Digital Commons Network^™

Evaluation Of Stratified Antibiograms For Use In Laboratory And Antimicrobial Stewardship, Linsey Donner

Theses & Dissertations

Antibiograms are critical for choosing empiric antimicrobial therapy. Cumulative antibiograms, which aggregate susceptibility data, can mask differences within specific patient subsets or clinical syndromes. This dissertation was done to determine if antibiotic susceptibilities showed substantial differences when comparing stratified antibiograms to cumulative antibiograms.

Antibiotic susceptibility data was retrospectively obtained from Nebraska Medicine January 1, 2017 – December 31, 2019 for Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, and Enterococcus faecalis. The University of Nebraska Medical Center’s web antibiogram clinical decision support tool was used to export the data. Bacteria-antibiotic susceptibility rates of stratified antibiograms …

Post-Transplant Hepatic Graft Fibrosis In Pediatric Liver-Inclusive Transplant Recipients, Hanh D. Vo

Theses & Dissertations

Hepatic graft fibrosis is a common histologic finding following pediatric liver transplant (LT) that may affect the long-term graft outcome. Hence, it is essential to identify hepatic graft fibrosis at a stage where fibrosis is not yet clinically apparent but has the potential for progression to initiate appropriate intervention and prevent its progression. Liver biopsy is the gold standard for fibrosis staging, but it is invasive, requires general anesthesia in children, and has potential complications. Our long-term goal is to implement non-invasive tests to assess and monitor the progression of hepatic graft fibrosis in liver-inclusive transplant children. The work presented …

Approximate Likelihood Based Estimations For Joint Models With Intractable Likelihoods, Karl Stessy M. Bisselou

Theses & Dissertations

This dissertation focuses on the development of approximation approaches for the joint modeling (JM) of repeated measures data and time-to-event data in the presence of analytically or numerically intractable likelihoods. Current likelihood-based inferences for JMs show several limitations including (i) intractability of integrals during marginal likelihood derivations due to the complexity in computations, and (ii) the large number of nuisance parameters (unobserved) posing a problem with convergence. The h-likelihood (HL) and synthetic likelihood (SL) are two computationally efficient estimation approaches that overcome these challenges.

In the presence of extremely high censoring rates, the HL can produce bias parameter estimates. We …

Delivery Of Sirna With Drugs Targeting Polyamine Metabolism As Combinational Cancer Treatment, Ao Yu

Theses & Dissertations

Cancer has been a major public health issue worldwide for years and is the second leading cause of death in the United States. Important barrier must be broken to extend the life expectancy in every country. The standard care for cancer causes severe side effects which affects patients’ physical health and quality of life. Polyamines are highly related with the cell proliferation and apoptosis. Dysregulated polyamine metabolism in cancer leads to increased polyamine concentration in neoplastic cells. Thus, polyamine metabolism for cancer therapy can be an intriguing target. However, the heterogeneity affecting key cancer pathways poses significant challenges for effective …

Glad To Be Out. I Was Running Out Of Womb: A Study Of Omega-6 And Omega-3 Fatty Acid Metabolites At Delivery And Their Relationship To Infant Growth, Prematurity, And Admission To The Neonatal Intensive Care Unit, Maranda Thompson

Theses & Dissertations

Normal pregnancy relies on inflammation for implantation, placentation, and parturition, but uncontrolled it can lead to poor infant outcomes. Maternal diet is one modifiable factor that can impact inflammation. Omega-3 and omega-6 fatty acids have been shown to be metabolized into bioactive metabolites that effect inflammation. The presence and importance of these metabolites at the time of delivery are not well understood. Therefore, the purpose of this dissertation was to first quantify omega-3 and omega-6 metabolites in maternal plasma, cord plasma, and placental tissue. Then the relationships between metabolites and infant outcomes, including birth weight percentile, length percentile, head circumferences …

Integrative Analysis Of Multi-Omics Kinome Data And Virtual Screening Of Identified Targets With Pan-Cancer Application, Siddesh Southekal

Theses & Dissertations

Cancer is a heterogeneous disease characterized by the uncontrolled growth and dissemination of abnormal cells. Unfortunately, it is also challenging to treat due to the heterogeneous nature of the tumors and the lack of known drugs that are effective against all tumor subpopulations.

The human protein kinases represent an essential and diverse family of enzymes and are often dysregulated in cancer. The human kinome comprises only around 2% of all coding genes of the human genome but phosphorylates about 30% of cellular proteins critical for regulating various biological processes such as cell proliferation, cell cycle progression, apoptosis, motility, growth, differentiation, …

Molecular Investigation Into The Biologic And Prognostic Elements Of Peripheral T-Cell Lymphoma With Regulators Of Tumor Microenvironment Signaling Explored In Model Systems, Tyler Herek

Theses & Dissertations

Peripheral T-cell lymphoma (PTCL) is heterogenous group of mature T-cell neoplasms characterized by distinctive transcriptional and genetic lesions. Herein, we investigated DNMT3A mutations in angioimmunoblastic T-cell lymphoma (AITL, n = 176) and novel molecular subtypes (i.e., PTCL-GATA3, n = 61 and PTCL-TBX21, n = 80) within PTCL- NOS and observed significant biological and prognostic differences associated with DNMT3A mutations. DNMT3A-mutated PTCL-TBX21 cases showed inferior overall survival (OS; p < 0.005), with DNMT3A mutations (DNMT3A-MT) skewed toward the methyltransferase domain and in the dimerization domain (S881-R887). Transcriptional profiling demonstrated significant enrichment of activated CD8⁺ T-cell cytotoxic gene signatures in the tumor microenvironment of DNMT3A-MT PTCL-TBX21 cases. Genome-wide methylation analysis of DNMT3A-R882/Q886 versus wild-type in PTCL-TBX21 cases demonstrated hypomethylation in target genes regulating T-cytotoxic genes, TCR …

Engineering Advanced Micro And Nanofiber Materials For Biomedical Applications, Alec D. Mccarthy

Theses & Dissertations

At the functional crossroads of engineering and biomedical sciences lies the interdisciplinary field of biomedical engineering. Principles of biomedical engineering are vast, and the rigorous application of engineering towards clinically-relevant medicine has the ability to take novel concepts from bench to bedside. Arguably one of the most promising and productive sub-fields within the biomedical engineering discipline is biomaterial engineering. Here, novel biomaterials, synthesized from natural, synthetic, or hybrid materials, can be used in tissue repair and regeneration, hemostasis, as anatomical support and drug delivery vessels, or as diagnostic devices.

Of particular interest are applications of nanofiber and microfiber objects, which …

Metabolic Heterogeneity And The Roles Of Cody And Ccpa In Central Metabolism And S. Aureus Biofilm Formation., Logan L. Bulock

Theses & Dissertations

Staphylococcus aureus is a metabolically versatile human pathogen, causing disease in many areas of the body. Its versatility can be attributed to the fact that it utilizes a variety of tools to adapt to many different environments, including toxins to scavenge from the host and multiple transporters to compete for its preferred carbon sources. S. aureus can also survive in harsh conditions through biofilm development, which are notoriously recalcitrant to antibiotics and immune defenses. Biofilms exhibit marked heterogeneity, with division of labor for production of matrix components and differential gene expression among various niches within the biofilm.

In this study, …

Nuclear Receptor Coactivator 3 In Endoplasmic Reticulum Stress And Stress Granule Dynamics In Pancreatic Cancer, Andrew Kisling

Theses & Dissertations

Pancreatic cancer is predicted to be the second-leading cause of cancer-related deaths within the next decade. Nuclear receptor coactivator 3 (NCOA3/SRC3/AIB1) regulates an array of metabolic and signaling pathways and has been established by our group and others as a critical regulator pancreatic cancer progression and metastasis. A recent study demonstrated NCOA3 regulation by the IRE1α-XBP1 axis of the unfolded protein response (UPR), suggesting a link between NCOA3 and cellular stress management. Furthermore, NCOA3 has been shown to directly bind to a scaffolding protein of stress granules (SGs). Since SG assembly is regulated by the UPR, we hypothesized that NCOA3 …

Northern Dene Astronomical And Sky-Related Knowledge: A Comparative Anthropological Study, Chris M. Cannon

Anthropology

The sky and its contents are routinely overlooked in Northern Dene ethnology as a meaningful part of linguistic and cultural knowledge. However, more than 11 years of primary fieldwork learning with and from elders, speakers, and culture bearers from 12 Northern Dene groups across 32 communities in Alaska and Canada has shown that astronomical knowledge is deeply rooted in both practical and sacred ways of knowing. With a focus on detail and breadth, this comparative ethnological study utilized an experience-based approach to investigate the ways in which Northern Dene Peoples perceive, conceptualize, and integrate the sky and its contents into …

Bridging The Cultural Divide: Creating Culturally Diverse Therapeutic Foster Homes In Rural Alaska, Erica A. Dillard

Justice

The disproportionate number of American Indian and Alaska Native children being removed from their homes and communities by Child Protective Services is statistically alarming. Despite the current resources available, many families are unable to take advantage of these resources due to issues caused by their rural environments. This paper reviews the causes leading up to the removal of American Indian and Alaska Native children from their homes and communities, examines the importance of cultural identity, and discusses the resources that are needed to prevent these removals from occurring.

Hatred And Harm: The Influence Of Digital Pimps And The Miseducation Of The Hyper-Masculine Man, Justin Lantier-Novelli

Justice

The purpose of this research project is to measure the effects of a correlation between exposure to violent, hardcore sexually-explicit Internet materials, or SEIM (also known as pornography), and behaviors and attitudes that demean, degrade, subjugate, and abuse women and girls resulting in systemic gender inequality. Research is based on peer-reviewed journal articles, subject-matter publications, crime statistics, personal interviews with experts, and meta-analyses of previous research on related topics. The research has demonstrated a very strong correlation between exposure to SEIM and hyper-masculine attitudes and behaviors of gender-inequality toward women, beginning at one end of the spectrum with verbal micro-aggressions …

Implementing A Proctored Aleks-Based Adaptive Learning Strategy To Evaluate Student Preparedness And Predict Success In Calculus I At The University Of Alaska Fairbanksanks, Md Azizul Islam

Mathematics and Statistics

In Fall 2016, the Department of Mathematics and Statistics (DMS) at the University of Alaska Fairbanks (UAF) initiated a study to determine if the Assessment and LEarning in Knowledge Spaces Placement, Preparation, and Learning test (ALEKS PPL), given under proctored conditions, can be an effective tool for measuring student preparedness and predicting success in Calculus I while controlling for enrollment and demographic information. The study includes 583 students who took a Calculus I course in Fall 2016, Fall 2017, Spring 2018, Fall 2018, Spring 2019, and Spring 2020 semesters and took a Proctored ALEKS PPL test (PAPL). Of the 583 …

Population Estimates Of Brown Bears Near Yakutat, Alaska Using A Bayesian Integrated Population Model, Mackenzie Parrott

Mathematics and Statistics

This paper discusses the specification of an Integrated Population Model (IPM) for the brown bear (Ursus arctos) population within and near Yakutat, Alaska. A Bayesian analysis is used in this paper in conjunction with Markov Chain Monte Carlo in order to produce the results. The goal of this project is to estimate the number of brown bears over multiple years. This project was made possible in collaboration with the Alaska Department of Fish and Game (ADF&G) Department of Wildlife Conservation through Anthony Crupi and Jason Waite.

A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …

Hit The Lights On Your Way Out, Ryan Zimmerman

Theses

Artifacts of industry remain scattered throughout the American rustbelt. A region built and reliant upon manufacturing, destined to fail when companies found themselves in jeopardy. Jobs came and went, businesses folded. What remains in their place are vacant factories, warehouses, and the workforce itself. This area of the country is where my life began and where I have found myself once again. Growing up in Erie, Pennsylvania, part of a family that endured this cycle of ups and downs, I have a certain familiarity and fondness for this post-industrial landscape and its inherent struggles. "Hit the Lights on Your Way …

A Literature Review Of Wetland Treatment Systems Used To Treat Runoff Mixtures Containing Antibiotics And Pesticides From Urban And Agricultural Landscapes, Emily R. Nottingham, Tiffany L. Messer

Biosystems and Agricultural Engineering Faculty Publications

Wetland treatment systems are used extensively across the world to mitigate surface runoff. While wetland treatment for nitrogen mitigation has been comprehensively reviewed, the implications of common-use pesticides and antibiotics on nitrogen reduction remain relatively unreviewed. Therefore, this review seeks to comprehensively assess the removal of commonly used pesticides and antibiotics and their implications for nitrogen removal in wetland treatment systems receiving non-point source runoff from urban and agricultural landscapes. A total of 181 primary studies were identified spanning 37 countries. Most of the reviewed publications studied pesticides (n = 153) entering wetlands systems, while antibiotics (n = 29) had …

Fsec Meeting Minutes December 17, 2021, University Of Rhode Island Faculty Senate

Faculty Senate Executive Committee Minutes

No abstract provided.

Two Students Awarded Independent Pharmacy Grant, Patrick Smith

University of Mississippi News

Hayden Wooldridge and Lindsey Simmerman plan for future in community pharmacy

Decreasing Maternal Breastfeeding Dissatisfaction During The Night Shift Related To Lactation Support, Robyn Caston

Master's Projects and Capstones

Abstract

Problem

This paper will discuss the Clinical Nurse Leader (CNL) project's specific aim: to decrease maternal dissatisfaction during the night shift related to lactation support in a high-risk maternal department.

Context

Research has shown that adding lactation support improves the decision to exclusively breastfeed and increases the duration. Breastfeeding for all infants starting at birth and continuing until at least 6 months of age has been recommended by the World Health Organization, UNICEF, and the American Academy of Pediatrics. Many studies about lactation support have demonstrated the health benefits to mothers and their infants.

Interventions

A baseline survey will …

Employee Engagement And Increasing Patient Satisfaction In The Pediatric Outpatient Setting, Carol Liang

Master's Projects and Capstones

Problem: An ambulatory pediatric surgical center in the San Francisco Bay Area has an organizational goal of reaching the 85th percentile in NRC patient satisfaction scores. The annual compliance report states the current score is at 80.7 as of September 2021. These NRC findings indicate several areas for improvement including: (1) trust providers with care, (2) care providers listened, (3) was told when could leave, (4) got help as soon as wanted, (5) care provider explain things, (6) NPS: facility would recommend, and (7) procedure began on time.

Context: Priorities include implementing strategies to increase employee engagement and patient satisfaction. …

Seeking Visionary: Ginsberg And The Beat Influence On Progress, Mark Howard

English Department Theses

This thesis examines and reevaluates the impact of poet Allen Ginsberg and his Beat Generation counterparts on defining and portraying societal progress through countercultural literature and how they themselves may damage the impact of their works. Beat poets like Ginsberg may not act as the best representation of the counterculture due to unethical and immoral behaviors that take away from the credibility and impact of their work. In addition, the Beat Generation itself must be reevaluated for clarity in who should be associated with the original Beat writers as modern critics’ use of the beat terminology has lumped in artists …

Spin-Dependent Electronic Transport In Noncollinear Antiferromagnetic Antiperovskites, Gautam Gurung

Department of Physics and Astronomy: Dissertations, Theses, and Student Research

Spin-dependent properties are the heart of spintronic devices. Spintronics exploits electron’s spin, in addition to charge, to process and store the information. Recently, antiferromagnetic (AFM) spintronics has emerged as a subfield of spintronics, where an AFM order parameter (the Néel vector) is exploited to control spin-dependent transport properties. Due to being robust against magnetic perturbations, producing no stray fields, and exhibiting ultrafast dynamics, antiferromagnets can serve as promising functional materials for spintronic applications.

Among antiferromagnets, high Néel temperature noncollinear antiperovskites ANMn₃ (A = Ga, Ni, Sn, and Pt) are interesting due to their magnetic group symmetry supporting non-trivial spin-dependent …

Peer Support Wellness Groups In Physician Assistant School, Allison Pingston, Alexa Wagoner

Physician Assistant Capstones, 2020-current

Objective: To investigate the effect of peer support wellness groups on the perceived stress, anxiety, and depressive symptoms encountered in Physician Assistant (PA) school in order to implement a wellness program for James Madison University (JMU) PA students. Design: Systematic literature review. Methods: Searches were done in PubMed and Google Scholar using the search terms: “wellness,” “peer support,” “small group(s),” “medical school,” and “PA school.” The limits used were: randomized controlled trials, meta-analysis, and completed in the past 10 years. Results: Search results revealed three articles that met inclusion and exclusion criteria. Conclusion: No articles showed statistical significance. However, all …

Paracetamol Compared To Nsaids As Treatment For Patent Ductus Arteriosus In Neonates, Toné Boykins, Carly Anne C. Wilson

Physician Assistant Capstones, 2020-current

Objective: To evaluate the use of paracetamol in the treatment of closure of patent ductus arteriosus (PDA), as well as to investigate the amount of adverse side effects. Design: Systematic literature review. Methods: Searches were done in PubMed and Google scholar, using the search terms Paracetamol for patent ductus arteriosus and alternative treatment patent ductus arteriosus. In PubMed the following limits and terms were used: randomized control trial, English, and secondary endpoints. Results: Randomized control trial studies by Dash et al., El-Mashad et al., and El-Farrash et al. were included based on inclusion/exclusion criteria of the meta-analysis and with secondary …

The Effect Of Hydroxychloroquine On Mortality In Hospitalized Covid-19 Patients, Misha Suresh, Jeff Abraham

Physician Assistant Capstones, 2020-current

As of October 2020, there are no commonly accepted or proven effective treatments for coronavirus disease 2019 (COVID-19). Hydroxychloroquine (HCQ) is an established anti-malarial drug with demonstrated action against SARS-CoV-2 (the virus that causes COVID-19) in-vitro and early observational studies and anecdotal evidence supported its use in treatment of COVID-19. In this review, three of largest and most statistically powerful studies to date (two cohort studies and one randomized controlled trial [RCT]) are synthesized for the purpose of determining whether HCQ is effective in reducing mortality in patients hospitalized with COVID-19. All three studies found no statistically significant difference in …

Are Polypills A Viable Option To Improve Health Outcomes In Those With Cardiovascular Disease?, Alexander Voytovich, Cara Mckee

Physician Assistant Capstones, 2020-current

Objective: Does the use of polypill therapy improve systolic blood pressure and low-density lipoprotein cholesterol (LDL-C) levels more than usual care in adults with established cardiovascular disease (CVD) or with 10-year atherosclerotic cardiovascular disease risk >10%. Design: Systematic literature review. Methods: Searches were performed in PubMed and UpToDate using the following search terms polypill and cardiovascular. Other limits included: randomized control trials, adults, published in the last 10 years, LDL-C and systolic blood pressure. Results: Analysis of articles to ensure similar design, intervention and fit with the other inclusion/exclusion criteria yielded three studies: Labefer et al, Muñoz et al, and …

The Necessity Of Implementing A Wellness Curriculum Into Physician Assistant Programs, Jessica K. Erim, Darryl Bines Jr.

Physician Assistant Capstones, 2020-current

Purpose: In response to the decline of mental health and wellness of students within medical school programs, recent research has been exploring the effects of implementation of wellness curriculums. The purpose of this review is to highlight the research that has been conducted in the medical school environment and to establish the need for further research. This review will specifically discuss the implementation of a student-led wellness curriculum at James Madison University’s Physician Assistant Program and its impact on students. Methods: A thorough search was conducted using Google Scholar using specific inclusion and exclusion criteria (see Table 1). …

Effectiveness Of Tpa At Reducing Amputations In Patients With Severe Frostbite, Kylie Gravatt, Meredith Mahen

Physician Assistant Capstones, 2020-current

Objective: To determine the efficacy of tissue plasminogen activator (tPA) therapy in reducing the number of limb and digit amputations in patients with severe frostbite.

Introduction: Current treatment regimens for frostbite consist mainly of rapid rewarming measures and wound care. This regimen is unfortunately many times not sufficient in cases of severe frostbite and frequently leads to delayed amputations.

Methods: A search was conducted in Pubmed using the terms "Frostbite"[Mesh]) AND "Tissue Plasminogen Activator"[Mesh]. Articles were chosen based on relevancy to the research question and having a publication date after 2005. Case reports were excluded.

Results: All three studies reported …