Medicine and Health Sciences Commons^™

Type 2 Diabetes Mellitus (T2dm) Onset And "Remission"., Srikanth Tangelloju

Electronic Theses and Dissertations

Background: Type 2 diabetes mellitus (T2DM) is a progressive disease condition. As the disease progresses the function of beta (β) cells (cells which regulate insulin) decline, thereby increasing the circulating blood glucose levels. If left unmanaged the disease progresses from onset to development of T2DM related complications and eventually death. When managed, in certain individuals, T2DM onset can be prevented and/or slowed down and in certain T2DM individuals, remission is observed. There are some known modifiable risk factors such as diet and physical activities that are associated with the speed and direction of progression, but much is still unknown. In …

Carnosine, A Therapeutic Potential For Critical Limb Ischemic., Adjoa Agyemang Boakye

Electronic Theses and Dissertations

Critical Limb ischemia (CLI) is a serious manifestation of peripheral artery disease. Advanced CLI patients are poor candidates for vascular surgeries. Numerous studies have shown that hypoxia inducible factor 1α (HIF1-α) plays an important role in recovery from murine hindlimb ischemia (HLI). HIF1-α is regulated by oxygen dependent prolyl hydroxylases (PHDs). Previous studies have shown that inhibition of PHDs by metal quenchers and viral delivery of HIF1-α improves blood flow to the ischemic limb. However, clinical trials with these therapies are largely negative partly because they do not address the underlying chronic oxidative stress. Based on recent observations that endogenous …

The Impact Of The Patient Protection And Affordable Care Act’S Risk Adjustment Program On Adverse Selection : First Year Case Study., Steven K. Zimmerman

Electronic Theses and Dissertations

In 2014 the Patient Protection and Affordable Care Act (ACA) implemented a risk adjustment program to stabilize premiums and neutralize premiums in the individual health insurance marketplace. This dissertation will examine the impact of the ACA risk adjustment program on adverse selection for one insurer during 2014. This study utilized enrollment and claims data for one insurer and employs graphical analysis to test for adverse selection. Previous studies have been unable to utilize actual insurer data to test for adverse selection in under the ACA risk adjustment program. Until the implementation of the ACA, insurers relied on underwriting methods to …

Air Pollution, Pulmonary Oxidative Stress, And The Endothelin System In The Development Of Cardiovascular Injury., Jordan B. Finch

Electronic Theses and Dissertations

The goal of this project was to examine the role of endothelin-1 (ET-1) as a mediator in the pathway between air pollution exposure and the development of vascular injury. A human cohort and male mice (C57BL/6 and ecSOD-Tg) were used to evaluate changes in the ET-1 system in response to exposures of fine particulate matter (PM2.5). Human ET-1 levels were significantly associated with environmental factors and markers of vascular change, but were decreased with increased PM2.5. No association was seen between ET-1 and endothelial progenitor cells (EPCs) except for EPC-4, possibly indicating a regulatory relationship with this specific population. In …

Vinyl Chloride-Diet Interactions In Liver Disease : Potential Roles Of Autophagy And Energy Management., Anna L. Lang

Electronic Theses and Dissertations

Vinyl chloride (VC) is a prevalent environmental toxicant that has been shown to cause liver injury at high, occupational exposures. However, most studies have not addressed interactions of low doses with risk-modifying factors. This study aims to explore low-level VC metabolite exposure interactions with other potential risk-modifying factors and their effect on underlying liver disease. We examined sub-hepatotoxic effects of a VC metabolite (chloroethanol, CE) in two murine models of liver injury using ethanol and lipopolysaccharide (LPS). In both, CE significantly enhanced liver injury when compared to either ethanol or LPS alone. Previous studies have shown an increase in mTOR …

Toll-Like Receptor 4 Mutation Suppresses Hyperhomocysteinemia-Mediated Hypertension., Anastasia Familtseva

Electronic Theses and Dissertations

Background: Hyperhomocysteinemia (HHcy) has been observed to promote hypertension, but the mechanisms are unclear. Toll-like receptor 4 (TLR-4) is a cellular membrane protein that is ubiquitously expressed in all cell types of the vasculature. TLR-4 activation has been shown to promote inflammation that has been associated with pathogenesis of hypertension. In this study, we hypothesize that HHcy induces hypertension by TLR-4 activation that promotes inflammatory cytokine up-regulation (IL-1β, IL-6, TNF-α) and initiation of mitochondrial dysfunction leading to cell death and chronic vascular inflammation. Methods: To test this hypothesis, we used C57BL/6J mice (WT); Cystathionine-β-synthase deficient mice (CBS+/-) with genetic mild …

Developing A More Clinically-Relevant Mouse Model Of Cisplatin-Induced Nephrotoxicity., Cierra N. Sharp

Electronic Theses and Dissertations

Cisplatin is a nephrotoxic chemotherapeutic that causes acute kidney injury (AKI) in 30% of patients. Although recovery can occur after one episode of cisplatin-induced AKI, studies have indicated multiple episodes may lead to the development of chronic kidney disease (CKD), an irreversible disease with no current treatments. The standard mouse model of cisplatin-induced AKI consists of one, high dose of cisplatin (> 20 mg/kg) that is lethal to the animal three days later. This model doesn’t accurately reflect the repeated dosing regimen patients receive, and doesn’t allow for long-term outcome studies of pathologies associated with CKD. We have developed a …

Life Balance In Adult Healthy Siblings Of Individuals With Childhood Cancer., Yolanda Williams

Electronic Theses and Dissertations

Siblings of children who were diagnosed with cancer in childhood experience significant stress and psychological difficulties as a result of the cancer. Furthermore, the needs of siblings have often been overlooked in the cancer literature, prompting the need for more studies. The purpose of this dissertation is to examine the life balance and social support outcomes of adults who grew up in the household with a sibling that was diagnosed with cancer. The study sample consisted of 120 adult healthy siblings who grew up in a household with a sibling that was diagnosed with cancer prior to age 19. Participants …

Impact Of Luminance And Spatial Parameters On The Generation Of The Human Pattern Electroretinogram., Kate A. Godwin

Electronic Theses and Dissertations

The current work assessed some of the key hypotheses behind the generation of the pattern electroretinogram (PERG) response. The first of these hypotheses states that the PERG response is the result of linear cancellation of simultaneous increment and decrement retinal responses, as generated by the retinal ON- and OFF-pathways. Experiment 1 evaluated the possibility of simulating the PERG by summing the ERG responses elicited by increment and decrement flashes, and found that it was indeed possible to simulate the PERG from these responses. However, only the steady-state PERG could be modeled consistently. The second hypothesis evaluated a theory that the …

The Discovery Of A Novel, Ras-Mediated Nore1a/Pmliv Tumor Suppressor Complex., Jessica Mezzanotte Sharpe

Electronic Theses and Dissertations

Ras is the most commonly activated oncogene in human cancer. Activated Ras drives cell growth and proliferation by activating multiple mitogenic signaling pathways. However, Ras also has the paradoxical ability to promote anti-growth, pro-apoptotic, and pro-senescent signaling. The signaling pathways of many of these biological effectors remain poorly defined. One group of proteins capable of promoting Ras-induced apoptosis and cell cycle arrest is the RASSF family of tumor suppressors. Novel Ras Effector 1A, or NORE1A, was the first member of this family discovered and is a bona fide tumor suppressor that is lost or inactivated in a number of different …

Characterization Of Pg1604 (Porz) As An Essential Component Of Type 9 Secretion System In Porphyromonas Gingivalis., Apurva Tadimari Prabhakar

Electronic Theses and Dissertations

Background: The numerous virulence factors of Porphyromonas gingivalis are essential for the organism to invade host tissues while escaping immune responses [1, 2]. Some of these factors, like major proteases referred to as gingipains, are secreted by a unique secretion system called PerioGate or Type IX Secretion System (T9SS). T9SS consists of a number of membrane and periplasmic proteins, which provide transportation only for proteins that possess a conserved C-terminal domain (CTD). The CTD functions as a specific recognition signal for the T9SS. PG1604 of P. gingivalis W83 is a CTD-containing protein, which has been shown in our initial studies …

In Vivo Monitoring Of Therapeutic Efficacy And Virulence Profile By Bioluminescent Klebsiella Pneumoniae., Ramy Ameen Fodah

Electronic Theses and Dissertations

Klebsiella pneumoniae causes an acute respiratory infection in human with severe outcomes and high mortality rates even with antibiotic treatment. Even with its critical clinical importance, few virulence systems have been identified for K. pneumoniae limiting the development of new therapeutic strategies. Accordingly, we performed Next Generation sequencing for the strain ATCC 43816, a virulent strain in mouse respiratory disease models, and compared its genomic data with two previously sequenced strains NTUH-K2044 and MGH 78578 for the purpose of identifying genes required for colonizing host lungs. Furthermore, the virulence potential of the three K. pneumoniae strains were tested in a …

Endothelial Hspa12b Is A Novel Protein For The Preservation Of Cardiovascular Function In Polymicrobial Sepsis Via Exosome Mir-126, Xia Zhang

Electronic Theses and Dissertations

Sepsis is the most frequent cause of mortality in most intensive care units. Cardiovascular dysfunction is a major complication associated with sepsis, with high mortality rates up to 70%. Currently, there is no effective treatment approach for sepsis.

The integrity of the endothelium is fundamental for the homeostasis of the cardiovascular system. Sepsis induces endothelial cell injury which is the key factor for multiple organ failure. The increased expression of adhesion molecules and chemokines in endothelial cell promotes leukocytes infiltration into the tissue. The loss of tight junction proteins and increased permeability of the endothelial cells will provoke tissue hypoxia …

The Combined Effects Of Leptin And Coenzyme Q10 In Ameliorating Obesity- Induced Infertility In Female Rats, Adekunle Adedeji

Electronic Theses and Dissertations

Infertility is one of the major problems of obesity. Studies have shown that administration of leptin reversed obesity-induced infertility in rats and mice. Coenzyme Q₁₀ (CoQ₁₀) is an antioxidant and also supplies the energy needed for ovulation and embryo development. We hypothesized that leptin when combined with CoQ₁₀ could greatly improve obesity-induced infertility. The results showed a significant decrease in food intake, body weight, and the regular estrous cycle was restored after treatment with leptin+CoQ₁₀. There was a significant increase (p10 significantly (p10 can improve fertility in obese infertile female rats. This study could …

Using The Theory Of Planned Behavior To Predict Executives’ Intentions To Hire Psychologists In Federally Qualified Health Centers, Robert M. Tolliver

Electronic Theses and Dissertations

Health psychologists with training in integrated care are ideal candidates to work in Federally Qualified Health Centers (FQHCs). However, despite the large documented need for more behavioral health providers in FQHCs, psychologists are underrepresented in this setting compared to other behavioral health professions. The purpose of this study was to: 1) examine the specific beliefs that are most relevant to executives’ intentions to hire psychologists, 2) determine how executives’ perceived control over hiring psychologists varies by several demographic variables, and 3) examine how well the Theory of Planned Behavior (TPB) predicts executives’ intentions to hire psychologists. Method: Executives (N …

Stop The Pricks: A Validation Study Of A Noninvasive Lactate Threshold Device, Rebecca M. Mcmorries

Electronic Theses and Dissertations

ABSTRACT

Purpose: The aim of this study is to assess the validity of a noninvasive lactate threshold device (NID) to determine lactate threshold heart rate (LTHR) and aerobic threshold heart rate (AeTHR).

Methods: Twenty-one recreational athletes completed a personalized graded exercise test on a treadmill. All participants wore the noninvasive device and blood lactate samples were taken at the end of 3-minute stages. Lactate threshold heart rate and aerobic threshold heart rate were then calculated using four traditional methods and compared against the same heart rate values calculated by the device.

Results: No significant differences were found in lactate threshold …

Comparison Of Two Body Weight Screenings Of Self-Conscious Emotions And Coping, Rachel N. Nanez Ms.

Electronic Theses and Dissertations

Novel technologies are currently being utilized in fitness and clinical settings. However, there is not much research to examine the emotional responses to such screenings.

PURPOSE: To examine the group differences between the FIT3D and DXA protocol on emotional responses and the differences between weight classifications.

METHODS: The Body and Appearance-related Self-conscious Emotions Scale and WEIGHTCOPE were used to assess self-conscious emotions and intention to utilize 10 different weight-related coping strategies following the scans. Motivation was measured by a 10-point Likert scale measuring motivation pre and post scans.

RESULTS: There were no differences in motivation, affective response, or intention to …

Optimism Bias In Fitness, Katrielle Marx

Electronic Theses and Dissertations

The people of the United States of America have been concerned with the population’s overweight and obesity rate for a while. The purpose of this study was to find out if optimism bias had an influence on fitness. Optimism bias is overestimating the likelihood of positive events and underestimate the likelihood of negative events happening in one’s life. This study created a fitness optimism scale and used a set of fitness assessments and exercise questions to correlate with the fitness optimism bias. There were 105 students who participated in this study, 82 females and 23 males with a mean age …

Biopsychosocial Factors Of Resilience In The Medically Indigent Adult Population, Kaitlin E. Puckett

Electronic Theses and Dissertations

The medically indigent adult population continues to struggle with the effects of not having insurance coverage, despite the efforts of the Affordable Care Act to provide more affordable healthcare coverage to the population. Based on the United States Census Bureau’s reported population in 2015, an estimated 45 million Americans are without insurance. This study aims to identify and explore the impacts of the biopsychosocial factors of resilience that enable the population to face adversity, stress, and manage distress in the face of trauma (Masten, Best, & Garmezy, 1990; Rutter, 2006; Zimmerman, 2015). Four hypotheses follow a review of literature and …

Relationship Of Force Variables To Vertical Jumps Performance, Hugo A. De Paula Santana

Electronic Theses and Dissertations

The isometric mid-thigh pull (IMTP) has been cited often in the scientific literature; however, there is still a lack of agreement as to the ideal body position used during this test, and how body position impacts the relationship between IMTP performance and dynamic performance. Thus, one aim of this dissertation was to compare two different IMTP positions and correlate the kinetic outputs from each position to vertical jump (VJ) performance. Another purpose of this dissertation was analyze which method of data normalization for IMTP force variables best correlates to squat jump (SJ) and countermovement jump (CMJ) performance.

In the first …

Microrna-186 And Metastatic Prostate Cancer., Dominique Zilpha Jones

Electronic Theses and Dissertations

MicroRNA (miR) dysregulation alters cancer-associated gene expression, which contributes to cancer pathogenesis. For example, miR-186 over expression lead to enhanced proliferation and migration in pancreatic cancer cell models. However, the role of miR-186 in prostate cancer (PCa) remains controversial. Previously, miR-186-5p was up-regulated in PCa patient serum (stage III/IV) compared to controls. Furthermore, miR-186-5p was up-regulated in metastatic PCa (PC-3, MDA PCa 2b, LNCaP) relative to normal prostate epithelial cells (RWPE1). We hypothesized miR-186 inhibition will reduce aggressive PCa using metastatic cell models. To test this, we evaluated whether miR-186-5p inhibition would reduce aggressive PCa behavior and overexpression induce malignant …

Modulation Of Cardiac Kv Currents By Kvbeta2 And Pyridine Nucleotides., Peter Joseph Kilfoil

Electronic Theses and Dissertations

Myocardial voltage-gated potassium (Kv) channels regulate the resting membrane potential and the repolarization phase of the action potential. Members of the Kv1 and Kv4 family associate with ancillary subunits, such as the Kvβ proteins, that modify channel kinetics, gating and trafficking. Previous investigation into the function of cardiac β subunits demonstrated that Kvβ1 regulates I_to and I_K,slow currents in the heart, but the role of Kvβ2 in the myocardium remains unknown. In heterologous expression systems, Kvβ2 increases surface expression of Kv1 channels, shifts the activation potential of Kv1 channels to more polarized voltages, and increases the inactivation of …

Predicting Nclex-Rn Performance : An Exploration Of Student Demographics, Pre-Program Factors, And Nursing Program Factors., Heather Davis Mitchell

Electronic Theses and Dissertations

Nursing programs are experiencing a decline in National Council Licensure Examination for Registered Nurses (NCLEX-RN) pass rates among graduates. While researchers have attempted to identify predictors of performance on the NCLEX-RN, identification of predictors remains elusive. Although the literature is replete with studies exploring NCLEX-RN predictors, prediction under the new 2013 NCLEX test plan and passing standards is not well established. Considering the ever-evolving diversity in students, combined with recent changes in the NCLEX-RN, further exploration of predictors of performance is warranted. Using a correlational design, the study sought to identify the predictors of NCLEX-RN performance for Bachelors of Science …

Long Term Facial Alveolar Bone Changes Associated With Endosseous Implants In The Anterior Maxilla., Deepika Joshi

Electronic Theses and Dissertations

Aim: To quantify the radiographic presence and thickness of facial alveolar bone (FAB_r) adjacent to implants placed in the anterior maxillary region. Lack of FAB_r may suggest that graft procedures are desirable prior to implant placement. Material and Methods: With IRB approval, a retrospective analysis of cone beam computed tomographic cross-sectional images of sites with at least one implant in the anterior maxillary region was performed. Details regarding type of implant and location were recorded. FAB_r perpendicular to the long axis each implant was measured at seven levels by two observers independently and means and standard …

Role Of Microrna-21 In Atherogenesis., Rihab Hamed-Berair

Electronic Theses and Dissertations

MicroRNA-21 (miR-21) is an evolutionarily conserved microRNA, abundant in most cardiovascular tissues. It has been implicated in the pathogenesis of several cardiovascular diseases including restenosis, myocardial infarction, and heart failure. However, little is known about the contribution of miR-21 in atherosclerosis. My data show that expression of miR-21 is increased by >1.5-fold in murine atherosclerotic lesions and by 1.5-2.0-fold in the macrophages of Western diet (WD)-fed LDLR-KO mice (for 12-20 weeks). In vitro, LDL, oxidized LDL, acetylated LDL and LPS induced miR-21 by 2-4-fold and down-regulated its target protein, PDCD4, in bone marrow-derived macrophages. Basally, macrophages isolated from miR-21-KO …

Influence Of In-Office Oral Hygiene Instructions On The Parental Assessment Of Their Child's Oral Health., Sireesha Kodali

Electronic Theses and Dissertations

Purpose: To identify the relation between oral health education and parental assessment of their child’s dental condition. Methods: Our study population included 33,342 children, from Smile KY! annual screenings from 2002 to 20014. Data collection was through questionnaire forms. Our primary risk factor was “dental health instructions received” (yes/no) and our outcome of interest was “parental assessment of your child’s dental health” (good/fair/poor). We had 13 years of data from 2002 to 2014 and used ‘SAS’ statistical software for data manipulation and recoding. Descriptive statistics, chi-square test of independence, trend analysis and multiple logistic regression modeling were performed on ‘SPSS’ …

Psychological And Sociocultural Influences Of Current And Historical Intimate Partner Violence In Pregnancy, Cindy D. Phillips

Electronic Theses and Dissertations

The Centers for Disease Control and Prevention (CDC) estimates that 1.5 million women are victims of intimate partner violence (IPV) each year, and 324,000 of these women are pregnant (2013). Research on the predictability of certain factors and their relationship to current and historical IPV is limited. In order to better understand IPV as it related to a sample of 1,016 Appalachian pregnant women selected for the Tennessee Interventions for Pregnant Smokers (TIPS), it was important to evaluate various influences that may predict the prevalence of IPV in this population when compared to the State of Tennessee and the U.S. …

Biosand Water Filter Evaluation: Meta-Evaluation And Pilot Study Of Field Use Indicators, Bethesda O'Connell

Electronic Theses and Dissertations

Diarrheal diseases are a global public health burden, killing 1.8 million people annually. Diarrhea disproportionately affects children and those in poverty. Most diarrheal cases can be prevented through safe drinking water, basic hygiene and/or sanitation measures, with drinking water interventions having the most impact on reducing diarrheal disease. A meta-evaluation was completed of studies evaluating a specific household water treatment method, the biosand water filter. Results from the meta-evaluation illustrate that biosand water filters improve drinking water quality and reduce diarrheal disease. However, there is no generally agreed upon field method for determining biosand water filter effectiveness that is useable …

Sa-4-1bbl As A Modulator Of Innate, Adaptive, And Regulatory Immunity : Implications For Cancer Prevention And Treatment., Hampartsoum Barsoumian

Electronic Theses and Dissertations

SA-4-1BBL is a recombinant costimulatory molecule that is active in its soluble form and has pleiotropic effects on the functions of innate, adaptive, and regulatory immune cells. We have previously shown that SA-4-1BBL makes CD4+ T conventional cells (Tconvs) resistant to suppression by CD4+CD25+Foxp3+ T regulatory cells (Tregs). The mechanistic basis of this observation is the subject of this study. We demonstrate that Tconvs, but not Tregs, are the direct targets of SA-4-1BBL-mediated evasion of Treg suppression without contribution from antigen presenting cells (APCs). SA-4-1BBL engagement with its receptor, 4-1BB, on Tconvs resulted in the production of high levels of …

Strategies Of Balancing: Regulation Of Posture As A Complex Phenomenon, Allison Leich Hilbun

Electronic Theses and Dissertations

The complexity of the interface between the muscular system and the nervous system is still elusive. We investigated how the neuromuscular system functions and how it is influenced by various perturbations. Postural stability was selected as the model system, because this system provides complex output, which could indicate underlying mechanisms and feedback loops of the neuromuscular system. We hypothesized that aging, physical pain, and mental and physical perturbations affect balancing strategy, and based on these observations, we constructed a model that simulates many aspects of the neuromuscular system. Our results show that aging changes the control strategy of balancing from …