Medicine and Health Sciences Commons^™

Feasibility Of A Laboratory Model For Evaluating The Use Of An Alternative Response Option In Mitigating Caregiver Treatment Integrity Errors, Jessie K. Weber

Theses & Dissertations

The current study assessed the feasibility of a laboratory model designed to evaluate options for mitigating common caregiver errors in the implementation of destructive behavior treatment. We developed a computer-based analogue to caregiver implementation of extinction for attention-maintained destructive behavior; the model included contingencies on both caregiver errors of commission and adherence to the treatment protocol. We also conducted a preliminary investigation of the effects of participant access to alternative activities as a potential strategy for mitigating integrity errors. Participants included 14 MTurk workers or staff in a severe behavior clinic, and individual response patterns revealed distinct sensitivities to the …

Impacts Of Perinatal Oxycodone Exposed Offspring In Early Adolescence, Adrian Flores

Theses & Dissertations

The Opioid Epidemic has been a point of public health interest for the last twenty years. In this time, use of prescription opioids has grown exponentially, including use by pregnant women. The initial crisis has been focused on mitigating immediate problems such as lowering the significant loss of life in overdoses and providing support to cessation. Despite these advancements a separate phenomenon is on the rise: The rise in neonatal opioid withdrawal syndrome in neonatal care and associated challenges for these children as they age.

Currently preclinical research and epidemiological data suggests that exposed children are at risk for experiencing …

The Impact Of An Educational Cooking Class On Inflammatory Potential Of Diet In Cancer Survivors, Mariah K. Jackson

Theses & Dissertations

Cancer survivors face long-term effects from cancer treatments, with cognitive dysfunction being an important, yet understudied, consequence of cancer treatment. Inflammation is a proposed mechanism for impaired cognition status. As research demonstrates diet is associated with both pro- and anti-inflammatory effects, diet may represent a novel strategy to mitigate cognitive decline in cancer survivors. The purpose of this study was to 1) quantify the impact of an educational cooking class on inflammatory potential of diet (measured by the Dietary Inflammatory Index (DII)) in cancer survivors and 2) determine the relationship between dietary changes and cognitive function in cancer survivors. Dietary …

Association Of Inflammatory Markers And Growth Factors With Radiographically Assessed Wound Healing Of Extraction Sockets, Sasha Mohammadi

Theses & Dissertations

The purpose of this prospective cohort pilot study was to investigate the association of the periodontal status and inflammatory markers from the gingival crevicular and wound fluid with the healing outcomes following tooth extraction. The central research hypothesis is that extraction sites and the adjacent teeth that exhibit increased markers of inflammation, or decreased growth factors, at baseline or 2 weeks will be associated with reduced healing outcomes observed radiographically 3 months following surgery. Nine patients at the UNMC College of Dentistry who were seeking care to extract a posterior tooth due to advanced periodontal bone loss, non-restorable caries or …

Exploiting Vulnerabilities In The Ras-Rac Signaling Pathway For The Selective Targeting Of Pancreatic Cancer Cells, Neha Chaudhary

Theses & Dissertations

Deregulation of the KRas (Kirsten rat sarcoma virus) GTPase is one of the early hallmarks of Pancreatic Cancer (PC). The most common genetic alteration found in PC are mutations in the KRas protein that block its ability to hydrolyze GTP to GDP and resulting in higher levels of GTP-bound KRas, its active form. Pancreatic tumors driven by oncogenic mutants of KRas tend to be addicted to the oncogene, to the extent that its repression leads to the induction of cell death. This addiction to the KRAS oncogene makes the KRas protein an ideal target for cancer therapy. However, the globular …

Design And Synthesis Of Small Molecule Drugs For Cns Disorders, Kirsten T. Tolentino

Theses & Dissertations

Dopamine (DA) is an important neurotransmitter for the regulation and long-term function of the central nervous system (CNS). DA binds to Dopamine Receptors (DR) to stimulate or inhibit adenyl cyclase production to further elicit a pharmacological response. DRs were cloned, and it was determined that there are two families separated by their function and five total subtypes distinguished by their amino acid structure. The Dopamine 4 receptor (D4R) is the second least studied subtype but has high expression in the frontal cortex, amygdala, hippocampus, hypothalamus, globus pallidus, substantia nigra pars reticula, and thalamus. Dopamine signaling and transmission, especially in the …

Improving Peripheral Nerve Regeneration Through Rehabilitation And Biomaterial-Based Drug Delivery Strategies, Yunfan Kong

Theses & Dissertations

Peripheral nerve injury (PNI) is a common problem worldwide, with trauma being a common cause. PNI can lead to loss of sensory and motor functions, chronic neuropathic pain, and mental health issues, significantly impacting patients' family life, work, and social situation. Recent studies revealed that beyond the topical injury site at peripheral nerves, PNIs can also induce dysfunctions in the central nervous system (CNS) by causing maladaptive plasticity, which will result in exaggeration and exacerbation of the pathological condition caused by primary injuries. The common therapy strategies for PNI treatment are using sutures, nerve autografts or conduits in cases requiring …

Effect Of Computerized Cognitive Training In Persons With Multiple Sclerosis, Sam Jack

Theses & Dissertations

Between one million and 1.75 million persons with multiple sclerosis (PwMS) worldwide are estimated to suffer from cognitive impairment. Unfortunately, there is currently no consensus on the best treatment for cognitive impairment in PwMS. Finding non-pharmacological interventions to mitigate cognitive decline is essential to ensure that quality of life for PwMS matches our ability to treat and mitigate their physical symptoms of MS. Computerized cognitive training has emerged as a potential option for PwMS suffering from cognitive impairment. The objective of this study was to determine the effectiveness of computerized cognitive training with BrainHQ on changes in cognitive impairment for …

Evaluating The Impact Of Routine Enteral Iron Fortification On Gastrointestinal Dysbiosis In Premature Infants, Matthew Van Ormer

Theses & Dissertations

The gastrointestinal microbiome in preterm infants bears significant influence on optimal outcomes – dysbiosis is shown to substantially increase the risk of the life-threatening necrotizing enterocolitis, whereas optimal microbiome composition improves nutrient digestion and immune function. Iron is a vital nutrient especially during the perinatal window of rapid hemoglobin production, tissue growth, and foundational neurological development. However, excess colonic iron exhibits potent oxidation capacity and alters the competitive environment of microbes – potentially facilitating the proliferation of pathological bacterial strains in the gut. Of note, breastfed preterm infants routinely receive iron fortification starting at 14 days of life and are …

Variations In Source And Pattern Of Arterial Supply To The Trigeminal Ganglion With Clinical Relevance, William S. Srinivasan

Theses & Dissertations

The trigeminal ganglion (TG) is known to receive its arterial supply from branches of the internal carotid artery (ICA), middle meningeal artery (MMA), accessory meningeal artery (AMA), or superior cerebellar artery (SCA). Existing information about the prevalence and patterns of blood supply to the TG is limited despite their high clinical relevance to basicranial surgeries. The objective of this study is to investigate the source and pattern of arterial supply to TG and discuss their clinical relevance. Left and right TG were examined on 75 embalmed human cadavers from an ethically approved anatomical donor program. A literature review was conducted, …

Cystic Duct Morphology And Heister Valves: A Cadaveric Study, Cierra R. Goerish

Theses & Dissertations

Continued occurrence of cholelithiasis, gallstones, commonly results in cholecystectomy, removal of the gallbladder. Having a comprehensive anatomical, histological, and physiological knowledge of the biliary apparatus is imperative in clinical medicine today. Additionally, the functionality of cystic duct (CD) Heister valves (HV) has been speculatory since being reported in 1732. This study summarizes the morphology, orientation, and variability of the gross biliary system and provides data to help justify HV functionality.

Cadaveric dissection was utilized for gross observation and analysis of the biliary system. The angulation of the CD was found primarily as an acute angle; however, obtuse angulation could be …

Use Of Pre-Transplant Cmi To Predict Infection And Mortality Post-Cardiac Transplantmortality Post-Cardiac Transplant, Chetaj A. Mahabir

Theses & Dissertations

This paper discusses a study investigating the relationship between the cell-mediated immunity (CMI) level before cardiac transplant and the incidence of infection and mortality after the transplant. CMI is an important measure of a person's immune system. The study included 126 patients who underwent cardiac transplants between September 2011 and January 2020. Out of these, 21 patients had a low CMI level (<225), and 105 had a high CMI level (≥ 225) before transplant. The mean CMI level in the low CMI group was 175.3, while in the high CMI group, it was 479.9. The two groups were similar except for the lower white cell count and cardiac output in the CMI< 225 groups and the higher Caucasian demographic in the CMI≥ 225 groups. The study concludes that patients with lower CMI levels before cardiac transplant have a higher risk of infection (p=0.052) and mortality (p=0.005) one year after the transplant. The risk of dying for patients with CMI <225 is 12.9 times the risk of dying for patients with CMI ≥ 225 after adjusting for the other covariates in the model. However, this study has some limitations including its retrospective nature, small sample size, and single-center design. Further studies are needed to replicate these findings and investigate the optimal immunosuppressive regimens based on baseline CMI levels.

Mechanisms Of Mutated Myosin Vb Mediated Cholestasis In Microvillus Inclusion Disease, Melissa S. Holzapfel

Theses & Dissertations

Microvillus inclusion disease (MVID) is a constitutive intestinal epithelial disease which causes definitive intestinal failure and cholestatic liver disease primarily caused by mutations in the Myosin Vb gene. Genotype-clinical phenotype associations suggest that the progression of liver disease can be predicted through a correlation between myosin Vb residual function and variable retention of bile salt transport machinery in intestinal enterocytes and liver hepatocytes. We proposed that aberrant distribution of bile salt transport proteins disrupts enterohepatic regulation of bile acids and contributes to the progression of cholestatic liver disease. To investigate the genotype-phenotype correlation, samples from MVID patients were evaluated for …

Translating A Pediatric Weight Management Intervention Into Medically Underserved Areas, Caitlin Golden

Theses & Dissertations

Despite substantial prevention and treatment efforts, childhood obesity remains a pressing public health concern. Disparities persist in obesity prevalence among children of lower socioeconomic status, racial and ethnic minority groups, and those residing in rural areas. The vast majority of efficacious pediatric weight management interventions (PWMIs) have been based in larger cities and urban areas delivered through inter-disciplinary teams in a hospital or medical center, and the degree to which these or other efficacious PWMIs have been translated to, and are feasible in, typical rural or micropolitan areas is unclear. This dissertation describes a dissemination strategy and a systematic approach …