Medicine and Health Sciences Commons^™

Environmental Sampling Techniques For Herd-Level Surveillance Of Bovine Viral Diarrhea Virus, Jaden Carlson

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

Control of Bovine Viral Diarrhea Virus (BVDV) relies on resource-intensive individual animal sampling to detect and remove persistently infected (PI) cattle. Herd-level surveillance tools would be useful for herds with unknown BVDV status and for monitoring herds with BVDV-free status. The overall objective of this thesis is to explore the viability of BVDV surveillance at a herd-level using samples collected without handling individual animals. The first objective was to determine the feasibility of using stable flies as a sampling tool to detect BVDV. The second objective was to determine the feasibility of using drinking water to detect BVDV. To accomplish …

Association Of Office And Ambulatory Blood Pressure With Mortality And Cardiovascular Outcomes, Wen-Yi Yang, Jesus D. Melgarejo, Lutgarde Thijs, Zhen-Yu Zhang, José Boggia, Fang-Fei Wei, Tine W. Hansen, Kei Asayama, Gladys E. Maestre, Takayoshi Ohkubo

School of Medicine Publications

Importance Blood pressure (BP) is a known risk factor for overall mortality and cardiovascular (CV)-specific fatal and nonfatal outcomes. It is uncertain which BP index is most strongly associated with these outcomes.

Objective To evaluate the association of BP indexes with death and a composite CV event.

Design, Setting, and Participants Longitudinal population-based cohort study of 11 135 adults from Europe, Asia, and South America with baseline observations collected from May 1988 to May 2010 (last follow-ups, August 2006-October 2016).

Exposures Blood pressure measured by an observer or an automated office machine; measured for 24 hours, during the day or …

Oxidative Phosphorylation: A Critical Feature And Novel Therapeutic Target In Melanoma Brain Metastases, Grant Fischer

Dissertations and Theses (Open Access)

We recently showed via RNA-sequencing (RNA-seq) analysis of clinical samples that melanoma brain metastases (MBMs) have higher expression of oxidative phosphorylation (OXPHOS) genes (including PPARGC1A or PGC1α) than patient-matched extracranial metastases (ECMs). Thus, the central hypothesis of this dissertation is that OXPHOS plays a critical role in the pathogenesis of MBMs.

RNA-seq analysis identified increased expression of OXPHOS genes in intracranial (ICr) vs. subcutaneous (SQ) xenografts of 4 different human melanoma cell lines. Increased OXPHOS in the ICr xenografts was confirmed by direct metabolite analysis and [U-¹³C]-glucose tracing analysis. Together, these studies indicate that the brain TME …

Tracking Treatment Response And Resistance To Parp Inhibition (Talazoparib) In Hereditary Pancreatic Cancer., Jennifer Goldstein

Dissertations and Theses (Open Access)

polyADP ribose polymerase (PARP) inhibitors are a class of drugs that block the PARP enzymes, involved in the repair of singe-stranded DNA breaks through the base excision repair pathway. PARP inhibition leads to replication-associated double stranded DNA breaks, which are repaired by homologous recombination (HR). In tumors with HR defects (i.e. BRCA mutants), there is a shift to error-prone DNA repair and subsequent genomic instability and cell death.

In 2014, Olaparib became the first FDA-approved PARP inhibitor for the treatment of BRCA-mutant ovarian cancer. In the phase III POLO (Pancreas cancer OLaparib Ongoing) trial presented at the American Society …

Role Of Nudt21 Mediated Alternative Polyadenylation And Hyaluronan In The Development Of Pulmonary Hypertension, Scott Dale Collum

Dissertations and Theses (Open Access)

Pulmonary hypertension (PH) is a progressive disease with serious effects on quality of life and life expectancy of patients. PH is a complex disease that likely develops due to multiple influences, and no curative treatments exist for this disease. It has been shown that alternative polyadenylation (APA) due to depletion of Nudix Hydrolase 21(NUDT21) is involved in several disease states including the chronic lung disease idiopathic pulmonary fibrosis (IPF). Additionally, hyaluronan, an extracellular matrix glycosaminoglycan has been associated with PH. The role and mechanism of NUDT21 and hyaluronan have not yet been described in this disease. My results reveal that …

Early Life Child Micronutrient Status, Maternal Reasoning, And A Nurturing Household Environment Have Persistent Influences On Child Cognitive Development At Age 5 Years: Results From Mal-Ed, Benjamin J J. Mccormick, Stephanie A. Richard, Laura E. Caulfield, Laura L. Pendergast, Jessica C. Seidman, Beena Koshy, Reeba Roshan, Rita Shrestha, Erling Svensen, Muneera Rasheed

Department of Paediatrics and Child Health

Background: Child cognitive development is influenced by early-life insults and protective factors. To what extent these factors have a long-term legacy on child development and hence fulfillment of cognitive potential is unknown.
Objective: The aim of this study was to examine the relation between early-life factors (birth to 2 y) and cognitive development at 5 y.
Methods: Observational follow-up visits were made of children at 5 y, previously enrolled in the community-based MAL-ED longitudinal cohort. The burden of enteropathogens, prevalence of illness, complementary diet intake, micronutrient status, and household and maternal factors from birth to 2 y were extensively measured …

Visualizing Ischemic Skin Flap Necrosis Through Phasor Analysis Of Autofluorescence Lifetime Images, Hallie Ramser Toomer

Graduate Theses and Dissertations

Necrotic skin flaps are difficult to predict and treat due to the lack of quantitative biomarkers. Label-free multiphoton microscopy is well suited for non-invasively monitoring skin metabolism through NAD(P)H and other intrinsic fluorophores, and offers immediate future directions for assessing necrosis in the clinic. The objective of this study was to assess whether phasor FLIM could be used to evaluate skin flap status and treatment efficacy in ex vivo skin sections. Phasor maps revealed differences in growth factor treatment and region, but changes in skin flap autofluorescence at 755nm excitation and 460nm emission were not just related to NAD(P)H. A …

Investigation Of Microbiota In Health And Disease Of Poultry, Bishnu Adhikari

Graduate Theses and Dissertations

The microbiotas play vital roles in health and diseases of both humans and animals. 16S rRNA genes sequence analysis is one of the most popular and commonly used methods in the analysis of microbiotas associated with hosts. In this dissertation, the microbiotas of chickens (broilers, breeders, and layers) and turkeys were evaluated by 16S rRNA gene sequencing. Characterization of the culturable subpopulations of Lactobacillus in the chicken gut can serve as a valuable resource for probiotic development. In Chapter 2, Lactobacillus subpopulations recovered on MRS from chicken gut were defined comprehensively for the first time using 16S rRNA gene profiling, …

Prediction And Evaluation Of Breast Myopathy, Barbara De Almeida Mallmann

Graduate Theses and Dissertations

Broiler breast myopathies, including woody breast, white striping, and spaghetti breast, negatively impact the industry. Therefore, evaluation, prediction, and frequency of these muscle abnormalities on modern birds are important for decision making. Modern broilers are not highly active and often sit with the breast of the bird resting on the floor. Therefore, the first experiment was to promote bird movement and explore the impact on the breast myopathies. The movement was stimulated by human interaction (walking through pen) and higher light intensity so that birds walked around the pen more often throughout the day. The control group had normal low …

Potential Antimicrobials For Controlling Listeria Monocytogenes In Frankfurters, Aaron Rashad Bodie

Graduate Theses and Dissertations

Listeria monocytogenes is a pathogenic microorganism that causes Listeriosis. Listeriosis is a highly mortal disease with approximately 20% mortality rate. Listeria is psychrophilic, therefore it is able to survive in the refrigerator. This affects foods at cool storage such as fresh produce and RTE meats. To ensure the safety of RTE meat, post processing treatments are used such as vacuum packing, edible films, dip and treatment. One-way RTE can be treated is with the use of antimicrobials. However, in the past chemical substances were used. Currently, consumers want more natural and organic preservatives to combat health problems from toxic components …

How Acceptable Is The Hiv/Aids Self-Testing Among Women Attending Immunization Clinics In Effurun, Southern Nigeria, Wasiu Olalekan Adebimpe, Doraebikeme Ebikeme, Olubukunola Omobuwa, Edward Oladejo

Marshall Journal of Medicine

HIV testing remains the gateway to HIV/AIDS prevention, treatment, care and support interventions. In Nigeria, a significant proportion of the populations do not know their HIV status. HIV self-testing done without the help of a healthcare provider could remove identified barriers to HIV testing, and close gaps in HIV treatment and prevention cascades. This study set out to assess the knowledge and acceptability of hiv self-testing (HIVST) among women of child bearing age attending immunization clinics in Effurun, Nigeria. A descriptive, cross-sectional study was conducted among 357 women of child-bearing age selected using multistage sampling technique. Research instrument used was …

Development Of Novel Zika And Anthrax Viral Nanoparticle Vaccines, Elizabeth Henderson

KGI Theses and Dissertations

Vaccines protect against numerous infectious diseases and prevent millions of deaths annually, but there are still many infectious diseases for which no licensed vaccine exists. Developing a new vaccine requires balancing safety and efficacy, and viral nanoparticle (VNP) vaccines possess both of these characteristics. The work herein demonstrates how tobacco mosaic virus (TMV) nanoparticles can serve as a platform to create candidate vaccines for Zika virus (ZIKV) and anthrax. In the first study, a ZIKV-specific epitope was genetically fused to TMV to create a safe and inexpensive vaccine that proved highly immunogenic in mice and led to the discovery of …

Short Amylin Receptor Antagonist Peptides Improve Memory Deficits In Alzheimer’S Disease Mouse Model, Rania Soudy, Ryoichi Kimura, Aarti Patel, Wen Fu, Kamaljit Kaur, David Westaway, Jing Yang, Jack Jhamandas

Pharmacy Faculty Articles and Research

Recent evidence supports involvement of amylin and the amylin receptor in the pathogenesis of Alzheimer’s disease (AD). We have previously shown that amylin receptor antagonist, AC253, improves spatial memory in AD mouse models. Herein, we generated and screened a peptide library and identified two short sequence amylin peptides (12–14 aa) that are proteolytically stable, brain penetrant when administered intraperitoneally, neuroprotective against Aβ toxicity and restore diminished levels of hippocampal long term potentiation in AD mice. Systemic administration of the peptides for five weeks in aged 5XFAD mice improved spatial memory, reduced amyloid plaque burden, and neuroinflammation. The common residue SQELHRLQTY …

Relationship Of Patient Self-Administered Copd Assessment Test To Physician Standard Assessment Of Chronic Obstructive Pulmonary Disease In A Family Medicine Residency Training Program, Jessica E. Burchette, Ivy A. Click, Leigh Johnson, S. Alicia Williams, Brett Tyler Morgan

Journal of Patient-Centered Research and Reviews

Assessing the global impact of chronic obstructive pulmonary disease (COPD) on a patient’s life can be difficult to perform in the clinical setting due to time constraints and workflow challenges. The primary objective of this study was to compare disease impact ratings between patient self-administered COPD Assessment Test (CAT) and physician standard office assessment. This prospective study was conducted at a family medicine residency clinic in northeast Tennessee. The study included two study groups: 1) adult patients seen at the clinic during the 3-month study period with an active diagnosis of COPD, and 2) their physicians. Physicians’ assessment of the …

Multiple Sclerosis Pathophysiology, Carolyn Ricketts

Nursing Student Class Projects (Formerly MSN)

Abstract

Multiple Sclerosis (MS) is a chronic autoimmune disease characterized by inflammation in the central nervous system and demyelination of the white matter in the brain and spinal cord, leading to lesions and axonal damage, possibly followed by relapse. It is a progressively debilitating disease with a variety of symptoms that mimic other diseases, such as blurred vision, nerve pain, fatigue, weakness, paresthesia, and unsteady gait. It occurs more frequently further from the equator. The pathophysiology of MS is unknown. Several new research theories are emerging which include innate and adaptive immunity playing a role (TH1 and TH17 specifically), infection …

‘Dancing At The Vatican,’ About Huntington’S Families' Remarkable Papal Audience, Premieres July 27, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Endovascular Management Of Free Floating Common Carotid Thrombi, Kevin Carr Md, Zachary Thwing Md, Ravishankar Shivashankar Md, Yafell Serulle Md

Radiology

• The incidence of symptomatic free-floating thrombi of the common carotid artery (CCA) is as low as 0.24-5% incidence in stroke victims. Patients are predisposed to a prothrombotic state
• Historical management options were limited to surgical and medical options both with individual attendant risk profiles
• Large thrombi can present with various degrees of clinical severity
• The endovascular approach is a viable tool to manage these patients

Community Stroke Practice Experience With Small Vessel Thrombectomy, Kevin Carr Md, Zachary Thwing Md, David Pasquale Md, Ravishankar Shivashankar Md, Yafell Serulle Md

Radiology

• Emergent endovascular revascularization is currently mainstay for patients presenting with emergent Large Vessel Occlusion (LVO) of the intracranial circulation
• Stroke symptoms affecting smaller vessels can carry significant morbidity
• Newer technologies and greater experience with the endovascular approach make treatment for small vessel occlusions increasingly more manageable
• This is more relevant in patients presenting outside the tPA window with poor collateral circulation
• We present our technical institutional experience with the endovascular management of acute occlusions of the M2-M3 MCA, A1-A2 ACA and P1-P2 PCA territories.

“I Don’T Want To Look Sick Skinny”: Perceptions Of Body Image And Weight Loss In Hispanics Living With Hiv In South Texas, Jordan W. Abel, Omar Allen, Delia Bullock, Erin Finley, Elizabeth Walter, Phillip Schnarrs, Barbara S. Taylor

Journal of Health Disparities Research and Practice

Objective: Obesity is rising in people with HIV (PLWH) and Hispanics. Both HIV and obesity are associated with cardiovascular disease morbidity and mortality. Our goal is to understand perceptions of body image and lifestyle in Hispanics with HIV to adapt interventions appropriately.

Methods: We conducted semi-structured interviews with 22 Hispanic PLWH and 6 providers. Purposive sampling selected patient participants across weights and genders. Interviews were coded and analyzed using grounded theory, comparing perspectives between patients with and without obesity, and patients and providers.

Results: Participants felt obesity and diabetes were “normal” in the community. Patients exhibited understanding of healthy diet …

Cardioprotective Effects Of Sphingosine-1-Phosphate Receptor Immunomodulator Fty720 In A Clinically Relevant Model Of Cardioplegic Arrest And Cardiopulmonary Bypass, Naseer Ahmed, Adeela Mehmood, Daniele Linardi, Soban Sadiq Sadiq, Maddalena Tessari, Sultan Ayoub Meo, Rehana Rehman, Waseem M. Hajjar, Nazeer Muhammad, Mohammad Iqbal, Anwar Gilani, Giuseppe Faggian, Alessio Rungatscher

Department of Biological & Biomedical Sciences

Objective: FTY720, an immunomodulator derived from sphingosine-1-phosphate, has recently demonstrated its immunomodulatory, anti-inflammatory, anti-oxidant, anti-apoptotic and anti-inflammatory properties. Furthermore, FTY720 might be a key pharmacological target for preconditioning. In this preclinical model, we have investigated the effects of FTY720 on myocardium during reperfusion in an experimental model of cardioplegic arrest (CPA) and cardiopulmonary bypass.
Methods: 30 Sprague-Dawley rats (300-350 g) were randomized into two groups: Group-A, treated with FTY720 1 mg/kg via intravenous cannulation, and Group-B, as control. After 15 min of treatment, rats underwent CPA for 30 min followed by initiation of extracorporeal life support for 2 h. Support …

Implementation Of An Inpatient Diabetes Team: Impact On Hypoglycemia Recurrence, Martha Bertin, Elva Diaz

All Publications

No abstract provided.

Managing Intracranial Hemorrhage In Patients With A Durable Continuous Flow Left Ventricular Assist Device, Godly Jack, Phil Barker, Ryan Searcy, Jason N. Katz

The VAD Journal

Background: While intracranial hemorrhage (ICH) is a known complication of left ventricular assist device (LVAD) support, and is associated with high morbidity and mortality, optimal care pathways have neither been elucidated nor reported. We describe management of LVAD patients following ICH, with a focus on anticoagulation, operative interventions, care team designation, complications, and outcomes.

Methods: We retrospectively reviewed all durable continuous-flow LVAD implantations at our academic medical center from January 2007 to July 2018. Patients who experienced ICH after LVAD were identified. We defined baseline and ICH characteristics, medical and surgical interventions, care teams, and outcomes including death, device thrombosis, …

Retrospective Evaluation Of Weight Loss In Maine Medical Center Cancer Institute (Mmcci) Patients Receiving Radiation Treatment For Head And Neck Cancer, Julian Johnson, David Debartolo-Stone, Jessica Moore, Ruth Hanselman, Stephen Tyzik, Suneela Nayak, Amy Sparks

Operations Transformation

Treatment for head and neck cancer often results in weight loss as a side effect. One option to mitigate this weight loss is placement of a percutaneous endoscopic gastrostomy (PEG) tube placement. Radiation oncologists at a academic tertiary medical center discuss the option of PEG placement during patient consultation.

A retrospective evaluation of weight loss in patients receiving radiation was conducted over a two-year period. The goal of this data collection was to create a standard for oncology consultations regarding PEG tube placement.

Baseline metrics and a root cause analysis drove subsequent data collection steps. After analyzing the raw data, …

Transmissible Dermatological Diseases Affecting Syrian Refugees In Lebanon, Nisrine Kawa, Edith Hanna, Abdul Rahman Bizri

Journal of Refugee & Global Health

The Syrian war led many to seek shelter in Lebanon, creating a major refugee crisis. Displaced populations in crowded unequipped settlements are vulnerable to infectious diseases. The burden and incidence of various transmissible skin conditions affecting Syrian refugees in Lebanon and their impact on the Lebanese public health system were evaluated. Literature regarding these conditions among Syrian refugees in host countries, and epidemiological data from the Lebanese Ministry of Public Health Surveillance Unit and primary health-care network were reviewed. Lebanon has witnessed skin disorder outbreaks associated with the Refugee crisis, mainly leishmaniasis, scabies and lice infestations with little data about …

Education-Based Interventions Effects On 30-Day Readmission Rates For Patients With Copd, Gina Hand-Eoloff

Dissertations

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing education-based program for Chronic Obstructive Pulmonary Disease (COPD) and its effect on 30-day readmission rates in one hospital in rural Missouri.

Method: A retrospective chart review was completed on 493 patients with an inclusive diagnosis of COPD from June 1, 2018, to March 31, 2019, using a cohort study design and a two-sample t-test analysis. Additional variables were analyzed to determine if there were predictive factors of an elevated risk of readmission.

Results: The two-sample t-test reveals there is no statistically significant difference between the rates of readmission …

Evaluating The Delivery Of Diabetes-Related Care Among The Asian Population, Lyly Bui

Dissertations

Purpose: This project evaluated current practices for Type 2 diabetes mellitus (T2DM) screening and management among Asian Americans (AAs) presenting to a primary care clinic and determined whether these practices adhered to the American Diabetes Association (ADA)’s 2018 guidelines.

Methods: A retrospective chart review was performed to extract data from clinical case records of AAs who visited the Vietnamese Health Center (VHC) between November 1, 2017 and November 1, 2018. Descriptive statistics were utilized to analyze the data.

Results: Of 173 charts reviewed, 76.3% of AAs had no previous T2DM diagnosis and 23.7% had a previous diagnosis. Among those without …

In Vitro Characterization Of Sonothrombolysis And Echocontrast Agents To Treat Ischemic Stroke, Himanshu Shekhar, Robert T Kleven, Tao Peng, Arunkumar Palaniappan, Kunal B Karani, Shaoling Huang, David D Mcpherson, Christy K Holland

Faculty, Staff and Student Publications

The development of adjuvant techniques to improve thrombolytic efficacy is important for advancing ischemic stroke therapy. We characterized octafluoropropane and recombinant tissue plasminogen activator (rt-PA)-loaded echogenic liposomes (OFP t-ELIP) using differential interference and fluorescence microscopy, attenuation spectroscopy, and electrozone sensing. The loading of rt-PA in OFP t-ELIP was assessed using spectrophotometry. Further, it was tested whether the agent shields rt-PA against degradation by plasminogen activator inhibitor-1 (PAI-1). An in vitro system was used to assess whether ultrasound (US) combined with either Definity or OFP t-ELIP enhances rt-PA thrombolysis. Human whole blood clots were mounted in a flow system and visualized …

Navigating A Difficult Transition In Pulmonary Arterial Hypertension: A Clinical Case Study, Tina Hyman, Michael Salinero, Francisco Javier Jimenez-Carcamo, Margarita Pallares, Maribel Matos

Nursing & Health Sciences Research Journal

Over the past 20 years, Pulmonary Arterial Hypertension (PAH) patients and providers have seen an increase in options to treat PAH. Currently, there are choices for the delivery of medications approved to treat patients with PAH where at one point the only option was intravenous (IV) therapy. This case study details the transition from IV Epoprostenol to oral Treprostinil for the treatment of a 53 year old female diagnosed with severe Pulmonary Arterial Hypertension whose quality of life became unbearable by the IV medication delivery route. This patient was a synchronized swimmer in her youth and her passion for water …

Challenges Of Implementing An Individual Randomized Controlled Trial (Women First: Preconception Maternal Nutrition Study) In A Rural Study Site: A Case Study From Pakistan, Sumera Aziz Ali, Umber S. Khan, Farina Abrejo, Sarah Saleem, Michael K. Hambidge, Nancy F. Krebs, Jamie E. Westcott, Robert L. Goldenberg, Elizabeth M. Mcclure, Omrana Pasha

Community Health Sciences

Persistent global disparities in maternal and neonatal outcomes associated with poor maternal nutrition provided the genesis of the Women First (WF) study, an individually randomized controlled trial on preconceptional maternal nutrition. This article describes the challenges that arose in implementing this trial related to nutrition or diet of the mother, in District Thatta-Pakistan. During different phases of the study, we encountered problems in identifying the eligible participants, taking consent from couples, randomizing participants in different arms, conducting biweekly follow-up visits on time, ensuring compliance to the intervention, and measuring the primary outcome within the 24 hours of birth. Each challenge …

Short Relative Leg Length Is Associated With Overweight And Obesity In Mexican Immigrant Women, Mireya Vilar-Compte, James Macinko, Beth C. Weitzman, Carlos M. Avendaño-Villela

Department of Public Health Scholarship and Creative Works

Background: Prior research suggests that undernutrition and enteric infections predispose children to stunted growth. Undernutrition and infections have been associated with limited access to healthy diets, lack of sanitation, and access barriers to healthcare - all associated with human rights. Stunting has also been documented to be a major determinant of subsequent obesity and non-communicable diseases. Short leg length relative to stature during adulthood seems to be a good proxy indicator tracking such barriers, and has been reported to be associated with adverse health effects during adulthood. Our objective was to examine the association between relative leg length (as measured …