Medicine and Health Sciences Commons^™

Targeting Wnt/Β-Catenin Pathway In Hepatocellular Carcinoma Treatment, Valery Vilchez, Lilia M. Turcios, Francesc Marti, Roberto Gedaly

Surgery Faculty Publications

Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death worldwide. Liver cancer is generally related to hepatitis B or C infection and cirrhosis. Usually, patients with HCC are asymptomatic and are diagnosed at late stages when surgical treatment is no longer suitable. Limited treatment options for patients with advanced HCC are a major concern. Therefore, there is an urge for finding novel therapies to treat HCC. Liver cancer is highly heterogeneous and involved deregulation of several signaling pathways. Wnt/β-catenin pathway is frequently upregulated in HCC and it is implicated in maintenance of tumor initiating cells, drug …

Unbalanced But Satisfied?, Asha N. Shenoi

Pediatrics Faculty Publications

No abstract provided.

Phlpp Negatively Regulates Cell Motility Through Inhibition Of Akt Activity And Integrin Expression In Pancreatic Cancer Cells, Alena J. Smith, Yang-An Wen, Payton D. Stevens, Jingpeng Liu, Chi Wang, Tianyan Gao

Markey Cancer Center Faculty Publications

Pancreatic adenocarcinoma is currently the fourth leading cause for cancer-related mortality. Malignant progression of pancreatic cancer depends not only on rapid proliferation of tumor cells but also on increased cell motility. In this study, we showed that increased PHLPP expression significantly reduced the rate of migration in pancreatic ductal adenocarcinoma (PDAC) cells whereas knockdown of PHLPP had the opposite effect. In addition, cell motility at the individual cell level was negatively regulated by PHLPP as determined using time-lapse imaging. Interestingly, the expression of β1 and β4 integrin proteins were decreased in PHLPP overexpressing cells and increased in PHLPP knockdown cells …

Local Admixture Of Amplified And Diversified Secreted Pathogenesis Determinants Shapes Mosaic Toxoplasma Gondii Genomes, Hernan Lorenzi, Asis Khan, Michael S. Behnke, Sivaranjani Namasivayam, Lakshmipuram S. Swapna, Michalis Hadjithomas, Svetlana Karamycheva, Deborah Pinney, Brian P. Brunk, James W. Ajioka, Daniel Ajzenberg, John C. Boothroyd, Jon P. Boyle, Marie L. Dardé, Maria A. Diaz-Miranda, Jitender P. Dubey, Heather M. Fritz, Solange M. Gennari, Brian D. Gregory, Kami Kim, Jeroen P. J. Saeij, Chunlei Su, Michael W. White, Xing-Quan Zhu, Daniel K. Howe, Benjamin M. Rosenthal, Michael E. Grigg, John Parkinson, Liang Liu, Jessica C. Kissinger

Veterinary Science Faculty Publications

Toxoplasma gondii is among the most prevalent parasites worldwide, infecting many wild and domestic animals and causing zoonotic infections in humans. T. gondii differs substantially in its broad distribution from closely related parasites that typically have narrow, specialized host ranges. To elucidate the genetic basis for these differences, we compared the genomes of 62 globally distributed T. gondii isolates to several closely related coccidian parasites. Our findings reveal that tandem amplification and diversification of secretory pathogenesis determinants is the primary feature that distinguishes the closely related genomes of these biologically diverse parasites. We further show that the unusual population structure …

Metabolomics Workbench: An International Repository For Metabolomics Data And Metadata, Metabolite Standards, Protocols, Tutorials And Training, And Analysis Tools, Manish Sud, Eoin Fahy, Dawn Cotter, Kenan Azam, Ilango Vadivelu, Charles Burant, Arthur Edison, Oliver Fiehn, Richard M. Higashi, K. Sreekumaran Nair, Susan Sumner, Shankar Subramaniam

Toxicology and Cancer Biology Faculty Publications

The Metabolomics Workbench, available at www.metabolomicsworkbench.org, is a public repository for metabolomics metadata and experimental data spanning various species and experimental platforms, metabolite standards, metabolite structures, protocols, tutorials, and training material and other educational resources. It provides a computational platform to integrate, analyze, track, deposit and disseminate large volumes of heterogeneous data from a wide variety of metabolomics studies including mass spectrometry (MS) and nuclear magnetic resonance spectrometry (NMR) data spanning over 20 different species covering all the major taxonomic categories including humans and other mammals, plants, insects, invertebrates and microorganisms. Additionally, a number of protocols are provided for …

Serum Amyloid A Impairs The Antiinflammatory Properties Of Hdl, Chang Yeop Han, Chongren Tang, Myriam E. Guevara, Hao Wei, Tomasz Wietecha, Baohai Shao, Savitha Subramanian, Mohamed Omer, Shari Wang, Kevin D. O'Brien, Santica M. Marcovina, Thomas N. Wight, Tomas Vaisar, Maria C. De Beer, Frederick C. De Beer, William R. Osborne, Keith B. Elkon, Alan Chait

Physiology Faculty Publications

HDL from healthy humans and lean mice inhibits palmitate-induced adipocyte inflammation; however, the effect of the inflammatory state on the functional properties of HDL on adipocytes is unknown. Here, we found that HDL from mice injected with AgNO₃ fails to inhibit palmitate-induced inflammation and reduces cholesterol efflux from 3T3-L1 adipocytes. Moreover, HDL isolated from obese mice with moderate inflammation and humans with systemic lupus erythematosus had similar effects. Since serum amyloid A (SAA) concentrations in HDL increase with inflammation, we investigated whether elevated SAA is a causal factor in HDL dysfunction. HDL from AgNO₃-injected mice lacking Saa1.1 …

Color Your Plate: A Pilot Nutrition Education Intervention To Increase Fruit And Vegetable Intake Among Older Adults Participating In The Congregate Meal Site Program In Kentucky Senior Centers, Emily Dickens

Theses and Dissertations--Nutrition and Food Systems

The purpose of this study was to determine if the amount and variety of fruit and vegetable intake increased among community-dwelling older adults participating in Kentucky’s congregate meal site program following a series of educational nutrition lessons. A convenience sample (n=35) of community-dwelling older adults at two intervention (n=19) and two control (n=16) senior centers in central Kentucky participated in this quasi-experimental pre-post pilot study. Following the intervention there was a trend towards increased self-reported intake in the variety of fruit and vegetables among the intervention group (range:0.03±3.31 to 1.32±2.75 servings per week); a significant increase in the number of …

Promoting Healthy Eating And Physical Activity: A Qualitative Examination Of Community-Based Obesity Interventions In Rural Kentucky, Brooke F. Butterworth

Theses and Dissertations--Nutrition and Food Systems

Rural Americans are medically underserved groups and are at greater risk of becoming obese than urban Americans. The purpose of this qualitative study was to determine the perceived causes of obesity in six counties of rural Kentucky and to determine how to customize strategies to reduce obesity in these areas. University of Kentucky Cooperative Extension Service Agents formed coalitions in each of the six counties to assess their communities’ needs and assets to inform plans for implementing evidence-based obesity interventions. Between February and August of 2015, the coalitions were convened for a total of 11 meetings. Each of the coalition …

Perceived Stress, Caffeine Consumption, And Gpa Of Undergraduate Students At A Large Public University, Emma Simpson

Theses and Dissertations--Nutrition and Food Systems

Evidence suggests that college students may increase caffeine consumption to cope with the stress and demands of college. The relationships between perceived stress, caffeine consumption, and GPA were examined in students at a large public university. Students were surveyed to determine perceived stress (Cohen’s Perceived Stress Questionnaire), beliefs about caffeine, caffeine consumption, workload in and outside of the classroom, and GPA. Surveys were administered at the beginning of the semester and again at midterm. Based on Cohen’s 40-point scale, average stress scores increased from 15.95 ± 6.34 at the beginning of the semester to 18.89 ± 6.94 at midterms. Additionally, …

Novel Role Of Cd47 In Obesity-Associated Metabolic Dysfunctions, Heather L. Norman-Burgdolf

Theses and Dissertations--Pharmacology and Nutritional Sciences

Obesity and its associated comorbidities are of global concern. These complications are largely driven by perturbations in energy homeostasis, inflammation, and oxidative stress within metabolic tissues. Although these underlying pathways have been established, molecular mechanisms augmenting metabolic dysfunction have not been fully defined. CD47, a ubiquitously expressed cell membrane receptor, has been previously implicated in the development of inflammation and oxidative stress in a number of disease conditions. Previous work from our lab and others has confirmed that the most potent ligand of CD47, TSP1, plays a critical role in facilitating inflammation and metabolic dysfunction in diet-induced obesity. Whether these …

Sexual Minority (Lgbtq) Youth And Role Of Health Care Provider, Mandakini Sadhir, Stephanie J. Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

Adolescence is a time period of physical, psychological and cognitive changes. It is an important phase for an individual to discover who they really are (self-identity), how they are perceived (social identity) and how they fit into the environment they live in.¹ One of the major tasks of adolescence is sexual maturation and sexual and /or gender identity development.² Adolescents who are developing as gay, lesbian, bisexual or transgender face a tremendous challenge of establishing their identity which is often complex.³ They cope with the feelings of being different and are in constant dilemmas about revealing their …

Evaluation Of Guideline-Recommended Combined Antiretroviral Treatment Regimens In Commercially-Insured Patients Living In The United States Between 2007 And 2009, Joye Brigitte Allen

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Randomized clinical trials of combination antiretroviral therapy (cART) inform the use of specific antiretrovirals (ARV) and their combination for optimizing therapeutic efficacy. It is critical that patients have access to and receive the most appropriate first-line treatment.

Objective: To examine factors that impact receiving initial guideline-recommended cART within a cohort of commercially insured patients in the United States (US)

Research Design: A population based cohort study.

Data Sources: A secondary administrative insurance claims database.

Subjects: Employed, commercially insured individuals with HIV who were continuously eligible for insurance coverage from January 2007 through December 2009 and received a new ARV …

Undiagnosed Pulmonary Obstruction And Restriction And Dust Exposure: Pilot Investigations Examining The Relationship Among Agricultural Workers, Caroline E. Holsinger

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Chronic obstructive pulmonary disease (COPD) is a progressive disease that is characterized by limited airflow.1 In the United States (U.S.) alone, COPD is the third leading cause of death.2,3 While smoking remains the strongest risk factor for COPD, 20 percent of patients who die from COPD have never smoked.5–7 The American Thoracic 3 Society showed that about 15% of COPD cases might be attributable to workplace exposure.8 Agricultural dust exposure has long been recognized as a cause of decreased respiratory function, and exposures to both forms of dust may exacerbate other important risk factors of COPD and lead to the …

An Assessment Of Workplace Injury In Kentucky’S Commercial Logging Industry, Logan Ray

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: To identify demographic, operational, and task-related characteristics associated with increased frequency and severity of injury in Kentucky’s commercial loggers.

Methods: Kentucky Master Loggers attending mandatory continued education courses completed a survey tool eliciting demographic and operational characteristics of their companies, and details of any on-site injury in the years 2012 through 2015 that led to medical costs, lost days or time, and/or decreased production. Associations to injury frequency and injury severity were assessed using logistic regression analysis.

Results: 86 Kentucky Master Loggers representing 66 of Kentucky’s 120 counties reported 33 accounts of non-fatal logging injury. Master Loggers were full-time …

Cross Sectional Analysis Of Patients With Alpha-1 Antitrypsin Deficiency Enrolled In A Disease Management And Prevention Program, Jordan T. Perkins

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Alpha-1 antitrypsin deficiency is a heritable genetic condition that is largely underdiagnosed and has been estimated to affect 1 out of every 5,000-7,000 people in North America. The condition is characterized by a decrease in the production or activity of the alpha-1 antitrypsin protein, increasing risk for chronic lung or liver inflammation, that may lead to disease. Currently, there is no cure for the condition and augmentation therapy, which replaces the lost protein, has shown mixed results, meaning preventive measures taken by the patient are a large component of the prescribed treatment. Thus, patients with the condition are strongly …

The Association Between Latent Tuberculosis Infection And Diabetes Mellitus Control In The United States, Whitney L. Remy

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Rationale: Diabetes mellitus (DM) is recognized as a common comorbid condition for tuberculosis (TB). Those with comorbid conditions are more likely to develop active TB, to have trouble with treatment, and to have more severe symptoms.

Objective: To measure the prevalence and distribution of latent tuberculosis infection (LTBI) and DM control in the United State and test their association when measured by tuberculin skin test (TST) or QuantiFERON®-TB Gold In-Tube blood test (QFT-GIT) and by HbA1c, respectively. Literature Review: One-third of the world population is infected with TB. Ten percent of TB cases worldwide are linked to diabetes mellitus. Studies …

Occupational Risks For Recent Asthma Episodes Among Adults, Molly Reese

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective

Asthma affects more than 37 million Americans at some point in their lives, making it one of the most common, but costly chronic conditions. There are many known risk factors for asthma, but additional research on environmental and occupational factors is needed to better understand the association between these variables and asthma. This study investigates the associations between occupational exposures and asthma episodes among adults.

Methods

Data was obtained from the 2011-2013 Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey for adults. There was a final study population of 11,408 participants after the exclusion criteria were applied. The …

An Instrument To Measure Dental Students' Communication Skills With Patients In Six Specific Circumstances: An Exploratory Factor Analysis, Joanna Alice Aalboe, Mitzi M. Schumacher

Center for Oral Health Research Faculty Publications

The aim of this study was to explore the internal structure of an instrument assessing dental students' confidence in their ability to communicate with patients in six specific circumstances (anxious, in pain, etc.) using exploratory factor analysis. In a Communication in the Dental Health Care Setting course at a U.S. dental school, second-year dental students in two years (2013 and 2014) responded to the six items on a survey instrument. Of the total 123 students, 122 fully completed the instrument, for a response rate of 99%. Analysis of the results identified a unidimensional scale with regards to patient-specific communication self-efficacy …

Chronic Pancreatitis, Pain, And Anxiety In An Alcohol And High Fat Mouse Model, Tiffanie Clinkinbeard

Theses and Dissertations--Gerontology

Homeodynamic space (HDS) shrinks as vulnerability increases with aging and repeated damage to the cells. HDS is lost in alcoholic pancreatitis patients due to overconsumption of alcohol, smoking, and high fat diets. Etiologically relevant animal models for study of chronic pancreatitis (CP) are needed. In order to begin filling this gap a central purpose of this dissertation research was to examine relationships between the alcohol and high fat diet (AHF) and pancreatitis with attention to hypersensitivity and anxiety-like behaviors. The AHF diet induced pancreatitis described here etiologically mimics human risk factors of AHF consumption for advancement to alcoholic CP.

In …

Molecular Genetics Of Ms4a6a And Alzheimer's Disease, Ryan Harpole

Lewis Honors College Capstone Collection

Increased Alzheimer’s disease (AD) risk has previously been associated with a SNP called rs610932 near the gene MS4A6A. The goal of this experiment was to quantify the expression of two MS4A6A isoforms in the brains of AD and non-AD subjects, particularly as a function of rs610932 genotype. According to an article titled “Alzheimer’s Disease Susceptibility Variants in the MS4A6A Gene are Associated with Altered Levels of MS4A6A Expression in Blood”, MS4A6A has four different isoforms that have been reported to be differentially expressed in the blood of AD subjects compared to non-AD subjects (Petroula et al., 2014). After statistically …

The Impact Of General Strike On Government Healthcare Delivery In Kerala State In India, Aasems Jacob, Heidi L. Weiss, Aju Mathew

Markey Cancer Center Faculty Publications

General strike (also known as hartal) is used as a mode of protest by organizations and political parties in India. It is generally thought that hartals negatively impact the healthcare delivery in a society. We used the Right to Information Act to obtain data from government health centers in Kerala state in India for four hartal days (H-day) and two control days (A-day and B-day) for each H-day, from sixteen health centers including 6 Community Health Center (CHC), 6 Secondary Health Center (SHC), and 4 Tertiary Health Center (THC). Data on emergency room visits was available for six HCs. 15 …

Molecular Cause And Functional Impact Of Altered Synaptic Lipid Signaling Due To A Prg-1 Gene Snp, Johannes Vogt, Jenq-Wei Yang, Arian Mobascher, Jin Cheng, Yunbo Li, Xingfeng Liu, Jan Baumgart, Carine Thalman, Sergei Kirischuk, Petr Unichenko, Guilherme Horta, Konstantin Radyushkin, Albrecht Stroh, Sebastian Richers, Nassim Sahragard, Ute Distler, Stefan Tenzer, Lianyong Qiao, Klaus Lieb, Oliver Tüscher, Harald Binder, Nerea Ferreiros, Irmgard Tegeder, Andrew J. Morris, Sergiu Gropa, Peter Nürnberg, Mohammad R. Toliat, Georg Winterer, Heiko J. Luhmann, Jisen Huai, Robert Nitsch

Gill Heart & Vascular Institute Faculty Publications

Loss of plasticity‐related gene 1 (PRG‐1), which regulates synaptic phospholipid signaling, leads to hyperexcitability via increased glutamate release altering excitation/inhibition (E/I) balance in cortical networks. A recently reported SNP in prg‐1 (R345T/mutPRG‐1) affects ~5 million European and US citizens in a monoallelic variant. Our studies show that this mutation leads to a loss‐of‐PRG‐1 function at the synapse due to its inability to control lysophosphatidic acid (LPA) levels via a cellular uptake mechanism which appears to depend on proper glycosylation altered by this SNP. PRG‐1^+/− mice, which are animal correlates of human PRG‐1^+/mut carriers, showed an altered cortical network …

Cobalt Use And Regulation In Horseracing: A Review, K. Brewer, G. Maylin, C. K. Fenger, Thomas Tobin

Veterinary Science Faculty Publications

Cobalt, atomic weight 58.9, is a metallic element and environmental substance found in the animal in microgram quantities, predominantly as vitamin B12, but is also a component of at least one mammalian enzyme unassociated with B12. Cobalt is a required trace mineral and has long been administered as a dietary supplement to humans and animals. Cobalt deficiency outside of its requirement in vitamin B12 has not been reported in humans. The administration of cobalt salts was once standard treatment for anaemia in humans, owing to its ability to stimulate red blood cell synthesis. Elemental cobalt acts by stabilising hypoxia inducible …

Music Therapy As Procedural Support For Young Children Undergoing Immunizations: A Randomized Controlled Study, Olivia S. Yinger

Music Faculty Publications

Background: Children undergoing routine immunizations frequently experience severe distress, which may be improved through music therapy as procedural support.

Objective: The purpose of this study was to examine effects of live, cognitive-behavioral music therapy during immunizations on (a) the behaviors of children, their parents, and their nurses; and (b) parental perceptions.

Methods: Participants were children between the ages of 4 and 6 years (N = 58) who underwent immunizations, their parents (N = 62), and the nurses who administered the procedure (N = 19). Parent/child dyads were randomly assigned to receive music therapy (n = 29) …

Improvement Of Under-Represented Minority Individuals In The Healthcare Field Of Communication Sciences And Disorders, Allison Webb

Lewis Honors College Capstone Collection

Individuals from under-represented minority backgrounds are scarce within healthcare careers. Former research has suggested that this lack of diversity begins at the undergraduate level. This proposal discusses a potential solution to this problem occurring at the University of Kentucky and other colleges across the United States. Suggested intervention targeted diverse populations, connected students with faculty and staff, and provided shadowing resources for individuals from under-represented minority backgrounds. Based on research and current diversity statistics, populations of individuals from diverse backgrounds are expected to increase within the Communication Sciences and Disorders program. Demographic information for the fall 2016 semester will become …

Modeling Dementia Risk, Cognitive Change, Predictive Rules In Longitudinal Studies, Xiuhua Ding

Theses and Dissertations--Epidemiology and Biostatistics

Dementia is increasing recognized as a major problem to public health worldwide. Prevention and treatment strategies are in critical need. Nowadays, research for dementia usually featured as complex longitudinal studies, which provide extensive information and also propose challenge to statistical methodology. The purpose of this dissertation research was to apply statistical methodology in the field of dementia to strengthen the understanding of dementia from three perspectives: 1) Application of statistical methodology to investigate the association between potential risk factors and incident dementia. 2) Application of statistical methodology to analyze changes over time, or trajectory, in cognitive tests and symptoms. 3) …

The Effect Of Varying Bisphosphonate Treatment On Changes In Bone Microdamage In Osteoporotic Women, Stefanie L. Pagano

Theses and Dissertations--Biomedical Engineering

Bisphosphonates (BPs) are used for the treatment of osteoporosis. This study evaluated changes in bone microdamage with BP treatment duration. Fifty-one iliac crest biopsies were obtained from Caucasian women, ages 41 to 87 years, who were previously diagnosed and treated for osteoporosis with oral BPs for 1-16 years duration. Patients diagnosed with any disease, drug, or substance abuse that may affect bone metabolism were excluded.

Bone samples were sectioned, stained, and histologically examined using light and fluorescence microscopy. Bone area, number and length of microcracks were quantified. Following adjustment for age, BMD, BV/TV, trabecular thickness, and turnover, regression analysis revealed …

Medication Adherence After Post Percutaneous Coronary Intervention: An Educational Intervention, Rebecca Shelton Thomas

DNP Projects

Purpose: The purpose of this evidenced-based education project was (i) assess current barriers and determining factors associated with medication adherence and how this coincides with health outcomes, (ii) assess whether medication adherence and hospital re-admission rates were improved with a comprehensive medication discharge educational plan.

Setting: The project took place on a 35 bed post interventional care unit (4IC) located in a 433 bed community care hospital in Central Kentucky.

Population: The population for this study was a sample of 10 acute myocardial infarction patients post percutaneous coronary intervention. Thirty percent of participants were female and 60% were male. Mean …

Patient Characteristics Associated With Inpatient Psychiatric Re-Admissions And The Utility Of The Readmit Clinical Risk Index, Autumn P. Roque

DNP Projects

In response to the problem of frequent 30 day re-admissions to inpatient psychiatric facilities, Vigod and colleagues (2015) developed the READMIT clinical risk index to identify risk factors for psychiatric inpatient re-admissions. The question addressed in this study was: Can the READMIT clinical risk index be used to identify patients that are at high risk for 30 day inpatient psychiatric re-admissions at Eastern State Hospital? This project used a descriptive retrospective design. Data were extracted from the discharge summaries of patients discharged from Eastern State Hospital between September 2013 and December 2014. Data collected included patient demographic variables (age, gender, …

Piloting An Intervention To Improve Continuity In Lung Cancer Patients, Stacy L. Richey

DNP Projects

Purpose: Kentuckians facing a lung cancer diagnosis are at greater risk for care fragmentation due to the complexities associated with the diagnosis, staging and treatment of the disease combined with multiple health disparities such as advanced age, multiple comorbid conditions, low socioeconomic status, geographic isolation, and low literacy levels. Transitioning from primary to specialist care can be especially difficult for these patients. The main purpose of this paper was to determine the feasibility and effect of a nurse-led, multidimensional intervention designed to improve relational (RC), informational (IC), and management continuity (MC) across the primary to secondary care interface, as well …