorders, neurodegenerative muscular diseases and cancer.

Autophagy is a double edged sword in that it has both pro-survival and pro-death roles in cancer cells. Its cancer suppressive roles include the clearance of damaged organelles, which could otherwise lead to inflammation and therefore promote tumorigenesis. In its pro-survival role, autophagy allows cancer …

Adherens Junctions And The Actomyosin Network Regulate Organ Growth By Modulating Hippo Pathway Activity In Drosophila, Chih-Chao Yang

Dissertations and Theses (Open Access)

Adherens junctions (AJs) and basolateral modules are important for the establishment and maintenance of apico-basal polarity. Loss of AJs and basolateral module members lead to tumor formation, as well as poor prognosis for metastasis. Recently, in mammalian studies it has been shown that loss of either AJ or basolateral module members deregulate Yorkie activity, the downstream transcriptional effector of the Hippo pathway. Importantly, it is unclear if AJ and basolateral components act through the same or parallel mechanisms to regulate Yorkie activity.

Here, we dissect how loss of AJ and basolateral components affects Hippo signaling in Drosophila. Surprisingly, while …

Transcriptional Regulation Of Profilin Is Required For Drosophila Larval Wound Closure, Amanda Brock

Dissertations and Theses (Open Access)

Injury is an inevitable part of life, making wound healing essential for survival. In postembryonic skin, wound closure requires that epidermal cells recognize the presence of a gap and change their behavior to migrate across it. In Drosophila larvae, wound closure requires two signaling pathways (the Jun N-terminal kinase (JNK) pathway and the Pvr receptor tyrosine kinase signaling pathway) and regulation of the actin cytoskeleton. In this and other systems, it remains unclear how the signaling pathways that initiate wound closure connect to the actin regulators that help execute wound- induced cell migrations. Here we show that chickadee, which encodes …

Platelets And Anti-Angiogenic Resistance In Ovarian Carcinoma, Justin N. Bottsford-Miller

Dissertations and Theses (Open Access)

Background: Resistance to targeted anti-angiogenic therapy is a growing clinical concern given the disappointing clinical impact of anti-angiogenic. Platelets represent a component of the tumor microenvironment that are implicated in metastasis and represent a significant reservoir of angiogenic regulators. Thrombocytosis has been shown to be caused by malignancy and associated with adverse clinical outcomes, however the causal connections between these associations remain to be identified.

Materials and Methods: Following IRB approval, patient data were collected on patients from four U.S. centers and platelet levels through and after therapy were considered as indicators of recurrence of disease. In vitro effects of …

Development And Implementation Of A Remote Audit To Ol For High Dose Rate (Hdr) 192ir Brachytherapy Using Optically Stimulated Luminescence Dosimetry, Kevin Casey

Dissertations and Theses (Open Access)

This work aimed to create a mailable and OSLD-based phantom with accuracy suitable for RPC audits of HDR brachytherapy sources at institutions participating in NCI-funded cooperative clinical trials. An 8 × 8 × 10 cm³ prototype with two slots capable of holding nanoDot Al₂O₃:C OSL dosimeters (Landauer, Glenwood, IL) was designed and built. The phantom has a single channel capable of accepting all ¹⁹²Ir HDR brachytherapy sources in current clinical use in the United States. Irradiations were performed with an ¹⁹²Ir HDR source to determine correction factors for linearity with dose, dose rate, …

Regulation Of To Xin Synthesis By Clostridium Difficile, Charles Darkoh

Dissertations and Theses (Open Access)

Clostridium difficile is the leading definable cause of nosocomial diarrhea worldwide due to its virulence, multi-drug resistance, spore-forming ability, and environmental persistence. The incidence of C. difficile infection (CDI) has been increasing exponentially in the last decade. Virulent strains of C. difficile produce either toxin A and/or toxin B, which are essential for the pathogenesis of this bacterium. Current methods for diagnosing CDI are mostly qualitative tests that detect the bacterium, the toxins, or the toxin genes. These methods do not differentiate virulent C. difficile strains that produce active toxins from non-virulent strains that do not produce toxins or produce …

Effects Of The Acta2 R258c Mutation On Vascular Smooth Muscle Cell Phenotype And Properties, Katerina L. Byanova

Dissertations and Theses (Open Access)

Thoracic Aortic Aneurysms and Dissections (TAAD) are the fifteenth leading cause of death in the United States. About 15% of TAAD patients have family history of the disease. The most commonly mutated gene in these families is ACTA2, encoding smooth muscle-specific α-actin. ACTA2 missense mutations predispose individuals both to TAAD and to vascular occlusive disease of small, muscular arteries.

Mice carrying an Acta2 R258C mutant transgene with a wildtype Acta2 promoter were generated and bred with Acta2^-/- mice to decrease the wildtype: mutant Acta2 ratio. Acta2^{+/+ R258C TG}mice have decreased aortic contractility without aortic disease. Acta2 …

Identification And Analysis Of A Novel Role For The To Usled-Like Kinase In Regulating Mitotic Spindle Dynamics, Jason R. Ford

Dissertations and Theses (Open Access)

Deregulation of kinase activity is one example of how cells become cancerous by evading evolutionary constraints. The Tousled kinase (Tsl) was initially identified in Arabidopsis thaliana as a developmentally important kinase. There are two mammalian orthologues of Tsl and one orthologue in C. elegans, TLK-1, which is essential for embryonic viability and germ cell development. Depletion of TLK-1 leads to embryonic arrest large, distended nuclei, and ultimately embryonic lethality. Prior to terminal arrest, TLK-1-depleted embryos undergo aberrant mitoses characterized by poor metaphase chromosome alignment, delayed mitotic progression, lagging chromosomes, and supernumerary centrosomes.

I discovered an unanticipated requirement for TLK-1 …

Direct Effects Of Metformin On Pi3k And Ras Signaling In Endometrial Cancer, David A. Iglesias M.D.

Dissertations and Theses (Open Access)

Metformin has antiproliferative effects through the activation of AMPK and has gained interest as an antineoplastic agent in several cancer types, although studies in endometrial cancer (EC) are limited. The aims of this project were to evaluate pathways targeted by metformin in EC, investigate mechanisms by which metformin exerts its antiproliferative effects, and explore rational combination therapies with other targeted agents.

Three EC cell lines were used to evaluate metformin’s effect on cell proliferation, PI3K and Ras-MAPK signaling, and apoptosis. A xenograft mouse model was also used to evaluate the effects of metformin treatment on in vivo tumor growth. These …

Deciphering The C-Type Lectin Receptor Signaling Pathway In Macrophages In Response To Candida Albicans, Sara Gorjestani

Dissertations and Theses (Open Access)

Candida albicans causes opportunistic fungal infections in humans and is a significant cause of mortality and morbidity in immune-compromised individuals. Dectin-2, a C-type lectin receptor, is required for recognition of C. albicans by innate immune cells and is required for initiation of the anti-fungal immune response. We set out to identify components of the intracellular signaling cascade downstream of Dectin-2 activation in macrophages and to understand their importance in mediating the immune response to C. albicans in vivo. Using macrophages derived from Phospholipase-C-gamma 1 and 2 (PLCγ1and PLCγ2) knockout mice, we demonstrate that PLCγ2, but not PLCγ1, is required …

Ikkalpha Mediated Notch1 Activation Promotes Tumorigenesis Via Foxa2 Suppression, Mo Liu

Dissertations and Theses (Open Access)

Proinflammatory cytokine TNFa plays critical roles in promoting malignant cell proliferation, angiogenesis, and tumor metastasis in many cancers. However, the mechanism of TNFa-mediated tumor development remains unclear. Here, we show that IKKa, an important downstream kinase of TNFa, interacts with and phosphorylates FOXA2 at S107/S111, thereby suppressing FOXA2 transactivation activity and leading to decreased NUMB expression, and further activates the downstream NOTCH pathway and promotes cell proliferation and tumorigenesis. Moreover, we found that levels of IKKa, pFOXA2 (S107/ 111), and activated NOTCH1 were significantly higher in hepatocellular carcinoma tumors than in normal liver tissues and that pFOXA2 (S107/111) expression was …

Remittance Activity Among Brazilians In The Us And Canada, Igor Ryabov

Sociology Faculty Publications

This comparative study uses data collected in 1990 and 1991 to examine the remittance behavior of Brazilians who had recently arrived in Canada and the United States. These data permit an examination of remittance activity among immigrants relatively soon after their arrival in a pair of host destinations. Prior to contrasting the remittance activity of these newly arrived immigrants, we first document the high degree of similarity between the two groups at their time of arrival; a point that becomes important when contrasting their divergent outcomes. Next, this study contributes to the research literature on micro-level remittance patterns and behaviors …

Cracks In The Melting Pot: Immigration, School Choice, And Segregation, Elizabeth U U. Cascio, Ethan G. Lewis

Dartmouth Scholarship

We examine whether low-skilled immigration to the United States has contributed to immigrants' residential isolation by reducing native demand for public schools. We address endogeneity in school demographics using established Mexican settlement patterns in California and use a comparison group to account for immigration's broader effects. We estimate that between 1970 and 2000, the average California school district lost more than 14 non-Hispanic households with children to other districts in its metropolitan area for every 10 additional households enrolling low-English Hispanics in its public schools. By disproportionately isolating children, the native reaction to immigration may have longer-run consequences than previously …

Rodney Repko V. Guthrie Clinic

2012 Decisions

USDC for the Middle District of Pennsylvania

The Impact Of Epidural Steroid Injections On The Outcomes Of Patients Treated For Lumbar Disc Herniation: A Subgroup Analysis Of The Sport Trial., Kristen Radcliff, Alan Hilibrand, Jon D Lurie, Tor D Tosteson, Lawrence Delasotta, Jeffrey Rihn, Wenyan Zhao, Alexander Vaccaro, Todd J Albert, James N Weinstein

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: The Spine Patient Outcomes Research Trial (SPORT) is a prospective, multicenter study of operative versus nonoperative treatment of lumbar intervertebral disc herniation. It has been suggested that epidural steroid injections may help improve patient outcomes and lower the rate of crossover to surgical treatment.

METHODS: One hundred and fifty-four patients included in the intervertebral disc herniation arm of the SPORT who had received an epidural steroid injection during the first three months of the study and no injection prior to the study (the ESI group) were compared with 453 patients who had not received an injection during the first …

A Prospective Analysis Of Glove Perforation In Primary And Revision Total Hip And Total Knee Arthroplasty., Aaron H Carter, Md, David S Casper, Md, Javad Parvizi, Md, Mathew Austin, Md

Department of Orthopaedic Surgery Faculty Papers

Literature in regard to glove perforation rates in revision total joint arthroplasty (TJA) is scarce. Our purpose was to determine the incidence of perforation in revision TJA. Gloves from all scrubbed personnel were tested based on the American Society for Testing and Materials. A total of 3863 gloves were collected from 58 primary and 36 revision arthroplasty cases. Surgeons had a 3.7% outer-glove perforation rate in primary TJA compared with 8.9% in revision TJA. When both gloves were perforated, the outer-glove perforation was recognized intraoperatively 100% of the time, and the inner-glove perforation was noted only 19% of the time. …

المعايير المحاسبية العراقية ومدى توافقها مع المعايير المحاسبية الدولية على تطوير الممارسات المحاسبية في العراق – دراسة مقارنة للتوفيق بين المعايير, ميادة جعفر ناجي

Muthanna Journal of Administrative and Economics Sciences

تكشف الدراسة الحالية متطلبات التوافق والتطبيق بين معايير المحاسبة الدولية ومعايير المحاسبة العراقية في ظل الظروف البيئية الدولية والعراقية من خلال (أجراء دراسة مقارنة )، لتقريب وتوضيح وجهات النظر ولتحقيق التوافق بينهما، وهنا برز هدف الدراسة للكشف عن ما توصلت إليه المعايير الدولية من تطوير للأداء والممارسات المحاسبية , ومن ثم عكس تجربة البيئة الدولية ومحاولة تطبيقها في البيئة العراقية بقصد تقليل أو سد الفجوة بين متطلبات تطبيق المعايير الدولية والعراقية من اجل إيجاد ممارسات محاسبية تتوافق مع تلك الدولة لتوحيد اللغة المحاسبية وإضفاء الوضوح والموثوقية والمصداقية على تلك التطبيقات ،وضرورة الأخذ بمتطلبات التوافق والتطبيق مع البيئة الدولية وهذا أهم …

Measurement Of The Oxidation State Of Mitochondrial Cytochrome C From The Neocortex Of The Mammalian Brain, Y. Sakata, M. Abajian, M. O. Ripple, R. Springett

Dartmouth Scholarship

Diffuse optical remission spectra from the mammalian neocortex at visible wavelengths contain spectral features originating from the mitochondria. A new algorithm is presented, based on analytically relating the first differential of the attenuation spectrum to the first differential of the chromophore spectra, that can separate and calculate the oxidation state of cytochrome c as well as the absolute concentration and saturation of hemoglobin. The algorithm is validated in phantoms and then tested on the neocortex of the rat during an anoxic challenge. Implementation of the algorithm will provide detailed information of mitochondrial oxygenation and mitochondrial function in physiological studies of …

Refining The Global Spatial Limits Of Dengue Virus Transmission By Evidence-Based Consensus, Oliver J. Brady, Peter W. Gething, Samir Bhatt, Jane P. Messina, John S. Brownstein, Anne G. Hoen

Dartmouth Scholarship

Background: Dengue is a growing problem both in its geographical spread and in its intensity, and yet current global distribution remains highly uncertain. Challenges in diagnosis and diagnostic methods as well as highly variable national health systems mean no single data source can reliably estimate the distribution of this disease. As such, there is a lack of agreement on national dengue status among international health organisations. Here we bring together all available information on dengue occurrence using a novel approach to produce an evidence consensus map of the disease range that highlights nations with an uncertain dengue status.

Methods/Principle Findings: …