Medicine and Health Sciences Commons^™

Targeting Neuronal Nitric Oxide Synthase (Nnos) For Melanoma Treatment, Shirley Tong

Pharmaceutical Sciences (PhD) Dissertations

Human cutaneous melanoma is the most aggressive form of skin cancer and the incidence rates have continued to increase over the years. Neuronal nitric oxide synthase (nNOS) produces nitric oxide (NO) has been found to be overexpressed in human melanoma and the expression of nNOS is induced by interferon-gamma (IFN-γ). In our studies, nNOS has been implicated in IFN-γ-stimulated melanoma progression and the inhibition of nNOS using novel inhibitors effectively inhibited IFN-γ-stimulated tumor growth in a xenograft mouse model. Programmed death-ligand 1 (PD-L1) is overexpressed in melanoma and plays an important role in suppressing the immune system ^12-14. Our …

Transmission Risk Of Malaria Via Gas Flares In Africa, Elle Blake

Health, Human Performance and Recreation Undergraduate Honors Theses

Gas flaring occurs at oil drilling sites around the world. It is a method to get rid of the extra gas, as well as to release pressure in emergency situations. The pollutants that are contributed to the air through routine gas flaring can be extremely harmful. Chemicals such as sulfur dioxide and methane are burned into the air we breathe (Baker Hughes, 2019). Not only does this have a direct impact on our health, but also on greenhouse gas emissions. The effects on greenhouse gas emissions impact diseases such as Malaria by increasing the temperature of our planet. The purpose …

Effective Lifestyle Modifications Pro Football Players Utilize To Prevent Future Complications Of Chronic Traumatic Encephalopathy, Matthew Nicolas

Nursing | Senior Theses

The National Football League (NFL) is a billion-dollar entertainment industry that values itself on the physical and gritty sport of football. Even though these athletes are revered for their physical prowess and durability, at some point in their professional football careers these players are likely to sustain some variation of head injury—if not multiple. Each of the 22 players on the gridiron must physically wear out their matchup with tackles, stiff arms, bullrushes, rip moves, and any illegal hits the referee may not be able to see. The repeated blows these players sustain over the course of their career often …

Development Of A Nurse Practitioner Driven Program For Cardiology Providers To Increase Knowledge And Awareness Of Neurodevelopmental Assessment Needs In Children With Congenital Heart Defects, Michele Readman

Doctor of Nursing Practice Final Manuscripts

Children diagnosed with congenital heart defects are at increased risk for neurodevelopmental delays. Timely referral of patients to a neurodevelopmental clinic for initial evaluation and referrals to support services can improve learning outcomes, provide early intervention for neurodevelopmental disorders, and mediate factors affecting low quality of life. Nationally, a substantial proportion of pediatric cardiologists are not referring children for neurodevelopmental evaluation. A review of patient referrals to a Cardiac Neurodevelopmental Clinic within an urban children’s hospital demonstrated an opportunity to improve provider awareness and knowledge of referral recommendations. Using the Iowa Model of Evidence-Based Practice to Promote Quality Care, an …

Epidemiological And Clinical Characteristics Of Patients Hospitalised With Covid-19 In Kenya: A Multicentre Cohort Study, Loice Achieng Ombajo, Nyamai Mutono, Paul Sudi, Mbuvi Mutua, Mohammed Sood, Alliyy Muhammad Loo, Phoebe Juma, Jackline Odhiambo, Reena Shah, Frederick Wangai

Internal Medicine, East Africa

Objectives: To assess outcomes of patients admitted to hospital with COVID-19 and to determine the predictors of mortality.

Setting: This study was conducted in six facilities, which included both government and privately run secondary and tertiary level facilities in the central and coastal regions of Kenya.

Participants: We enrolled 787 reverse transcriptase-PCRconfirmed SARS-CoV2-infected persons. Patients whose records could not be accessed were excluded.

Primary and secondary outcome measures: The primary outcome was COVID-19-related death. We used Cox proportional hazards regressions to determine factors related to in-hospital mortality.

Results: Data from patients with 787 COVID-19 were available. The median age was …

Increasing The Utilization Of A Cardiovascular Risk Assessment & Screening Tool Through Education In A Primary Care Setting: A Quality Improvement Project, Taylor A. Massey

DNP Projects

Background and Significance: The World Health Organization (WHO) (2021) reports that 55.4 million people died worldwide in 2019; cardiovascular diseases due to ischemic heart disease and stroke were the top two leading causes of these deaths. Experts predict that by the year 2030, more than 22.2 million people will die annually from cardiovascular disease (Ruan et al., 2018). Noninvasive cardiovascular screening tests, such as the "Pulse4Pulse" screening tool, are a way to help providers identify patients at high-risk for cardiovascular disease and initiate treatment to reduce future risk.

Purpose: To increase provider utilization of the "Pulse4Pulse" screening test in a …

Increasing Awareness Of Hereditary Fructose Intolerance: An Evidence-Based Practice Implementation Project, Jacqueline M. Bridge

DNP Projects

Background: Hereditary Fructose Intolerance (HFI) is an inborn error of metabolism which results in the absence of an effective Aldolase B enzyme. Without this enzyme, ingestion of fructose and metabolic precursors leads to acute illness, multiorgan damage, and possible death. The increased presence of these sugars results in earlier onset of symptoms and more difficulty for those with HFI.

Purpose: The project’s aim is to increase awareness of HFI in healthcare providers using a learning module and assessments of knowledge at three different points in time.

Methods: The IOWA model for evidence-based practice projects was applied during the development and …

Implementing A Stroke Process Improvement Group To Reduce Time To Thrombectomy In Patients With Acute Ischemic Stroke At Greenwich Hospital, Victoria Merrill

DNP Projects

Introduction: Delays in door to skin puncture time for patients with ischemic stroke are associated with worse clinical outcomes. The following quality improvement study was conducted at Greenwich Hospital which aimed to decrease door to skin puncture time for endovascular stroke treatment. Greenwich Hospital began its new stroke program in January 2020 and opened thrombectomy capable interventional radiology (IR) services. Delays to door to skin puncture times existed with average time being 100 minutes with a goal time of 90 minutes or less for 50% or more of patients directly arriving to the hospital and 60 minutes or less for …

Hiv Virological Non-Suppression Is Highly Prevalent Among 18- To 24-Year-Old Youths On Antiretroviral Therapy At The Kenyan Coast, Moses K. Nyongesa, Mwaganyuma H. Mwatasa, Vincent A. Kagonya, Gabriel Mwambingu, Caroline Ngetsa, Charles R. J. C. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: In sub-Saharan Africa, data on virologic outcomes of young people living with HIV (YLWH) enrolled on antiretroviral therapy (ART) remains scarce. In this study, we describe the prevalence of HIV virological non-suppression (VNS) and its associated factors among YLWH aged 18–24 years from the Kenyan coast.

Methods: Data were analyzed for 384 YLWH who participated in a larger cross-sectional study conducted between November 2018 and September 2019 in two counties at the Kenyan coast (Kilif and Mombasa). Descriptive statistics were used to summarize sample characteristics and logistic regression was used for statistical modeling of factors associated with …

Effects Of Exercise On Parkinson's Symptom Relief, Brooke Burnett

The Eleanor Mann School of Nursing Undergraduate Honors Theses

In this review of twenty research articles, the effects of moderate exercise therapy on the symptoms of Parkinson’s Disease will be explored. Appropriate literature was located using the research question, “In older adults with a Parkinson’s Disease Diagnosis, how does moderate exercise influence the symptoms of this disease?” Twenty peer-reviewed research articles were examined for the impact of different forms of exercise on various symptoms associated with Parkinson’s. Nineteen of the articles reviewed provide substantial evidence in support of exercise therapy as a treatment option for people with Parkinson’s, and one of the articles found inconclusive evidence neither in support …

The Impact Of A Heart Healthy Diet On The Development Of Heart Disease, Fenina Gonzales

Nursing | Senior Theses

Heart disease is the leading cause of death in the United States. Both modifiable and non-modifiable risk factors contribute to the development of this disease. One modifiable risk factor is diet. Potentially, the right diet, i.e. one that is deemed heart healthy, can aid in the prevention of heart disease.

This thesis aims to determine what constitutes a heart healthy diet First, a literature review related to the use of diet and nutrition for the prevention of heart disease will be provided. Next, this thesis will present a research proposal for a longitudinal study that will compare five-year and 10-year …

An Evaluation Of Covid-19 Vaccination Rates Of The Patients At The Kentucky Racing Health Services Center., Aditya Mehta

College of Arts & Sciences Senior Theses

COVID-19 vaccines have been widely available to the U.S. public since early 2021. However, vaccination rates still vary considerably across geographical areas and different populations. The objective of this study was to research overall vaccination rates against COVID-19 for Latinx patients at the Kentucky Racing Health Services Center (KRHSC). Vaccination and booster data was collected from June to December 2021 for all unique patients visiting the center. It was initially hypothesized that these rates of vaccination and booster doses for the KRHSC patients would be lower than the data reported by Kentucky and Jefferson County. After a retrospective review, the …

Recipe Modification For Cardiovascular Health, Meg Tolbert

Human Nutrition and Hospitality Management Undergraduate Honors Theses

Cardiovascular disease (CVD) is the leading cause of death globally. CVDs affect the heart and blood vessels. The most prominent CVDs are coronary artery disease, cerebrovascular disease, rheumatic heart disease, and other conditions. More than four out of five CVD deaths are due to heart attacks and strokes.

The most important behavioral risk factors of heart disease and stroke are unhealthy diet and physical inactivity, but also include harmful abuse of tobacco and alcohol. These lifestyle factors display themselves as phenotypes like high blood pressure, high blood glucose and blood lipids, diabetes, and obesity. These risk factors, outside of genotype …

Development And Implementation Of A Protocol For Denosumab Administration In An Outpatient Infusion Clinic, Erin Stavrakas

The Eleanor Mann School of Nursing DNP Capstone Projects

Denosumab, or Prolia, is a medication given to increase bone mineral density (BMD) and prevent fracture risk in patients with osteoporosis. Guidelines for monitoring of side effects, data on long-term effects, and appropriate precautions are still being researched and developed. Healthcare teams are often unaware of preventative care measures to guide informed clinical decision making and patient care management. The recognized gap in care also reduces the standardization of health care delivery in clinics administering Prolia; this gap can lead to errors and miscommunication between patients and healthcare teams an increased risk for side effects. The aim of this translation …

Periodontal Disease And Covid-19, Zhaozhao Chen Dds, Ms, Phd, Laurie K. Mccauley Dds, Ms, Phd, Purnima S. Kumar Bds, Ms, Phd, Hom-Lay Wang Dds, Ms, Phd

The Journal of the Michigan Dental Association

As the gateway to the respiratory system, the oral cavity can play an essential role in SARS-CoV-2 invasion and transmission. Besides high expression of angiotensin‐converting enzyme 2 (ACE2), the oral cavity can harbor viral particles in saliva, gingival crevicular fluid, and the periodontal pocket. Microbial and inflammatory associations closely link periodontitis and COVID-19. In this review, we summarize the possible oral manifestations of COVID‐19, its association with periodontal diseases, the plausible underlying mechanisms of microbial and inflammatory crosstalk between COVID‐19 and periodontal diseases, and mitigation protocols during periodontal treatment.

Evaluation Of The Effect Of A Lippia Organoides Essential Oil Extract On Clostridium Perfringens Proliferation In Vitro And Necrotic Enteritis In Broiler Chickens, Makenly E. Coles

Graduate Theses and Dissertations

The purpose of the present research was to assess the effects of essential oils derived from the plant Lippia organoides on performance parameters, intestinal integrity, and necrotic enteritis (NE) in broiler chickens. To do this, a previously established challenge model for NE was utilized which included challenging with Salmonella Typhimurium on day 0, Eimeria maxima on day 18, and Clostridium perfringens on days 22 and 23. Treatment groups included a 1) non-challenged, negative control, 2) challenged control, and 3) challenged, Lippia origanoides (37ppm in the diet). Group 1 (negative control) had significantly (P < 0.05) higher body weight gain from d8-25 and d0-25 compared to both challenged groups. Feed intake was significantly different for all three groups (P < 0.05) at 8-25 days and 0-25 days with group 1 having the highest feed intake for both time periods. Total mortality was greater in the positive control when compared to both the negative and treatment groups. NE lesion scores were significantly different between all groups with the positive control having the highest mean lesion scores and the negative control having a mean lesion score of 0. The positive control group had the highest FITC-d amounts detected in the sera, being statistically higher than both the treatment group and negative group which were both statistically different from each other. At the present inclusion rate for the essential oil (37 ppm), there was an overall reduction in the negative impact from the NE infection. Further studies should be conducted to reach more significant conclusions.

The Influence Of Dash Diet Education On Knowledge And Adherence In Primary Care: A Quality Improvement Project, Paige Bekker

Masters Projects

Background/Local Problem: A rural family practice was concerned about the number of

patients with uncontrolled hypertension, 19.86% n = 56, as defined by the Centers for Disease Control and Prevention (CDC). After several quality improvement (QI) initiates to lower the prevalence rate of uncontrolled hypertension, including proper measurement techniques and home monitoring, the modifiable risk factor of adapting one’s food intake was introduced using the Dietary Approach to Stop Hypertension (DASH) diet as an intervention. The DASH diet is an evidence-based approach for lowering blood pressure. The QI project was completed with the purpose of implementing DASH diet education and …

Adipose-Derived Stromal Vascular Fraction Therapy Improves Age-Related Adrenergic Mediated Microvascular Dysfunction And Increases Revascularization Potential Following Injury., Gabrielle Brown

Electronic Theses and Dissertations

The role of the microcirculation is to balance blood flow and oxygen delivery to meet local metabolic and oxygen demands. With advancing age, the health of the endothelium declines leading to improper augmentation of the microcirculation; decreasing vasoreactivity and angiogenic potential which can further increase the risk of ischemia. The multiple contributing factors that drive the decline in endothelial health with age make traditional pharmacological interventions challenging whereas cell-based therapies can exert multifactorial gains. Adipose-derived stromal vascular fraction (SVF) is an emerging therapeutic for its easily accessible, autologous, anti-inflammatory, and angiogenic properties. It is a heterogenous population comprised of leukocyte …

Spectroscopic Measurements Of Meibum Compositional, Structural, And Functional Relationships To Elucidate The Role Of Meibum In Dry Eye., Anthony Chigozie Ewurum

Electronic Theses and Dissertations

The major aim of my dissertation was to investigate the etiology of dry eye disease which affects about 7 million people in the United States, causing symptoms that can lead to visual disturbance. Correlation between dry eye and an abnormal lipid layer of the tear film has been found. Tear film lipids originate mostly from the meibomian glands. Cholesteryl ester (CE) and Wax ester (WE) lipids make up most of the human meibum lipidome and the CE/WE ratio has been shown to decrease in patients with meibomian gland dysfunction. Model studies using synthetic CE and WE, although providing some insight, …

Etracellular Vesicles From Lactobacillus Rhamnosus Gg Protect Against Alcohol-Induced Liver Injury Through Suppression Of Intestinal Mir 194 And Subsequent Activation Of Fxr In Mice., Mengwei Jiang

Electronic Theses and Dissertations

Numerous studies have reported the efficacy of probiotics for alcohol-associated liver disease (ALD). These studies indicate a strong interest among the scientific and medical communities in identifying alternative or adjunctive approaches for ALD, for which there is no effective or widely accepted therapeutic option. However, in-depth molecular knowledge on how probiotics render their effects is lacking. Patients with ALD often have increased hepatic bile acids (BAs), which can be toxic and are an important causative factor in liver injury and hepatocyte death. BAs are released into the intestines and serve not only as a “detergent” to promote fat absorption, but …

Porphyromonas Gingivalis, Ethanol, And Chronic Diseases., Nicholas Alan Short

Electronic Theses and Dissertations

This dissertation is an investigation into the relationships among Porphyromonas gingivalis, ethanol, and a series of chronic diseases, focusing primarily on atherosclerosis. It uses evolutionary theory to understand clinical parameters related to chronic disease biology. The initial research question was, "If people who drink a glass of wine each day have a lower risk for atherosclerosis, could one explanation involve antibacterial effects on pathogens associated with causing atherosclerosis, namely, Porphyromonas gingivalis?". This dissertation is divided into four chapters. Chapter One provides the foundational information pertinent to the dissertation. Chapter Two describes an in- vitro experiment aimed at understanding …

Protest-Related Tear Gas Exposure And Menstrual Function, Emily Kathleen (Steinmetz) Reece

Electronic Theses and Dissertations

During the racial justice protests of 2020 and 2021, crowd control chemical irritants (referred to as “tear gas”) were deployed against protesters, after which there were anecdotal reports of altered menstrual cycles among exposed individuals. There is only one peer reviewed published study on tear gas exposure and menstrual health. This study examined whether tear gas exposure was associated with menstrual cycle outcomes among women attending the 2020-2021 protests. Data from 103 women who attended racial justice protests in 2020 and 2021 were collected through an online questionnaire. Data included protest attendance, acute symptoms of tear gas exposure, whether medical …

The Role Of Obesity In Macrophage-Mediated Mechanisms Promoting Early-Onset Colon Cancer., Katharina Marietta Scheurlen

Electronic Theses and Dissertations

Early-onset colon cancer (EOCC) is a leading cause of cancer death among people younger than 50 years of age in the United States and is associated with metabolic dysfunction and obesity. Anti-inflammatory tumor-associated macrophages (TAM) and low Peroxisome Proliferator Activated Receptor Gamma (PPARγ) gene expression in colon cancer (CC) tissue promote tumor progression and decreased patient survival. Obesity-related hormones, such as leptin and adiponectin, have the potential to affect gene expression in TAM to promote CC progression and thereby link obesity and EOCC. The aim of this project was to identify target genes in human CC and to investigate the …

Implementation Of 3-Minute Diabetic Foot Exam For At Risk Diabetic Patients In Urban Primary Care Setting, Suzana Alvarez

DNP Projects

Background: Healthcare providers manage chronic health concerns by reducing the risk of diabetic complications among their patient population. In 2017, diabetes was the seventh leading cause of death in the United States and Connecticut. In Connecticut, there are 19,500 newly diagnosed diabetics and four Connecticut cities have higher occurrence of diabetes: Waterbury, New Britain, Hartford, and Bridgeport. Bridgeport Primary Care (BPC) had no policy or procedure in place to require the providers to complete a routine diabetic foot exam. The aim of this project was to promote and implement a tool to assist the BPC providers in evaluating adult …

Investigating Molecular Mechanisms Behind Bacterial Chondronecrosis With Osteomyelitis (Bco) Pathogenesis In Modern Broilers, Alison Ramser

Graduate Theses and Dissertations

Bacterial chondronecrosis with osteomyelitis (BCO), a leading cause of lameness in broiler chickens, is characterized by infection, inflammation, and bone attrition. There are currently no effective treatments and positive diagnosis is only possible through necropsy evaluations. Lameness is also a rising animal welfare and economic concern, making prevention and detection of BCO all the more critical. These challenges are exacerbated by a lack of mechanistic understanding of BCO’s etiology. The question I asked during my dissertation was how bacteria induce bone attrition in BCO pathology. My research has shown that mitochondrial dysfunction is characteristic of BCO conditions along with autophagy …

Lgbtq+ Health Disparities: Healthcare Intervention, Kara Steinbrecher

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community has carried the burden of countless health disparities throughout its history tied to discrimination, bias, prejudice, and stigma. LGBTQ+ individuals are disproportionately at higher risk for substance abuse, sexually transmitted diseases, cardiovascular disease, mental illness, suicide, and unequal access to healthcare, related to social stigma and bias that exists in healthcare itself. The purpose of this systematic literature review is to analyze existing health disparities among the LGBTQ+ population in the United States and the efficacy of various interventions of health care professionals to reduce them. Twenty-one articles from multiple online …

Dexmedetomidine Vs. Propofol In Postoperative Delirium Prevention, Jaclyn Burnett Rn, Srna, Montana Betts Rn, Srna, Christhian De Ochoa Rn, Srna, Maciej Chec Rn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Postoperative delirium (POD) is an acute neurological condition affecting large numbers of surgical patients in various practice settings. Patients suffering from this condition face postoperative complications, increased lengths of stay, and tremendous financial burden. Understanding the contributing factors for POD, and how adjustments in intraoperative agents can prevent or reduce the incidence, is a crucial aspect of anesthesia practice. This scoping review will examine associations between POD and the intraoperative use of propofol versus dexmedetomidine with general anesthesia.

Methods Studies in this review were limited to peer-reviewed literature, published in medical and nursing journals within the last five years. …

Ulnar Nerve Palsy As Covid-19 Sequelae In 3 Patients, Cristina Terhoeve, Ryan Bliss, Rasheed Ahmad

School of Medicine Faculty Publications

The pathophysiology and treatment of COVID-19 have been at the forefront of medical research this past year. While great strides have been made in our knowledge of the disease, there is still much that is unknown. More than one-third of patients with COVID-19 present with symptoms involving the nervous system. The reason for this is unclear, although several theories have been postulated. In this case study, we present 3 patients with severe ulnar nerve dysfunction following treatment for COVID-19 in the intensive care unit. We discuss reasons why this may have occurred, the etiology of which is likely multifactorial. We …

Cannabinoids And Retinal Fibrotic Disorders., Lucy June Sloan

Electronic Theses and Dissertations

Retinal fibrosis is detrimental to vision. Retinal pigment epithelial (RPE) cells contribute to several retinal fibrotic diseases. Upon exposure to TGF-β, a key fibrotic cytokine, RPE cells trans-differentiate to myofibroblasts marked by the integration of α-SMA fibers into F-actin stress fibers, which confer strong contractility. Myofibroblasts produce and contract the collagen-rich fibrotic scar and disrupt retinal architecture. In this study, we investigated the in vitro effects of the putative endocannabinoid compound N-oleoyl dopamine (OLDA) on TGF-β2 induced porcine RPE cell contraction and α-SMA expression. Using an in vitro collagen matrix contraction assay, we found that OLDA inhibited TGF-β2 induced contraction …

Monkeypox Virus Hosts And Transmission Routes: A Systematic Review Of A Zoonotic Pathogen, Mary Walker

Biological Sciences Undergraduate Honors Theses

Monkeypox virus (MPXV) is an etiological agent of Monkeypox with origins believed to be of Central/West Africa. As a member of the orthopoxvirus family and due to its increasing emergence, it has become a pathogen in need of research. This paper works to find common trends of transmission routes and reservoir hosts in previous publications through a systematic review. Articles found on Web of Science containing the search term “Monkeypox” were sorted based on relevance to the review topics of potential reservoir hosts and transmission routes of Monkeypox virus. Through Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 1,036 …