Medicine and Health Sciences Commons^™

Vitamin A Compounds In Mothers And Infants At Birth, Jenna M. Paseka

Theses & Dissertations

OBJECTIVE: Little is known about the vitamin A status in mothers and infants at birth in the United States. The main objective of this study is to determine associations between maternal and infant serum retinol, provitamin A carotenoids, and non-provitamin A carotenoids. The secondary aim is to explore the relationship between maternal intake and maternal and infant serum levels of vitamin A compounds.

METHODS: This was a prospective cohort of 34 mothers and their infants admitted to the neonatal intensive care unit (NICU). Maternal and cord blood samples were collected at delivery. Serum retinol, lutein + zeaxanthin, β-cryptoxanthin, lycopene, α-carotene, …

Expression And Function Of Inflammation-Associated Micrornas In Traumatic Brain Injury, Emily Harrison

Theses & Dissertations

MicroRNAs (miRNAs) are important regulators of gene expression. Many neurological diseases, including traumatic brain injury alter expression of miRNAs in the brain. However, the function of these molecules in the context of TBI is largely unknown. Here we report multiple potential roles for miRNAs in TBI, some of which extend beyond the traditional model of post-transcriptional regulation, highlighting that these RNA molecules may have broader implications for the neurobiology of disease. We found that miR-155 plays an essential role in interferon expression after CCI and that miR-155 contributes to TBI induced anxiety, potentially through regulation of interferons. Expression of miR-155 …

Diet Quality Of Adolescent Females In Relation To Disease Risk, Heidi Pfeifer

Theses & Dissertations

Background: Many people are living longer with chronic diseases costing billions in healthcare costs every year. Many things influence the risk of chronic diseases but one easily modified risk factor is diet. Alternate Healthy Eating Index (AHEI) and Alternate Healthy Eating Index-2010 (AHEI-2010) diet quality indexes have been associated with chronic disease risk but has not been studied in disease risk in adolescents.

Purpose: The purpose of this study is to look at adolescent girls’ diet quality scores compared with known adult values associated with chronic diseases and risk of mortality.

Methods: This is a secondary analysis of a previous …

Global Trends In Cancer Burden Based On Geographic Location, Socio-Economic Status And Demographic Shift, Sanjib Chowdhury

Theses & Dissertations

The global burden of cancer is rising at an alarming rate. It remains as one of the top causes of morbidity and mortality worldwide. It is predicted that within 2020, there will be 15 million new cases of cancer in the world, with cancer-related deaths increasing to 12 million. According to the World Health Organization (WHO), the global cancer burden is expected to surge 57% worldwide in the next 20 years. A significant rise in cancer burden will occur in the low-income and middle-income (developing) countries not only due to demographic shifts, but also by the transition of risk factors …

Color Stability, Physical Properties And Antifungal Effects Of Zro2 And Tio2 Nanoparticle Additions To Pigmented Polydimethylsiloxanes, Mazen Alkahtany

Theses & Dissertations

Introduction: Color changes, physical degradation and fungal infections are potential challenges to the longevity of polydimethylsiloxane (PDMS) elastomers. The purpose of this study was to evaluate potential improvements in color change, physical properties and anti fungal properties of PDMS loaded with TiO2 and ZrO2 nanoparticles.

Methods: 1% weight of 40 nm or 200 nm diameter TiO2 or ZrO2 nanoparticles were mixed into PDMS with 2% functional intrinsic yellow pigment and polymerized. Control materials contained 13% weight 200 nm silica. Samples were exposed to either 3000 hours of UVB radiation (200 μW/cm2) or darkness. Color parameters L*a*b* and ΔE*, ultimate tensile …

Modifiable Barriers To Optimal Outcomes In Gout Management, Brian W. Coburn

Theses & Dissertations

Improving patient outcomes in chronic disease is of critical importance to the future of health care. Gout, affecting 4% of the US population, is a highly treatable chronic disease from which patients experience unnecessarily suboptimal outcomes. In this dissertation, I demonstrate how interrelated patient and provider factors affect patient outcomes in gout. First, I describe how only 14% of gout patients know their serum urate (SU) goal for urate lowering therapy (ULT) despite otherwise being knowledgeable about gout and its treatment. I then demonstrate the importance of multiple patient and provider factors in achieving SU goal. Specifically, I demonstrate that …

Proportion Of Heart Failure Patients Who Meet Criteria For Malnutrition Upon Hospital Admission Based On Aspen Guidelines, Sarah L. Johnson

Theses & Dissertations

Background: Current research estimates that approximately 50 percent of heart failure patients are categorized as malnourished. Heart failure patients are at increased risk of malnourishment due to increased catabolic processes that increase resting energy expenditure, decrease appetite, impair nutrient absorption, and lead to unintentional weight loss. The goal of standardized diagnostic criteria is to identify malnutrition early for more effective treatment. Current studies suggest the association of early diagnosis and nutrition intervention with increased positive patient outcomes and improved quality of life for heart failure (HF) patients. However, the proportion of patients with HF who meet criteria for malnutrition at …

Rural Nebraska Women's Explanatory Models Of Postpartum Depressive Symptomatology, Elizabeth Mollard

Theses & Dissertations

The purpose of this study was to construct the explanatory models of postpartum depressive symptomatology (PPDS) from the perspective of rural Nebraska women and to compare these models with the medical model of PPDS. A sample of 20 rural Nebraska women were interviewed in a one-on-one qualitative descriptive telephone interview using questions based on Kleinman’s (1980) explanatory model of illness. This study used feminist pragmatism as a guiding philosophical paradigm. Qualitative data were analyzed using content analysis, and results were compared and contrasted with the medical model of PPDS, which included the onset, symptoms, and duration listed in the DSM-5 …

Care Transitions: A Mixed Methods Study Using A Complexity Science Lens, Carol Geary

Theses & Dissertations

Research studies on care transitions from hospital to nursing home are few and heterogeneous, offering an inadequate characterization to support practice. The purpose of this study was to characterize multiple care transitions among hospitalized older adults with advanced chronic disease who were discharged to a nursing home. This prospective, mixed methods study used multiple case studies with an embedded quantitative strand and multiple sources of information.

Four cases included an index patient (an older hospitalized adult with advanced chronic illness), his or her informal caregiver, if available, and healthcare providers involved in the index patient’s care. Two hospitals and two …

Utilization Of Dissection Videos In Graduate-Level Gross Anatomy Education: An Analysis Of Student Confidence, Utilization, And Scoring Outcomes, Jessica Gamerl

Theses & Dissertations

The use of videos in anatomy education has become a potential tool for learning by students. It is currently unclear if using videos that show how to perform a dissection can have an impact on student practical scores. This thesis attempted to address that question as well as address how videos can impact student confidence levels and how students might implement videos into their study strategies. A set of high definition videos was made following the specific steps of a dissector guide and provided to students prior to their third and fourth lab practicals. A series of three surveys was …

Using Homeland Security Exercise Evaluation Program To Execute A Mass Prophylaxis Exercise In A Rural Community., Brian K. Smith

Theses & Dissertations

This project explores the execution of point of distribution exercises in a rural community. Harrison County Iowa is a rural county with a population over 15,000 located approximately 45 minutes north of the Omaha metro area. The project explored the existing point of distribution plans and inventory for the Harrison County Home and Public Health Department. Prior to this project, many staff at Harrison County Home and Public Health Department had no experience with table top or full scale exercises. The mass prophylaxis point of distribution plan had not been updated, and staff had not received training on the point …

Establishment Of Comprehensive Training Center In Tajikistan, Umeda Sadykova

Theses & Dissertations

There is a notable increase in the number of natural and manmade disasters all over the world in the past two decades. Emergency preparedness is a field that is drawing increased attention in many countries. Tajikistan is a disaster prone country with unforgiving nature and weak preparedness infrastructure/system. Tajikistan’s weak emergency preparedness system can be attributed to two main reasons; lack of coordination between the government and international emergency organizations, and the paucity of well trained and organized network of emergency professionals. This study drafted a proposal to establish a comprehensive training center in Tajikistan. This training center will be …

Human Papillomavirus And Its Impact On Vulnerable Populations, Harpriya Kaur

Theses & Dissertations

Human papillomavirus (HPV) is the most common sexually transmitted infection. The infection is higher in certain racial/ethnic groups and those who are immunocompromised including pregnant women. Because immune system is suppressed during pregnancy, women are at higher risk of various types of infection including HPV, a known risk factor for pregnancy complications. However, its role in adverse pregnancy outcomes is unclear. Another high risk population is Northern Plain American Indian. In the Northern Plains region, American Indian women have significantly higher rate of HPV infection than white counterparts and are infected with different types of HPVs than the general population. …

Gross Anatomy Dissection Videos: Effect On Student Dissection Confidence And Laboratory Examination Scores, Kevin J. Selting

Theses & Dissertations

As medical colleges across the world experience cadaver shortages, faculty shortages, and decreased time allotted to teaching gross anatomy, a need for different teaching modalities has emerged. New ways of teaching are being studied to optimize efficiency and to acquire the same, or better, student outcomes as before the previously mentioned variables became prevalent. This was the stimulus for our research. Dissection videos were made, closely adhering to the dissections performed by Physician Assistant, Physical therapy, and Medical students at the University of Nebraska Medical Center (UNMC). The current Gross Anatomy course at UNMC involves four written examinations covering material …

The Role Of Cbl Family Of E3 Ubiquitin Ligases In Intestinal Epithelial Homeostasis, Neha Zutshi

Theses & Dissertations

All adult organs are endowed with a small pool of resident stem cells that must be maintained throughout life to provide for cell turnover during homeostasis and tissue repair following any injury. The unique ability to self-renew as well as to differentiate into functional cells of organs in which they reside makes stem cells essential for the maintenance of organ systems. It is now becoming increasingly evident that aberrant activity of stem cells contributes to diseases such as cancer or tissue/organ atrophy. Thus, it is critical to better understand the mechanisms that regulate adult stem cells. Ligand-activated receptor tyrosine kinases …

Exploring Emergency Communication Experiences In Response To The 2010 Haiti Earthquake: Lessons Learned From International Donors And Local Government Agencies, Pierre Marie Barbara Roussel

Theses & Dissertations

Background:

In almost every disaster situation, the use of standardized communication procedures among humanitarian relief agencies has been identified as one of the efficient practices to minimize the mismanagement of resources and thus to maximize the response effort among actors to reduce the incidence impact on the public and to increase their resilience capabilities.

Agencies have access to several guidelines to follow during domestic disasters, but there have been very few manuals developed to guide relief organizations on best practices during international large and complex natural disasters such as the 2010 Haiti earthquake.

Haiti has experienced over its history several …

Recurrent Mutations Of T-Cell Receptor And Co-Stimulatory Signaling Proteins In Peripheral T-Cell Lymphomas, Joseph Rohr

Theses & Dissertations

Peripheral T-cell lymphomas (PTCLs) comprise a heterogeneous group of mature T-cell neoplasms with a poor prognosis. Recently, mutations in TET2 and other epigenetic modifiers as well as RHOA have been identified in these diseases, particularly in angioimmunoblastic T-cell lymphoma (AITL). CD28 is the major co-stimulatory receptor in T-cells which, upon binding ligand, induces sustained T-cell proliferation and cytokine production when combined with T-cell receptor stimulation, through many signaling molecules including VAV1. This thesis identifies recurrent mutations in CD28 in PTCLs, as well as mutations in VAV1. Two residues of CD28 – D124 and T195 – were recurrently mutated in 11.3% …

Genetic Predisposition And M1 Macrophage Polarization Created By Elastin-Derived Peptides Drive Abdominal Aortic Aneurysm Formation, Matthew A. Dale

Theses & Dissertations

Abdominal aortic aneurysm (AAA) is a dynamic vascular disease characterized by inflammatory cell invasion and extracellular matrix (ECM) degradation. Evidence has demonstrated a profound influence of genetic background on AAA formation. The work presented herein discusses two studies: the first demonstrates how genetic components can enhance the susceptibility to AAA formation and the second demonstrates how ECM degradation enhances AAA progression by influencing inflammatory cell phenotypes. An understanding of the pathways involved in AAA pathogenesis can help not only to identify potential patients at risk of AAA development, a heritable disease in which the incriminating component has yet to be …

Factors And Outcomes Associated With Potentially Inappropriate Medication Use In Rural Community-Dwelling Older Adults, Marcia Y. Shade

Theses & Dissertations

Potentially inappropriate medications (PIMs) use in older adults is a significant public health concern. The use of PIMs to avoid may lead to negative outcomes such as adverse drug events. Prior conceptual analysis of PIMs use and observation of health-related factors in rural adults led to the design of this dissertation study. A sample was recruited from a population of rural community-dwelling older adults to examine the following specific aims: 1) Describe the use of PIMs to avoid, 2) Explore individual demographic characteristics (age, gender, income, education, and rural home location), health experience (comorbidity, number of medications and health providers), …

Essays On Immigration-Related Disparities In Health Behavior And Health Care Utilization, Yang Wang

Theses & Dissertations

The number of immigrants in the United States has recently been increasing significantly. Immigrants may experience some worse health outcomes than natives, due to substantial legal and socioeconomic barriers. Many immigration-related disparities in health behavior and health care utilization still remain unexplored. This dissertation comprises of 3 independent studies examining such disparities across immigration status, including (1) E-cigarette use and acculturation effects; (2) Cancer-related office-based medical provider visits among cancer patients; and (3) Potentially preventable emergency department visits.

Two nationally representative data sources included National Health Interview Survey and Medical Expenditure Panel Survey. We categorized the respondents into three immigration …

Physical Activity Levels And Related Factors In Midwestern Rural Hispanic Or Latino Adults, Alison K. Clevette

Theses & Dissertations

The purpose of this dissertation was to examine physical activity levels and specific intrapersonal, interpersonal and community physical environment factors that influence physical activity in Midwestern rural Hispanic or Latino adults. Instruments used in the study included: Self-Efficacy for Exercise Behaviors Survey, Social Support for Exercise Survey, Short Acculturation Scale for Hispanics (SASH), and Neighborhood Environment Walkability Scale (NEWS). Physical activity was measured by 7-Day Physical Activity Recall and ActiGraph^® accelerometer data. In the study of 54 participants, it was found that there was a very low level of physical activity. For example, 97% of the time was spent …

Thyroid Cancer And Tumor Collaborative Registry (Tccr)., Oleg Shats, Whitney Goldner, Jianmin Feng, Alexander Sherman, Russell B. Smith, Simon Sherman

Journal Articles: Eppley Institute

A multicenter, web-based Thyroid Cancer and Tumor Collaborative Registry (TCCR, http://tccr.unmc.edu) allows for the collection and management of various data on thyroid cancer (TC) and thyroid nodule (TN) patients. The TCCR is coupled with OpenSpecimen, an open-source biobank management system, to annotate biospecimens obtained from the TCCR subjects. The demographic, lifestyle, physical activity, dietary habits, family history, medical history, and quality of life data are provided and may be entered into the registry by subjects. Information on diagnosis, treatment, and outcome is entered by the clinical personnel. The TCCR uses advanced technical and organizational practices, such as (i) metadata-driven software …

Moving Towards Effective Therapeutic Strategies For Neuronal Ceroid Lipofuscinosis., Ryan D. Geraets, Seung Yon Koh, Michelle L. Hastings, Tammy Kielian, David A. Pearce, Jill M. Weimer

Journal Articles: Pathology and Microbiology

The Neuronal Ceroid Lipofuscinoses (NCLs) are a family of autosomal recessive neurodegenerative disorders that annually affect 1:100,000 live births worldwide. This family of diseases results from mutations in one of 14 different genes that share common clinical and pathological etiologies. Clinically, the diseases are subcategorized into infantile, late-infantile, juvenile and adult forms based on their age of onset. Though the disease phenotypes may vary in their age and order of presentation, all typically include progressive visual deterioration and blindness, cognitive impairment, motor deficits and seizures. Pathological hallmarks of NCLs include the accumulation of storage material or ceroid in the lysosome, …

Imaging The Transgender Patient, Tanya M. Custer, Kim Michael

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Within the health care system, lesbian, gay, bisexual, and transgender (LGBT) persons face many obstacles that lead to health disparities. These disparities include social stigma, lack of provider knowledge and training, lack of sufficient health insurance coverage, and layout of physician practice. As noted by the Joint Commission, federal law prohibits the discrimination of individuals based on race, color, national origin, age, disability, and sex within the health care system.1 It is essential for all health care providers to be educated on the best practices in regard to caring for the LGBT patient.

The focus of this exhibit is to …

Nrp2 Transcriptionally Regulates Its Downstream Effector Wdfy1., Samikshan Dutta, Sohini Roy, Navatha S. Polavaram, Gustavo B. Baretton, Michael H. Muders, Surinder K. Batra, K Datta

Journal Articles: Biochemistry & Molecular Biology

Neuropilins (NRPs) are cell surface glycoproteins that often act as co-receptors for plexins and VEGF family receptors. Neuropilin-2 (NRP2), a family member of NRPs, was shown to regulate autophagy and endocytic trafficking in cancer cells, a function distinctly different from its role as a co-receptor. WD Repeat and FYVE domain containing 1 (WDFY1)-protein acts downstream of NRP2 for this function. Our results indicated that NRP2 maintains an optimum concentration of WDFY1 by negatively regulating its expression. Since increased expression of WDFY1 reduces the endocytic activity, maintenance of WDFY1 level is crucial in metastatic cancer cells to sustain high endocytic activity, …

Hiv-1 Cellular And Tissue Replication Patterns In Infected Humanized Mice., Mariluz Araínga, Hang Su, Larisa Y Poluektova, Santhi Gorantla, Howard Gendelman

Journal Articles: Pharmacology & Experimental Neuroscience

Humanized mice have emerged as a testing platform for HIV-1 pathobiology by reflecting natural human disease processes. Their use to study HIV-1 biology, virology, immunology, pathogenesis and therapeutic development has served as a robust alternative to more-well developed animal models for HIV/AIDS. A critical component in reflecting such human pathobiology rests in defining the tissue and cellular sites for HIV-1 infection. To this end, we examined the tissue sites for viral infection in bone marrow, blood, spleens, liver, gut, brain, kidney and lungs of human CD34+ hematopoietic stem cell engrafted virus-infected NOD.Cg-Prkdc(scid) Il2rg(tm1Wjl)/SzJ mice. Cells were analyzed by flow cytometry …

Hiv-1 Cellular And Tissue Replication Patterns In Infected Humanized Mice., Mariluz Araínga, Hang Su, Larisa Y Poluektova, Santhi Gorantla, Howard Gendelman

Journal Articles: Pharmacology & Experimental Neuroscience

Humanized mice have emerged as a testing platform for HIV-1 pathobiology by reflecting natural human disease processes. Their use to study HIV-1 biology, virology, immunology, pathogenesis and therapeutic development has served as a robust alternative to more-well developed animal models for HIV/AIDS. A critical component in reflecting such human pathobiology rests in defining the tissue and cellular sites for HIV-1 infection. To this end, we examined the tissue sites for viral infection in bone marrow, blood, spleens, liver, gut, brain, kidney and lungs of human CD34+ hematopoietic stem cell engrafted virus-infected NOD.Cg-Prkdc(scid) Il2rg(tm1Wjl)/SzJ mice. Cells were analyzed by flow cytometry …

Ablation Of Matrix Metalloproteinase-9 Prevents Cardiomyocytes Contractile Dysfunction In Diabetics., Priyanka Prathipati, Naira Metreveli, Shyam Sundar Nandi, Suresh C. Tyagi, Paras K. Mishra

Journal Articles: Cellular & Integrative Physiology

Elevated expression and activity of matrix metalloproteinase-9 (MMP9) and decreased contractility of cardiomyocytes are documented in diabetic hearts. However, it is unclear whether MMP is involved in the regulation of contractility of cardiomyocytes in diabetic hearts. In the present study, we tested the hypothesis that MMP9 regulates contractility of cardiomyocytes in diabetic hearts, and ablation of MMP9 prevents impaired contractility of cardiomyocytes in diabetic hearts. To determine the specific role of MMP9 in cardiomyocyte contractility, we used 12-14 week male WT (normoglycemic sibling of Akita), Akita, and Ins(2+∕-)/MMP9(-∕-) (DKO) mice. DKO mice were generated by cross-breeding male Ins2(+∕-) Akita (T1D) …

Community And District Empowerment For Scale-Up (Codes): A Complex District-Level Management Intervention To Improve Child Survival In Uganda: Study Protocol For A Randomized Controlled Trial., Peter Waiswa, Thomas O'Connell, Danstan Bagenda, Pricila Mullachery, Flavia Mpanga, Dorcus K. Henriksson, Anne R. Katahoire, Eric Ssegujja, Anthony K. Mbonye, Stefan S. Peterson

Journal Articles: Epidemiology

BACKGROUND: Innovative and sustainable strategies to strengthen districts and other sub-national health systems and management are urgently required to reduce child mortality. Although highly effective evidence-based and affordable child survival interventions are well-known, at the district level, lack of data, motivation, analytic and planning capacity often impedes prioritization and management weaknesses impede implementation. The Community and District Empowerment for Scale-up (CODES) project is a complex management intervention designed to test whether districts when empowered with data and management tools can prioritize and implement evidence-based child survival interventions equitably.

METHODS: The CODES strategy combines management, diagnostic, and evaluation tools to identify …

Community And District Empowerment For Scale-Up (Codes): A Complex District-Level Management Intervention To Improve Child Survival In Uganda: Study Protocol For A Randomized Controlled Trial., Peter Waiswa, Thomas O'Connell, Danstan Bagenda, Pricila Mullachery, Flavia Mpanga, Dorcus Kiwanuka Henriksson, Anne Ruhweza Katahoire, Eric Ssegujja, Anthony K. Mbonye, Stefan Swartling Peterson

Journal Articles: Epidemiology

BACKGROUND: Innovative and sustainable strategies to strengthen districts and other sub-national health systems and management are urgently required to reduce child mortality. Although highly effective evidence-based and affordable child survival interventions are well-known, at the district level, lack of data, motivation, analytic and planning capacity often impedes prioritization and management weaknesses impede implementation. The Community and District Empowerment for Scale-up (CODES) project is a complex management intervention designed to test whether districts when empowered with data and management tools can prioritize and implement evidence-based child survival interventions equitably.

METHODS: The CODES strategy combines management, diagnostic, and evaluation tools to identify …