Medicine and Health Sciences Commons^™

Dnmt3a Haploinsufficiency Provokes Hematologic Malignancy Of B-Lymphoid, T-Lymphoid, And Myeloid Lineage In Mice, Garland Michael Upchurch

Theses & Dissertations

DNA methyltransferase 3A (DNMT3A) is a master epigenetic regulator of benign and malignant hematopoiesis. To dissect the biological consequences of homozygous and heterozygous Dnmt3a inactivation in malignant hematopoiesis, we generated Dnmt3a homozygous null (Dnmt3a^Δ/Δ) and Dnmt3a heterozygous (Dnmt3a^+/–) mice and compared the presentations of hematologic malignancies between cohorts. Bi-allelic inactivation of Dnmt3a results in the presentation of mature lymphoid neoplasms resembling chronic lymphocytic leukemia (CLL; B220⁺CD19⁺CD5⁺; 88% penetrance (37/42)) and CD8+ peripheral T-cell lymphoma (PTCL; TCRβ⁺CD3⁺CD8⁺CD4^—; 40% penetrance (17/42)). …

The Roles Of Ecdysoneless In Endoplasmic Reticulum Stress And Oncogenesis, Appolinaire A. Olou

Theses & Dissertations

Tumor cells are well known to exhibit ER stress as a result of their altered environment characterized by redox and calcium imbalance, deregulation of protein synthesis to meet their oncogenic demands, and decreased vascularization associated with nutrient limitation and hypoxia, all of which are conducive of ER stress. Accordingly, markers of ER stress signaling response are up-regulated in various cancers. The outcome of ER stress signaling response varies from survival and adaption to apoptosis. Although pro-apoptotic ER stress signaling molecules are up-regulated in cancer, the mechanisms by which cancer cells seem refractory to, or evade, their apoptotic signaling are not …

Carotid Body-Mediated Chemoreflex Drive In The Setting Of Low And High Output Heart Failure., Rodrigo Del Rio, David C. Andrade, Camilo Toledo, Hugo S. Diaz, Claudia Lucero, Alexis Arce-Alvarez, Noah J. Marcus, Harold D. Schultz

Journal Articles: Cellular & Integrative Physiology

Enhanced carotid body (CB) chemoreflex function is strongly related to cardiorespiratory disorders and disease progression in heart failure (HF). The mechanisms underlying CB sensitization during HF are not fully understood, however previous work indicates blood flow per se can affect CB function. Then, we hypothesized that the CB-mediated chemoreflex drive will be enhanced only in low output HF but not in high output HF. Myocardial infarcted rats and aorto-caval fistulated rats were used as a low output HF model (MI-CHF) and as a high output HF model (AV-CHF), respectively. Blood flow supply to the CB region was decreased only in …

Epidemiologic Factors Related To Adherence To The Referral Process And Treatment Of Cervical Cancer Patients In Tanzania, Khadija H. Msami

Capstone Experience: Master of Public Health

Background: Cervical cancer is of high concern particularly in developing countries as a leading cause of morbidity and mortality with significant burden on the health system. A better prognosis of cervical cancer could be achieved by early detection, diagnosis and treatment. This study aimed to ascertain the extent of delays, initiation and completion of treatment among patients with cervical cancer, during the referral pathway between Muhimbili National Hospital (MNH) and Ocean Road Cancer Institute (ORCI)- the highest points of referral for cancer care and management in Tanzania.

Methods: This retrospective study included the identification of patients diagnosed with cervical cancer …

Induction Of Mir-155 After Brain Injury Promotes Type 1 Interferon And Has A Neuroprotective Effect., Emily Harrison, Kathleen M. Emanuel, Benjamin G. Lamberty, Brenda M. Morsey, Min Li, Matthew L. Kelso, Sowmya V. Yelamanchili, Howard S. Fox

Journal Articles: Pharmacology & Experimental Neuroscience

Traumatic brain injury (TBI) produces profound and lasting neuroinflammation that has both beneficial and detrimental effects. Recent evidence has implicated microRNAs (miRNAs) in the regulation of inflammation both in the periphery and the CNS. We examined the expression of inflammation associated miRNAs in the context of TBI using a mouse controlled cortical impact (CCI) model and found increased levels of miR-21, miR-223 and miR-155 in the hippocampus after CCI. The expression of miR-155 was elevated 9-fold after CCI, an increase confirmed by in situ hybridization (ISH). Interestingly, expression of miR-155 was largely found in neuronal nuclei as evidenced by co-localization …

Use Of A Team Building Activity To Teach Clinical Decision-Making Concepts To Physical Therapy Students, Robert Fuchs, Betsy J. Becker

Posters and Presentations: Physical Therapy

PURPOSE : The purpose of this research was to find out if a team building exercise carried out by student groups will facilitate learning how to make clinical decision involving concepts from the International Classification of Function (ICF).

SIGNIFICANCE: Scant literature exists regarding the concept of integrating student and expert team case-based learning with the ICF to develop clinical decision-making skills.

SUBJECTS: Subjects were 213 first-year physical therapy students in the DPT program at UNMC in the first semester of the curriculum of years 2013-2016.

METHODS AND MATERIALS: A patient case was developed which included clinical decision-making steps using concepts …

Synaptic Ribbon Active Zones In Cone Photoreceptors Operate Independently From One Another., Justin J. Grassmeyer, Wallace B. Thoreson

Journal Articles: Ophthalmology

Cone photoreceptors depolarize in darkness to release glutamate-laden synaptic vesicles. Essential to release is the synaptic ribbon, a structure that helps organize active zones by clustering vesicles near proteins that mediate exocytosis, including voltage-gated Ca(2+) channels. Cone terminals have many ribbon-style active zones at which second-order neurons receive input. We asked whether there are functionally significant differences in local Ca(2+) influx among ribbons in individual cones. We combined confocal Ca(2+) imaging to measure Ca(2+) influx at individual ribbons and patch clamp recordings to record whole-cell ICa in salamander cones. We found that the voltage for half-maximal activation (V50) of whole …

Refugee Health Needs Assessment In Omaha, Nebraska, Dejun Su, Drissa Toure, Kandy Do, Naw Latt Nlam, Jessica Ern

Reports: Center for Reducing Health Disparities

No abstract provided.

Greater Involvement Of Hiv-Infected Peer-Mothers In Provision Of Reproductive Health Services As "Family Planning Champions" Increases Referrals And Uptake Of Family Planning Among Hiv-Infected Mothers., Peter Mudiope, Ezra Musingye, Carolyne Onyango Makumbi, Danstan Bagenda, Jaco Homsy, Mai Nakitende, Mike Mubiru, Linda Barlow Mosha, Mike Kagawa, Zikulah Namukwaya, Mary Glenn Fowler

Journal Articles: Health Services Research & Administration

BACKGROUND: In 2012, Makerere University Johns - Hopkins University, and Mulago National Referral Hospital, with support from the National Institute of Health (under Grant number: NOT AI-01-023) undertook operational research at Mulago National Hospital PMTCT/PNC clinics. The study employed Peer Family Planning Champions to offer health education, counselling, and triage aimed at increasing the identification, referral and family planning (FP) uptake among HIV positive mothers attending the clinic.

METHODS: The Peer Champion Intervention to improve FP uptake was introduced into Mulago Hospital PMTCT/PNC clinic, Kampala Uganda. During the intervention period, peers provided additional FP counselling and education; assisted in identification …

Greater Involvement Of Hiv-Infected Peer-Mothers In Provision Of Reproductive Health Services As "Family Planning Champions" Increases Referrals And Uptake Of Family Planning Among Hiv-Infected Mothers., Peter Mudiope, Ezra Musingye, Carolyne Onyango Makumbi, Danstan Bagenda, Jaco Homsy, Mai Nakitende, Mike Mubiru, Linda Barlow Mosha, Mike Kagawa, Zikulah Namukwaya, Mary Glenn Fowler

Journal Articles: Health Services Research & Administration

BACKGROUND: In 2012, Makerere University Johns - Hopkins University, and Mulago National Referral Hospital, with support from the National Institute of Health (under Grant number: NOT AI-01-023) undertook operational research at Mulago National Hospital PMTCT/PNC clinics. The study employed Peer Family Planning Champions to offer health education, counselling, and triage aimed at increasing the identification, referral and family planning (FP) uptake among HIV positive mothers attending the clinic.

METHODS: The Peer Champion Intervention to improve FP uptake was introduced into Mulago Hospital PMTCT/PNC clinic, Kampala Uganda. During the intervention period, peers provided additional FP counselling and education; assisted in identification …

Filling The Gap. Clinical Skill Acquisition With Interactive Online Modules To Supplement Traditional Instruction, Keriann Shaw, Betsy J. Becker, Nicole M. Sleddens, Robin High

Posters and Presentations: Physical Therapy

PURPOSE

The purpose of this study was to assess the effectiveness of interactive e-learning modules to supplement traditional instruction for range of motion (ROM) clinical skill acquisition in a doctor of physical therapy(DPT) curriculum.

BACKGROUNDS/SIGNIFICANCE

Online resources have become highly favored to augment learning especially by millennials for convenience, self-paced content, and versatility in learning styles. It has been reported that elearning platforms are as effective as traditional face-to-face instruction, but may be best utilized as an adjunctive resource for teaching psychomotor skills. Student confidence has also been analyzed with reports of increased self-efficacy with use of online learning materials. …

H2s And Homocysteine Control A Novel Feedback Regulation Of Cystathionine Beta Synthase And Cystathionine Gamma Lyase In Cardiomyocytes., Shyam Sundar Nandi, Paras K. Mishra

Journal Articles: Cellular & Integrative Physiology

Hydrogen sulfide (H2S), a cardioprotective gas, is endogenously produced from homocysteine by cystathionine beta synthase (CBS) and cystathionine gamma lyase (CSE) enzymes. However, effect of H2S or homocysteine on CBS and CSE expression, and cross-talk between CBS and CSE are unclear. We hypothesize that homocysteine and H2S regulate CBS and CSE expressions in a dose dependent manner in cardiomyocytes, and CBS deficiency induces cardiac CSE expression. To test the hypothesis, we treated murine atrial HL1 cardiomyocytes with increasing doses of homocysteine or Na2S/GYY4137, a H2S donor, and measured the levels of CBS and CSE. We found that homocysteine upregulates CSE …

Evaluation Of A Student-Centered Digital Education Project In Health Science Education, Betsy J. Becker

Posters and Presentations: Physical Therapy

Student-centered learning is essential and evidence shows higher levels of achievement when students are engaged with educational activities that include critical thinking and effective communication in addition to creativity. The aim of this prospective cohort study was to evaluate a student-centered digital education project during a course about physical therapy (PT) management of chronic diseases. The objectives of this student project were to apply content through a well thought-out digital project and critically analyze information considering multiple points of view. Each project was evaluated by faculty using a rubric, and students completed a self- and peer-assessment. All projects were shared …

Satisfaction Among Early And Mid-Career Dentists In A Metropolitan Dental Hospital In China, Xiaoxi Cui, David G. Dunning, Na An

Journal Articles: College of Dentistry

A growing body of research has examined career satisfaction among dentists using a standardized instrument, dentist satisfaction survey (DSS). This project examined career satisfaction of early to mid-career dentists in China, a population whose career satisfaction, heretofore, has not been studied. This is an especially critical time to examine career satisfaction because of health care reform measures being implemented in China. A culturally sensitive Chinese-language version of the DSS (CDSS) was developed and electronically administered to 367 early and mid-career dentists in a tertiary dental hospital in Beijing, China. One hundred and seventy respondents completed the survey. The average total …

Nano-Assembly Of Amyloid Β Peptide: Role Of The Hairpin Fold., Sibaprasad Maity, Mohtadin Hashemi, Yuri L. Lyubchenko

Journal Articles: Pharmaceutical Sciences

Structural investigations have revealed that β hairpin structures are common features in amyloid fibrils, suggesting that these motifs play an important role in amyloid assembly. To test this hypothesis, we characterized the effect of the hairpin fold on the aggregation process using a model β hairpin structure, consisting of two Aβ(14-23) monomers connected by a turn forming YNGK peptide. AFM studies of the assembled aggregates revealed that the hairpin forms spherical structures whereas linear Aβ(14-23) monomers form fibrils. Additionally, an equimolar mixture of the monomer and the hairpin assembles into non-fibrillar aggregates, demonstrating that the hairpin fold dramatically changes the …

Easi-Crispr: A Robust Method For One-Step Generation Of Mice Carrying Conditional And Insertion Alleles Using Long Ssdna Donors And Crispr Ribonucleoproteins., Rolen M Quadros, Hiromi Miura, Donald W Harms, Hisako Akatsuka, Takehito Sato, Tomomi Aida, Ronald Redder, Guy P Richardson, Yutaka Inagaki, Daisuke Sakai, Shannon M Buckley, Parthasarathy Seshacharyulu, Surinder K Batra, Mark A Behlke, Sarah A Zeiner, Ashley M Jacobi, Yayoi Izu, Wallace B Thoreson, Lisa D Urness, Suzanne L Mansour, Masato Ohtsuka, Channabasavaiah B Gurumurthy

Journal Articles: Munroe-Meyer Institute

BACKGROUND: Conditional knockout mice and transgenic mice expressing recombinases, reporters, and inducible transcriptional activators are key for many genetic studies and comprise over 90% of mouse models created. Conditional knockout mice are generated using labor-intensive methods of homologous recombination in embryonic stem cells and are available for only ~25% of all mouse genes. Transgenic mice generated by random genomic insertion approaches pose problems of unreliable expression, and thus there is a need for targeted-insertion models. Although CRISPR-based strategies were reported to create conditional and targeted-insertion alleles via one-step delivery of targeting components directly to zygotes, these strategies are quite inefficient. …

Association Between Leisure Time Physical Activity Preference And Behavior: Evidence From The China Health & Nutrition Survey, 2004-2011., Junmin Zhou, Denise H. Britigan, Shireen S. Rajaram, Hongmei Wang, Dejun Su

Journal Articles: Health Promotion, Social & Behavioral Health

BACKGROUND: Previous studies have suggested that food preference is a good indicator of actual food intake and that sedentary activity preference is a significant predictor of lower physical activity level. But no studies have examined the direct relationship between leisure time physical activity (LTPA) preferences and actual LTPA behavior, especially studies using longitudinal data. This study seeks to determine the association between these two variables, and to assess whether the association differs between urban and rural areas in China.

METHODS: A total of 2427 Chinese adults were included in the analysis. Spearman correlation coefficients were used to test the association …

Communicatively Constructing The Bright And Dark Sides Of Hope: Family Caregivers' Experiences During End Of Life Cancer Care, Jody Koenig Kellas, Katherine M. Castle, Alexis Johnson, Marlene Z. Cohen

Journal Articles: College of Nursing

(1) Background: The communication of hope is complicated, particularly for family caregivers in the context of cancer who struggle to maintain hope for themselves and their loved ones in the face of terminality. In order to understand these complexities, the current study examines the bright and dark sides of how hope is communicated across the cancer journey from the vantage point of bereaved family caregivers; (2) Methods: We analyzed interviews with bereaved family caregivers using qualitative thematic and case oriented strategies to identify patterns in the positive and negative lived experiences when communicating about hope at the end of life; …

Targeted Delivery Of Drug Combinations Via Nanocarriers For Cancer Treatment, Kruti Soni

Theses & Dissertations

Combination therapy is preferred over monotherapy to treat cancer as it can show better therapeutic outcomes and also delay the onset of resistance by targeting multiple cell-survival pathways in cancer cells. Rationally developed combinations with monoclonal antibodies and small molecule drugs in the form of antibody-drug conjugates or antibody nanoparticle conjugates allow us to take advantage of the cellular targeting of the potent cytotoxic agents, thereby widening the scope for dose reduction while maintaining the required therapeutic response. This can in turn improve patient tolerability by reducing the off target toxicities. For the therapy of ErbB2 positive breast cancer, the …

Dynamics Of Maternal And Infant Vitamin E Tocopherols During Nicu Hospitalization, Jana K. Wells

Theses & Dissertations

OBJECTIVE: The main objective of this prospective cohort is to investigate serum levels of vitamin E tocopherol isoforms (specifically alpha and gamma) in mothers and infants admitted to the Neonatal Intensive Care Unit (NICU) in relation to infant feeding modality.

METHODS: This was a prospective cohort of 34 mothers and their infants admitted to the neonatal intensive care unit (NICU). Samples of maternal and cord blood were collected at the time of delivery, and a food frequency questionnaire (FFQ) was administered to the mother to measure maternal vitamin E tocopherol intake. After nutrition treatment of each feeding modality had been …

Vitamin D Supplementation In Allo-Hsct Patients, Bailey Nelson

Theses & Dissertations

BACKGROUND: Bone health is a serious concern for long-term survivors of Allo-HSCT due to multiple risk factors including steroids, chemotherapy, immunosuppressive drugs, and poor nutrition status1. Steroids have been long proven to have negative impact on bone health and the National Osteoporosis Foundation (NOF) lists steroids as a contributing factor to osteoporosis and fractures. NOF guidelines recommend providing adequate daily vitamin D as a safe and inexpensive way to help reduce fracture risk1. Therefore, proper supplementation of vitamin D may increase the quality of life for patients post Allo-HSCT.

PURPOSE: The purpose of this study is to determine if Allo-HSCT …

Delivery Of Small Molecule And Rna For The Treatment Of Type 1 Diabetes And Prostate Cancer, Di Wen

Theses & Dissertations

The aim of this thesis is to develop combination therapy using a small molecule and RNA including siRNA, shRNA, or miRNA inhibitor for the treatment of type 1 diabetes and prostate cancer. New amphiphilic biodegradable polymers capable of co-delivering small hydrophobic molecules and RNAs or human bone marrow-derived mesenchymal stem cell (hBMSC) for co-delivery of an shRNA and a miRNA inhibitor were used as drug delivery platform. The drug delivery properties were evaluated in vitro and in vivo islet transplantation, subcutaneous and orthotopic prostate cancer models.

In Chapter 1, an overview of prostate cancer, the role of miRNA and …

Genetic Influence On Resilience To Potentially Traumatic Events, Kosuke Niitsu

Theses & Dissertations

Most individuals experience at least one potentially traumatic event (PTE), such as a natural disaster. When exposed to PTEs, some individuals are more vulnerable to develop psychopathology, such as Post-Traumatic Stress Disorder (PTSD). In contrast, others are less adversely affected by PTEs, who are often described as “resilient”. A concept analysis of resilience (Manuscript #1) revealed: the antecedent is PTE; the defining attributes are ego-resiliency, emotion regulation, heredity, and social support; and the consequences are none to mild psychopathological symptoms and positive adaptation. Based on a systematic review of genetic influence on resilience (Manuscript #2), the following 10 polymorphisms were …

Peer Intervention To Increase Physical Activity Among Working Women, Sheri A. Rowland

Theses & Dissertations

Most Americans do not engage in enough healthy physical activity (PA), with working women particularly at-risk for inactivity. Workplace PA interventions have been effective, however studies using peers as the central theoretical strategy, have not been found. Social cognitive theory and social comparison theory were used to develop a peer-modeling workplace PA intervention. The aims of this experimental, two-group, preliminary study were: 1) assess intervention feasibility, 2) determine the intervention effect on cardiorespiratory fitness (primary outcome), and PA behavior, cardiovascular risk, self-efficacy, motivation, and social comparison, and 3) describe participant perceptions of the intervention using qualitative focus-group data. Female employees …

Meaningful Use Of Electronic Health Records For Population Health Management In U.S. Acute Care Hospitals, Niodita Gupta

Theses & Dissertations

Population health management (PHM) is used to identify the needs of a population and to align strategies to improve the health of the population through care coordination. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 emphasized the meaningful use (MU) of electronic health records (EHRs) to improve clinical and population health outcomes. The American Recovery and Reinvestment Act (ARRA) of 2009 approved the EHRs incentives program for eligible hospitals to demonstrate the MU of EHRs. Further, eligible hospitals which failed to demonstrate the MU of EHRs could face payment adjustments. Given a heightened focus on …

Sex And Sexuality Of Breast Cancer Survivors, Aja D. Kneip Pelster

Theses & Dissertations

With new diagnostic technologies and treatment modalities available, more people than ever are living as cancer survivors in the United States. A large group of this population consists of breast cancer survivors. The purpose of this research was to explore the intersection of breast cancer survivorship, at points beyond the termination of treatment, and sexuality, including expressions and performance of gender, relationships, and sexual behavior. The current study used semi-structured interviews, conducted with 21 Midwestern women at least 6-months post-treatment, to better understand the intersection of these two concepts. Following traditions of narrative and phenomenological qualitative research, the women’s own …

A Cadaveric Study Of Coronary Artery Variations, Mitchell Lee Milanuk

Theses & Dissertations

Coronary artery diseases, such as angina or myocardial infarction, are extremely prevalent and impact millions of people worldwide. Underlying the diseases, and how they affect each individual in a distinct manner, is the individual’s coronary artery anatomy. The aim of the present study is to have an intimate knowledge of the normal and variant anatomy of the coronary arteries. As an attempt to gain such knowledge, complete analysis of the anatomical variations of coronary arteries was performed. Classical cadaveric dissection of sixty human hearts was performed in the gross anatomy laboratory at the University of Nebraska Medical Center (UNMC). Precise …

Epidemiologic And Clinical Profiles Of Uterine Cancer In The Gharbiah Province Of Egypt, Saad Alshahrani

Theses & Dissertations

Background: Uterine cancer is one of the top-ranking cancers of women with wide international variations in incidence rates. Egypt has a lower incidence of uterine cancer than other countries in the Middle East. In addition to the international incidence variation, there are also wide variations in incidence by rural and urban areas within countries. Therefore, this research project focused on the Gharbiah province, north of Cairo in the Nile Delta, with the aims of investigating demographic and clinical characteristics of uterine cancer, assessing rural/urban variation in incidence rates, and evaluating the possible role of hysterectomy in under-estimating the disease incidence …

Analysis Of Graded Gross Anatomy Dissections And Demonstrations As A Supplemental Educational Tool, Stephanie Leanne Cummings

Theses & Dissertations

Teaching and assessment modalities for human anatomy curriculums vary between schools. The University of Nebraska Medical Center utilizes an integrated gross anatomy lab curriculum including hands-on dissection, lecture, and 3-D models. The GCBA 909 course, Human Gross Anatomy Lab, just recently incorporated graded dissections and demonstrations into their master of medical anatomy (MMA) curriculum. Students were required to complete and demonstrate eight additional dissections compared to physician assistant (PA), physical therapy (PT) students. Upon completion of these dissections, students were assessed based on the quality of their dissections and were also required to demonstrate the cadaveric dissections to anatomy faculty …

Anatomical Variations Of The Sciatic Nerve Divisions In Relation To The Piriformis Muscle And Clinical Implications, Jonathan I. Van Erdewyk

Theses & Dissertations

The goal of this project was to identify and quantify the anatomical variations of the sciatic nerve divisions in relation to the piriformis muscle and compare the data collected to the primary literature. This was done in an effort to provide awareness of sciatic nerve entrapments within the subgluteal space that may be responsible for posterior hip and buttock pain. While the current means of diagnosis are through physical examination, imaging techniques, and surgery, the results of this present study indicate that new methods of diagnosis need to be explored.