Medicine and Health Sciences Commons^™

Targeting The Glucose Metabolism Of Myeloid-Derived Suppressor Cells (Mdscs) To Stimulate Cancer Immunity., Jaspreet Grewal

Electronic Theses and Dissertations

Myeloid derived suppressor cells (MDSCs) are a heterogeneous group of immature myeloid cells that are significantly increased in cancer patients and correlate with higher stage and poor prognosis. MDSCs negatively modulate anti-tumor immunity, suppress T cell activity, promote angiogenesis and increase the risk of metastasis. In this study, we report that monocytic-MDSCs (M-MDSCs) but polymorphonuclear-MDSCs (PMN-MDSCs) over-express 6-phosphofructo-2-kinase/fructose-2, 6-bisphosphatases 3 (PFKFB3), an important regulator of glycolysis. Furthermore in the melanoma model, M-MDSCs but not PMN-MDSCs suppressed T cell function which correlated with PFKFB3 over-expression and increased rate of glycolysis. PFKFB3 inhibition with the first-in-class small molecule inhibitor, PFK-158 reversed M-MDSC …

Treg Regulation In Periodontal Disease During Pregnancy., Aislinn Leah Hays

Electronic Theses and Dissertations

Background: Although pregnancy is prone to induce more severe periodontal inflammation and tissue damage, its mechanism remains elusive. Periodontal diseases during pregnancy are associated with adverse pregnancy outcomes including preterm birth or low birth weight. Animal models are ideal for investigating immunological mechanisms in periodontal disease. With a newly modified ligature-induced disease model, we managed to develop periodontal disease in pregnant mice and investigate the immunological mechanism of more severe symptoms during pregnancy. Hypothesis: We hypothesis that P. gingivalis infection during pregnancy will lead to a down-regulation of Treg cells, therefore causing increased inflammation and disease severity. Methods: A ligature-induced …

Enhancing Cell Therapy For Ischemic Cardiomyopathy., Michael J. Book

Electronic Theses and Dissertations

Cardiac cell therapy using cardiac mesenchymal cells (CMC) significantly reduces ventricular dysfunction in patients with ischemic cardiomyopathy. Despite the improvement in function, a modest number of CMCs survive in the heart post-transplantation. In this study, we sought to improve the survival and retention of transplanted CMCs to prolong the therapeutic benefits afforded by cardiac cell therapy. To do this, we targeted the enzyme telomerase (TERT), known to be active in some highly proliferating cells (e.g. germ, stem). TERT is responsible for preventing telomere attrition, thereby allowing continued proliferation. TERT has also been shown to be protective, improve cell migration and …

The Effect Of Caffeine On Fecundability : Differences In Coffee, Tea, And Cola Consumption., Emily Kathleen Steinmetz

Electronic Theses and Dissertations

This study examined whether intake of caffeinated beverages (coffee, tea, and cola) was associated with fecundability (time to pregnancy) in a prospective cohort study. Data from 470 women from the Mount Sinai Study of Women Office Workers (1990-1994) were analyzed. Intake of coffee, tea, cola, and other variables were recorded in daily diaries and calculated as menstrual cycle level means for up to 20 cycles. Pregnancy was assayed using hCG and confirmed by physician diagnosis. The associations of caffeinated beverages with the probability of becoming pregnant during a given cycle were determined using discrete survival analysis, adjusted for potential confounders. …

Colorectal Cancer Fit Screening In The Hope Vi Population Of Jefferson County, Kentucky., Jeffrey D. Stone

Electronic Theses and Dissertations

Using pre-post survey data collected from 209 randomly selected African American people from the population of former residents of Clarksdale and Sheppard Square public housing areas, this study explores the relationship between individual characteristics and colorectal cancer screening behavior, measured by the uptake of the Fecal Immunochemical Test (FIT) and by prior colorectal screening, while controlling for neighborhood factors and geographic proximity to healthcare facilities. This particular public housing population is of interest because of their relocation from the downtown area, where healthcare facilities are within walking distances, to other public housing units either in large apartment complexes or scattered …

Pediatric Anxiety And/Or Depression Problems : Associations With Pm10, Fly Ash, And Metal Exposure., Abby Nicole Burns Hagemeyer

Electronic Theses and Dissertations

Background: In the last several decades, the use of coal has become more prevalent in turn increasing the amount of coal ash being produced. Coal ash, the by-product of coal combustion, is composed of small particles that contain essential elements, hazardous metals, polycyclic aromatic hydrocarbons, and radioactive material. While a small proportion of coal ash is reused, the majority gets discarded in open-air landfills and ash ponds. Fly ash, the major component of coal ash, can become emitted into the air and potentially contribute to the air pollution and metal exposure in the surrounding community. Few studies, particularly in the …

Phenomenological Study Of The Lived Experiences Of Appalachian Spouses Of Combat Veterans With Post Traumatic Stress Disorder, Janice E. Greene

Electronic Theses and Dissertations

This study was conducted to identify gaps in existing knowledge regarding impacts of combat-related PTSD on the spouse and to gain an understanding of the lived experience of Appalachian Spouses of combat veterans with PTSD. A systematic literature review was conducted to identify research and findings on the impacts of combat-related PTSD on spouses of veterans and a qualitative study was conducted to gain an understanding of the lives of Appalachian spouses of combat veterans with PTSD.

The systematic review identified 16 qualitative studies conducted between 1988 and 2016 in five countries spanning five wars. Regardless of the country of …

Assessment Of Social, Dietary And Biochemical Correlates Of Cardiometabolic Risk In Pre-Adolescent Hispanic Children, Abraham Basil Alhassan

Electronic Theses and Dissertations

Obesity, elevated blood pressure and dyslipidemia are highly prevalent in Hispanic children. Compared to their non-Hispanic White peers, Hispanic children experience higher prevalence of obesity and hypertension. The Hispanic population in Tennessee has been growing, with about a tenth of newborn babies being Hispanic. This study aimed to: 1. Examine the influence of sociodemographic factors on Hispanic children’s cardiometabolic risk; 2. Assess the relationship between food group intake and cardiometabolic risk in Hispanic children; and 3. Evaluate the efficacy of non-traditional biomarkers for detecting cardiometabolic risk in Hispanic children. Data for the study came from a larger cross-sectional pilot study …

Technical And Physical Match Demands Of A Ncaa Division I Soccer Goalkeeper, Joanne Spalding

Electronic Theses and Dissertations

The purpose of this study was to provide a better understanding of the goalkeeper position in order to prepare goalkeepers for competition. The objectives of this study were to characterize the technical and physical demands of an NCAA Division I collegiate goalkeeper over three seasons and examine trends from season to season. Count and frequency for each definition were analyzed. Results show that although the goalkeeper’s technical demands were characterized by engaging in play without action and being in the goal area, the gradually increased use of the feet over three season’s hints on the importance of skills performed with …

Coping Strategies Of Prelicensure Registered Nursing Students Experiencing Student-To-Student Incivility, Robin A. Foreman

Electronic Theses and Dissertations

Incivility is rude or discourteous behavior that demonstrates a lack of respect for others. Some nurses ignore the dictates of professionalism and exhibit a total disregard for colleagues and peers by purposefully targeting each other with uncivil behaviors. Incivility has invaded the nursing educational environment with deleterious results. Uncivil behaviors perpetrated by nursing students against other nursing students cause psychological and physiological distress for victims and witnesses. The purposes of this quantitative descriptive study were to identify the behaviors that constituted lateral student-to-student incivility, determine the frequency of experienced student-to-student incivility, and describe the coping strategies employed by prelicensure registered …

Correlates Of Human Papillomavirus (Hpv) Vaccine Acceptance In Appalachian Tennessee, Oluwatosin Ariyo

Electronic Theses and Dissertations

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the U.S., where one HPV-related cancer is diagnosed every 20 minutes. The most common HPV-related cancer is cervical cancer, with an estimated incidence of 12,000 cases annually, a third of which lead to death. Cervical cancer disparately affects women of ethnic minority groups and geographically isolated regions, such as Appalachia. Tennessee ranks third highest in cervical cancer incidence in the country. Many cases of cervical cancer could be prevented through vaccination against HPV, however, vaccination rates for females in Tennessee are among the lowest in the country. This mixed-methods …

Range-Wide Prevalence And Impacts Of Pseudocercosporella Inconspicua On Lilium Grayi And An Assessment Of L. Superbum And L. Michauxii As Reservoirs, Cindy L. Barrett

Electronic Theses and Dissertations

Lilium grayi (Gray’s Lily), a southern Appalachian endemic species, is threatened by a Lilium-specific fungal pathogen, Pseudocercosporella inconspicua. The disease is characterized by tan lesions that can cause early senescence, while also lowering seed production and viability. This project tested for P. inconspicua conidia and accessed health at nine locations. The disease was present and ubiquitous across the range of L. grayi. Through identification of P. inconspicua conidia in the field, L. superbum (Turk’s Cap Lily) was identified as an additional host, while L. michauxii (Michaux’s Lily) was disease-free. However, infection was inducible in both species. With …

The Impact Of Teach-Back As A Patient Education Tool In Women With Inadequate Maternal Health Literacy Seeking Immunizations For Their Children, Barbara Jared

Electronic Theses and Dissertations

Health literacy is recognized as a contributor to health outcomes and maternal health literacy is important to the health and wellbeing of children and families. Of particular interest are mothers seeking immunization services for their children. The complexity of the recommended immunization schedule and the care management of children receiving immunizations have the potential to create negative health outcomes in the low health literate population. Assessment of maternal health literacy and provision of effective patient education adapted to the health literacy level of the individual is important for information transfer. The Teach-Back provides an opportunity to both assess understanding and …

Student Self-Assessment Of Operative Dentistry Experiences : A Time Dependent Exercise In Best Practice Outcomes., Celine Joyce Cornelius Timothius

Electronic Theses and Dissertations

Purpose: The purpose of this project was to evaluate student self-assessment of operative dentistry experiences. Methods: First, a retrospective analysis of student self-assessment and faculty assessment grade sheets were evaluated for mean differences and correlations across time. Both preclinical (D2: n=120) and clinical (D3: n=120; D4: n=120) grades sheets were evaluated. Secondly, twenty-five (n=25) students from each of the D1, D2, D3 and D4 classes were asked to evaluate dentoform work. Twenty-five (n=25) operative calibrated faculty graded the same two dentoforms. Results: D2 student’s self-assessment scores were significantly higher than the faculty assessment scores (t-test; p0.05) and there was a …

Nutrient Content Of Human Breast Milk From Overweight And Normal Weight Caucasian Women Of Northeast Tennessee, Megan R. Kwon

Electronic Theses and Dissertations

Many factors influence the nutrient composition of breast milk (BRM) particularly within the fatty acids composition. In this study BRM between 2-14 weeks of lactation was collected from 44 Caucasian women (24 normal weight (NW, BMI 18.5-24.9kg/m²) and 20 overweight (OW, BMI >25.0kg/m²). BRM was subjected to proximate analysis and participants completed food frequency questionnaires (FFQ) to estimate fruit, vegetable, and fat intake. BMI differed between NW and OW groups, 22.03 vs 33.86kg/m² (p0.10) were identified for total calories (5,581.8 vs 5562.9cal/g), %fat (39.6 vs 43.9), or %protein (9.8 vs 8.9) for BRM in NW …

The Increasing Risk Of Vector-Borne Diseases: Mapping The Effects Of Climate Change And Human Population Density On Future Aedes Aegypti Habitats, Julie Obenauer

Electronic Theses and Dissertations

The Aedes aegypti mosquito is the vector for four infectious diseases of global concern – Yellow Fever, Dengue, Chikungunya, and Zikavirus. Previous attempts to model the expansion of the vector habitat due to global climate change have rarely included characteristics related to the human populations on which this mosquito is dependent. The purpose of this research was to determine whether the inclusion of human population density improves model performance while creating risk maps that can be used to determine where humans are most likely to be exposed to the vector in the future. The resulting model demonstrated that the inclusion …

Prevalence Of Communication Disorders In Children With Neonatal Abstinence Syndrome On School Speech-Language Pathology Caseloads: A National Survey, Brittany V. Ratliff

Electronic Theses and Dissertations

There is concern about the recently increasing number of infants born with Neonatal Abstinence Syndrome (NAS), yet little is known about its long-term neurodevelopmental effects. School-based speech-language pathologists (SLPs) are in a unique position to comment on potential long-term consequences of NAS because their caseloads include children with a variety of communication disorders and comorbidities. School-based SLPs across the United States (N = 258) responded to a survey about the presence of children with NAS on their caseloads and their perceptions of the children’s communication disorders and comorbidities. Results revealed that children with NAS currently are being treated by …

An Epidemiological Study Of Obesity Among Asian Americans In California, United States, Shaoqing Gong

Electronic Theses and Dissertations

Obesity has reached epidemic levels in the United States (U.S.). Despite an increasing number of studies on obesity, a very few have addressed this debilitating condition among Asian American adults. The overall objective of this study is to utilize the latest cycles of the California Health Interview Survey (CHIS) to better understand obesity and identify its correlates among Asian Americans. The study population comprised Asian American adults aged 18 years or older from the CHIS with data pooled from the 2013 and 2014 survey years. Obesity (≥27.5 kg/m²) was defined using the World Health Organization (WHO) Asian body …

Difference In Quality Of Life Between Group And Individual Exercise In A Faith-Based Sample, Everett Jackson Amburn

Electronic Theses and Dissertations

There is limited data on the quality of life of individuals who exercise in a group versus individuals who exercise alone. The purpose of this study was to determine if there is a difference in the quality life between adults who attend an exercise class and those who exercise alone. Using the WHOQOL-BREF, 27 adult females were surveyed in Central California at two Church of Latter Day Saints locations. Ten females were enrolled in a group exercise class while 17 were individual exercisers. The data was analyzed using a t-test for independent samples to determine if there is a …

The Perceptions Of Success Of Latino Nursing School Graduates In The Appalachian Region Of The United States, Barbara M. Rauscher

Electronic Theses and Dissertations

This qualitative narrative descriptive study focused on nine successful Latino nursing school graduates. Five participants were interviewed twice and four participants were interviewed once for a total of fourteen interviews. Participants and their families immigrated from Brazil, Costa Rica, Cuba, and Mexico. Participants attended school in North Carolina, South Carolina, and Tennessee.

Interviews revealed themes of Familism, Empowerment, and Perseverance. Familism was an overriding theme throughout each of the interviews. Participants described family as being their greatest support. They discussed sacrifices made by their families which assisted them in being successful. In addition, they also shared their willingness to make …

An Investigation Of The Relationship Between Child, Family, And Community Factors And Early Childhood Oral Health And The Utilization Of Dental Health Services, Nicole Holt

Electronic Theses and Dissertations

Background / Objective: Children under the age of 5 years bear a disproportionate burden of oral disease. The aim of this study is to investigate how child, family, and community determinants impact dental care utilization, and parental report of child’s oral health. Methods: Data for this study came from the 2011/2012 National Survey of Children’s Health for children aged 1 to 5 years old. Dependent variables evaluated were if the child had an oral health problem, been to a dentist in the past year, and parents description of the child’s teeth. Independent variables were selected from child, family, and community …

Mammography Utilization In African American Women, April D. Kidd

Electronic Theses and Dissertations

Purpose: Breast cancer presents differently among women causing breast cancer health disparities with women of color disproportionally shouldering later-stage screening, incidence, and treatment, and greater mortality. This study assessed 10 predictors and rates of recent and long-term mammography utilization for women 43-79 years of age to better understand differences among age strata and races. This was the first study to use both the calculated Gail Risk scores (calculates absolute breast cancer risk over time intervals) from the 2010 National Health Interview Survey (NHIS) and a temporary homelessness variable in predicting mammography utilization using national-level data.

Theoretical Framework: A modified Behavioral …

The Roles Of Perceived Stress, Coping Styles, And Perceived Social Support On The Alcohol Consumption Among American College Students, Jesse Wynn

Electronic Theses and Dissertations

The intention of this study was to better understand how certain aspects in a college student's life (i.e., perceived stress, styles of coping, and social support) or how combinations of these variables may contribute to higher levels of alcohol consumption. The present study examined the relationship between perceived stress, functional coping strategies, dysfunctional coping strategies, and perceived social support using Lazarus and Folkman's model of stress, appraisal, and coping. A sample of (N = 201) University of Denver undergraduate students between the ages of 18-25 complete measures of perceived stress, coping strategies, perceived social support, and alcohol use. Results …

Preclinical Assessment Of Immunocal® As A Preventative Treatment For Traumatic Brain Injury (Tbi) In A Mouse Model Of Closed Head Injury, Elizabeth Eugenia Ignowski

Electronic Theses and Dissertations

Over the past three decades, traumatic brain injury (TBI) has been considered a "silent epidemic" and recognized as an emergent public health problem by the Centers for Disease Control and Prevention (CDC). TBI is defined as a bump, blow, or jolt to the head that disrupts the normal function of the brain. Due to the debilitating effects and prevalence of TBI, novel preventative treatment regimens are highly desirable in at risk populations. According to the CDC groups disproportionately affected by TBI include athletes, people aged 75+, and service men and women, among others. Here, we investigated a unique whey protein …

The Ability To Critically Evaluate Research Literature In Speech-Language Pathology, David Gregorio

Electronic Theses and Dissertations

Research in Speech-Language Pathology provides the basis for understanding how and to what degree therapeutic techniques and interventions affect the health and quality of life of individuals with communication disorders. Across numerous fields of healthcare, research serves just as important a function and is used to guide the practices of professionals across the public health sector. Several disciplines, including chiropracty, nursing, and physical therapy, rely on the implementation of Evidence-Based Practice (EBP) to ensure that the process of rehabilitation and the techniques employed therein are carried out though the synthesis of best clinical judgment, empirical evidence, and patient values. The …

Synthesis And Characterization Of Ph/Temperature Dual Sensitive Multiblock Copolymer For Drug Delivery, Hyung Kyung Lee

Electronic Theses and Dissertations

The objective of this study was to develop a novel multiblock copolymer (MBCP) with temperature/pH dual-sensitivity which undergoes gelation at body temperature and degradation at acidic pH for controlled drug delivery applications. The MBCP with molecular weight of 42000 Da was synthesized by polycondensation between an acid-labile ketal linker, 2,2-bis(aminoethoxy)propane (BAP) and Pluronic® P104 using L-lysine diisocyanate ethyl ester (LDI) or 1,6-Diisocyanatohexane (HDI). The gelation temperature of 20% (w/v) MBCP was in the range of 29 to 31 ºC when tested with three different techniques: rheometer, test tube inversion method, and falling ball method. The polymer shopH-triggered degradation and drug …

Burden Of Illness And Pharmacoeconomic Evaluation Of Lumacaftor/Ivacaftor In Cystic Fibrosis, Pratyusha Vadagam

Electronic Theses and Dissertations

Objectives: (1) To estimate the burden of illness in cystic fibrosis (CF) using 2010-2014 Medical Expenditure Panel Survey (MEPS) data, and (2) to conduct a pharmacoeconomic evaluation of lumacaftor/ivacaftor in the treatment of CF.

Methods: The study was conducted in two parts. Part 1 involved a retrospective analysis using individuals in MEPS database with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code of 277.00 for a principal diagnosis of CF. Dependent variables were cumulative and out-of-pocket (OOP) expenditures and independent variables included patient demographics and clinical characteristics. Unweighted and weighted estimates of expenditure in CF group, …

Retention And Attrition In Bariatric Surgery Research: A Qualitative Study, William F. Gourash

Electronic Theses and Dissertations

Problem: Longitudinal bariatric surgical research studies often lack information on retention and attrition of study participants and the strategies utilized to optimize these. The potential for attrition bias with adverse effects on validity, reliability, and generalizability increases over time. The many factors potentially affecting retention and attrition in research, have been under studied.

Purpose: The purpose was to explore factors affecting research participation of bariatric surgical patients who are subjects in the Longitudinal Assessment of Bariatric Surgery (LABS) study. The research questions explored research participants’ perceptions, motivations, and attitudes concerning participation in the study, specifically participation in annual in-person visits …

The Effect Of Sport Participation On Bone, Maggie M. Minett

Electronic Theses and Dissertations

Mechanical loading – or physical activity – is essential in the bone remodeling process as well as optimizing the densitometric and geometric properties of bone throughout the lifespan. Participation in sports is a common mode of physical activity that can enhance bone mass accrual at younger ages and facilitate bone mass maintenance at older ages. Research suggests that sport participation continued from adolescence into high school and college provides added benefits on aBMD and cortical bone measures and these benefits remain 10-15 years after retirement from sport. However, in most studies, the higher rates of bone loss after sport cessation …

Enhanced Breast Cancer Classification With Automatic Thresholding Using Support Vector Machine And Harris Corner Detection, Mohammad Taheri

Electronic Theses and Dissertations

Image classification and extracting the characteristics of a tumor are the powerful tools in medical science. In case of breast cancer medical treatment, the breast cancer classification methods can be used to classify input images as benign and malignant classes for better diagnoses and earlier detection with breast tumors. However, classification process can be challenging because of the existence of noise in the images, and complicated structures of the image. Manual classification of the images is timeconsuming, and need to be done only by medical experts. Hence using an automated medical image classification tool is useful and necessary. In addition, …