Medicine and Health Sciences Commons^™

Factors Associated With Parental Decision Making And Childhood Vaccination, Zuwen Qiu-Shultz

UNLV Theses, Dissertations, Professional Papers, and Capstones

In order to better understand factors affecting immunization status, logistic regression was used to assess the association of various socio-demographic factors and whether parents would have their child immunized if not a state mandate. Factors included in the study were race, household income, number of children in the household, number of adults in the household, if the child had a primary provider, if the child had a health check-up in the last twelve months, and medical insurance status of the child. The combined Nevada Kindergarten Health Survey Result of 2009-2010 (Year Two) and 2010-2011 (Year Three) conducted by the Nevada …

Quantifying Value In Public Health: Using Economic Methods To Analyze System Change, Theresa M. Green

Dissertations

In this time of economic downturn, it is becoming increasingly important for organizations, including those in public health, to “prove their worth,” to show the value in improvement strategies. Health agencies have learned to discuss impact in terms of health outcome and mortality/morbidity measures. However, it is critical that these impacts are also expressed in a way that shows cost-efficiency and economic benefit especially for promising, evidence-based public health interventions. Although several methods of economic evaluation including cost-effective analysis, cost-utility analysis, or cost-benefit analysis and return on investment (ROI) have been used in social sciences and health research, fewer examples …

Evaluation Of Modafinil In Preclinical Behavioral Assays Of Abuse Liability, Amanda J. Quisenberry

Dissertations

Modafinil is an FDA-approved drug for the treatment of narcolepsy with efficacy in the treatment of chronic fatigue syndrome, obstructive sleep apnea, and shift-work sleep disorder. Modafinil’s wake-promoting and cognitiveenhancing effects are reportedly similar to those of traditional psychostimulants, but without the side effects typically associated with these substances. Modafinil has also been investigated as an agonist replacement therapy for psychostimulant dependence, although results of clinical trials are equivocal. Few studies have examined its behavioral effects in combination with psychostimulants and the neuropharmacological actions of modafinil are not well understood. The primary aim of this study was to assess modafinil’s …

Grip Strength, Multimorbidity, And Disability, Amy M. Yorke

Dissertations

The presence of two or more chronic health conditions, also known as multimorbidity, is one of the most prevalent health disorders experienced by adults. Adults with multimorbidity and functional limitations represent clinical and financial challenges to the current health care system. The purpose of this three-paper dissertation is to examine the relationship between grip strength, multimorbidity, and the prediction of disability in adults. Data from the 2008 Health and Retirement Study (HRS), a nationally representative, longitudinal study completed on Americans age 50 years and over, are used for the dissertation.

The objective of the first paper is to investigate the …

Psychometrics Of The Positive Thinking Skills Scale Among Dementia Caregivers, Abir K. Bekhet

College of Nursing Faculty Research and Publications

No abstract provided.

Humans' Bonding With Their Companion Dogs: Cardiovascular Benefits During And After Stress, Rebecca A. Campo, Bert N. Uchino

The Journal of Sociology & Social Welfare

This study examined whether having one's companion dog present during and after stress posed similar cardiovascular benefits as having a close friend present, even when the relationship quality for both the companion dog and friend was highly positive. Positive aspects of relationship quality for participants' dog and friend were not associated with one another, suggesting that these relationships exist independently. Additionally, compared to participants with a close friend present, those with their dog present had lower heart rate and diastolic blood pressure (p's < .05) while undergoing the stressors, and tended to have lower heart rate and systolic blood pressure (p's < .09) when recovering from stressors. This study indicates that even when relationship quality is similarly high for companion dogs and friends, dogs may be associated with greater reductions in owners' cardiovascular reactivity to stress, particularly if there is a potential for evaluation apprehension in the human friendships. These findings support the value of the human- companion animal relationship in promoting human welfare.

Anxiety In Children With Williams Syndrome : Association With Negative Reactivity, Self-Regulation, And Sensory Modulation., Nicole A. Crawford-Zelli

Electronic Theses and Dissertations

Williams syndrome (WS) is a neurodevelopmental disorder caused by a submicroscopic deletion of approximately 25 genes on chromosome 7q11.23 (Hillier et al., 2003). This genotype is associated with a characteristic set of phenotypic features including mild to moderate intellectual disability, a distinctive cognitive profile, facial dysmorphology, common personality traits, cardiovascular problems, and connective tissue disorders (Morris, 2010). In addition, behavioral difficulties such as anxiety symptoms (e.g., Leyfer, Woodruff-Borden, & Mervis, 2009), negative reactivity (e.g., Davies, Udwin, & Howlin, 1998), problems with self-regulation (e.g., Woodruff-Borden, Kistler, Henderson, Crawford, & Mervis, 2010), and sensory modulation difficulties (e.g., John & Mervis, 2010) are …

Telemental Health In Today's Rural Health System, David Lambert Phd, John A. Gale Ms, Anush Yousefian Hansen Ms, Ma, Zachariah T. Croll Ba, David Hartley Phd, Mha

Mental Health / Substance Use Disorders

Telemental health has long been promoted in rural areas to address chronic access barriers to mental health care. While support and enthusiasm for telemental health in rural areas remains quite high, we lack a clear picture of the reality of telemental health in rural areas, compared to its promise. This Research & Policy Brief reports on the first part of our study—the online survey of 53 telemental health programs—and describes the organizational setting, services provided, and the staff mix of these programs. We draw from our telephone interviews with 23 of these programs to help describe the organizational context of …

Correlation Between Central Corneal Thickness Measurements Using Two Uifferent Ultrasonic Pachymeters, Sharmeen Akram, Zarksis H, Anklesaria A, Khabir Ahmad

Department of Surgery Docs

Purpose: To assess correlation between central corneal thickness measurements using two different ultrasonic pachymeters. Material and Methods: This prospective study involved normal subjects aged 16 to 45 years. Central corneal thickness was measured in 47 eyes by two ultrasonic pachymeters – Tomey SP – 100 and Sonomed 300 AP. Correlations between CCT measurements assessed by the two pachymeters were tested by Pearson correlation. Results: Forty seven eyes were included in the study. The mean (± SD) age of the subjects was 27.79 years (± 6.88).The mean (± SD) Tomey Pachymeter CCT was 536.45 m (34.37) and the mean (SD) Sonomed …

Rna Interference Targeting Glucose-Regulated-Protein 78 Induces Hepg2 Cell Apoptosis, Brittany Blackman

Seton Hall University Dissertations and Theses (ETDs)

Cancer is a complex genetic disease that is driven by genetic mutations resulting in chronic, inappropriate cell proliferation. Many current cancer therapies lack specificity towards tumor tissues, ultimately leading to adverse side effects and limited clinical efficacy. Recently, selective cancer cell therapy has examined a well-characterized cell surface marker that is preferentially expressed on tumor cells. The over-expression of an endoplasmic reticulum chaperone protein, 78-kDa glucose-regulated-protein (GRP78), has been observed on the surface of cancer cells, but not on normal tissues. By selectively targeting GRP78 with short-interfering RNA (siRNA), potent GRP78 silencing is anticipated by the RNA interference (RNAi) pathway. …

Novel Functions Of Cetuximab In Egfr-Targeted Therapy: Radiosensitization, Glycolysis Inhibition, And Cellular Redox Status Regulation, Haiquan Lu

Dissertations and Theses (Open Access)

Epidermal growth factor receptor (EGFR) is overexpressed in the majority of head and neck cancers. The anti-EGFR antibody cetuximab has been approved by the FDA for the treatment of head and neck cancers, however, only a small fraction of patients respond to cetuximab treatment. Further investigation to understand the mechanisms underlying cetuximab-mediated EGFR-targeted therapy and to develop novel therapeutic strategies to improve the efficacy of cetuximab is urgently needed. In the present study, we elucidated the mechanism of cetuximab in radiosensitization, and discovered novel functions of cetuximab in glycolysis inhibition and cellular redox status regulation. We found that cetuximab inhibits …

An Evaluation Of The Consistency Of Imrt Patient-Specific Qa Techniques, Elizabeth M. Mckenzie

Dissertations and Theses (Open Access)

To ensure the integrity of an intensity modulated radiation therapy (IMRT) treatment, each plan must be validated through a measurement-based quality assurance (QA) procedure, known as patient specific IMRT QA. Many methods of measurement and analysis have evolved for this QA. There is not a standard among clinical institutions, and many devices and action levels are used. Since the acceptance criteria determines if the dosimetric tools’ output passes the patient plan, it is important to see how these parameters influence the performance of the QA device. While analyzing the results of IMRT QA, it is important to understand the variability …

Ezh2 T416 Phosphorylation Enhances Breast Cancer Tumorigenesis, Adam M. Labaff, Adam M. Labaff

Dissertations and Theses (Open Access)

Enhancer of zeste homologue 2 (EZH2) is the catalytic subunit of Polycomb repressive complex 2 (PRC2) and catalyzes the trimethylation of histone H3 on lysine 27 (H3K27Me3), to repress gene transcription. Many types of cancer stem and progenitor cells, including breast, have demonstrated EZH2 to be fundamental in the biology and promoting the expansion of their cellular populations. How EZH2 regulates each of these respective tumor initiating cells (TICs) populations has been studied, but the signaling transduction mechanisms that regulate EZH2 in these TIC populations is yet to be elucidated. Phosphorylation of EZH2 by cyclin dependent kinases (CDK) has been …

Characterization Of Oslds For Use In Small Field Photon Beam Dosimetry, Christopher Pham

Dissertations and Theses (Open Access)

The goal of this study was to redesign a Radiological Physics Center (RPC) mailable remote audit tool used for stereotactic radiosurgery (SRS) single beam dosimetry. A prototype phantom was designed and built housing nanoDot (Landauer Inc., Glenwood, IL) Al₂O₃:C optically stimulated luminescence dosimeters (OSLDs) whose visible active luminescent area has been masked. The phantom has two measurement points with two OSLDs at each location and a film insert for localization purposes only. The masked OSLDs were characterized accounting for various correction factors associated with OSLD dose calculations. The uncertainties for each correction factor were also investigated. …

Developmental And Molecular Functions Of Plakophilin-3, William A. Munoz

Dissertations and Theses (Open Access)

Plakophilin-3, the less studied member of the plakophilin-catenin subfamily, and the larger catenin family, binds directly to desmosomal cadherin cytoplasmic domains and enhances desmosome formation and stability. In mammals, plakophilin-3 is expressed at the highest levels in desmosome-enriched tissues such as epithelia, with the knock-out in mice producing corresponding reductions in ectodermal integrity. In tissue, cellular and intracellular contexts where plakophilin-3 is not at the desmosomal plaque, little is known about its functions in the cytoplasm or nucleus, where it also localizes.

My work employed embryos of the amphibian, Xenopus laevis, to examine plakophilin-3’s developmental roles. I first evaluated …

Investigation Of Respiratory Motion Management Techniques For Proton And Photon Radiotherapy Of Lung Cancer, Jason E. Matney

Dissertations and Theses (Open Access)

Protons as a source of therapeutic radiation can provide a substantial improvement over dose distributions that can be achieved with conventional sources of radiation such as high-energy photons. However, respiratory motion can significantly impact the delivered proton and photon dose distributions during lung cancer radiotherapy. The goals of this dissertation research were to evaluate the impact of respiratory motion and to estimate the benefit of respiratory gating for passively scattered proton therapy (PSPT) and intensity modulated photon therapy (IMRT).

The first aim of this project was to determine the impact of respiratory motion in PSPT and IMRT. Four dimensional dose …

The Role And Mechanism Of The Homeobox Gene Hoxa9 In The Growth Of Epithelial Ovarian Cancer, Song Yi Ko

Dissertations and Theses (Open Access)

Epithelial ovarian cancer (EOC) is the fifth leading cause of cancer death among women in the United States. The high lethality of EOCs stems from rapid peritoneal involvement. EOCs frequently colonize peritoneal surfaces that overlie connective and adipose tissues. However, the mechanisms that enable ovarian cancer cells to readily adapt to the peritoneal environment are poorly understood. HOXA9, a homeobox gene that is normally expressed in the developing female reproductive tract, is aberrantly expressed in EOCs and controls the morphologic features of these tumors. The differentiation pattern of a tumor is an important determinant of its clinical behavior and …

Therapeutic Efficacy Of P53 Restoration In Mdm2-Overexpressing Tumors, Qin Li

Dissertations and Theses (Open Access)

The TP53 tumor suppressor is the most mutated gene in human cancers. Recent studies using genetically modified mouse models have shown that restoring the expression of wild-type p53 has led to tumor growth suppression in various types of tumors lacking p53. Other mechanisms, e.g. upregulation of Mdm2 levels, exist in tumors to inactivate the p53 pathway. Mdm2, an E3 ubiquitin-ligase that targets p53 for proteasomal degradation, is present at high levels in many tumors with wild-type p53. In this study, we probed the effects of restoring p53 activity in Mdm2-overexpressing tumors genetically using animal models. Here we demonstrated high levels …

Radiogenic Second Cancer Risk Differences In Female Hodgkin Lymphoma Patients Treated With Proton Versus Photon Radiotherapies, Kenneth L. Homann

Dissertations and Theses (Open Access)

Hodgkin Lymphoma (HL) is the most common cancer diagnosis of young adults in the United States. Advances in curative treatments for HL, including the use of photon radiation therapy (RT) techniques, have increased 10 year survival rates to approximately 90% among young patients. These RT treatments, however, contribute to an increased incidence of radiogenic second cancer (RSC) formation to the healthy tissue surrounding the tumor volume relative to the general population. These RSCs are the leading cause of death among long-term HL survivors. Proton therapy has been shown to reduce the therapeutic dose, and therefore, the risk of developing a …

Mtorc1 Signaling In Memory Formation And Dysfunction, Natalia S. Rozas De O'Laughlin

Dissertations and Theses (Open Access)

The mechanistic Target of Rapamycin Complex 1 (mTORC1) pathway integrates cellular availability of growth factors, energy and amino acids to regulate protein synthesis and autophagy. The mTORC1 pathway has also been shown to be required for memory consolidation, and its dysregulation is associated with many neurological disorders. MTORC1 is negatively regulated by the tuberous sclerosis complex (TSC1/2). When ATP and growth factors are available, TSC1/2 is inhibited and mTORC1 activity can be restored. In a complementary regulatory pathway, amino acids signal to mTORC1 through the Rag GTPases and Ragulator complex, which modulate the translocation of mTORC1 from the cytoplasm to …

The Staphylococcus Pseudintermedius Adhesin Spsd Contains A Central Fibronectin-Binding Domain, Andrea S. Bordt

Dissertations and Theses (Open Access)

Staphylococcus pseudintermedius is a Gram-positive bacterium significant because of its ability to cause costly and difficult to treat veterinary infections worldwide. It exhibits several similarities to Staphylococcus aureus, however, very little is known about its surface adhesins. Surface adhesins in S. aureus are significant contributors to pathogenesis. S. pseudintermedius encodes the surface protein SpsD, which contains characteristics of the microbial surface components recognizing adhesive matrix molecules family and confers attachment of the heterologous host Lactococcus lactis to fibronectin. This work has identified a centrally-located fibronectin binding domain in SpsD which binds the 30 kDa N-terminal domain of fibronectin with …

Characterizing The Effect Of Dasatinib On Anti-Tumor Immune Response And Exploring The Potential Of Combining Targeted Therapy And Immunotherapy In A C-Kit Mutant Mastocytoma Model, Yan Yang

Dissertations and Theses (Open Access)

Targeted therapy and immunotherapy eradicate malignant cells through different mechanisms, and the strengths and weaknesses of these two approaches are potentially complementary. Therefore, the combination of molecular targeted drugs with immune- based therapies is considered an attractive approach for improving the therapeutic efficacy of cancer treatment. The mutation and amplification of the c-KIT proto- oncogene are associated with multiple different cancer types, and multiple c-KIT inhibitors have been tested clinically. In spite of some encouraging results using these agents, most patients with c-KIT mutant cancers still relapse due to drug resistance. This also demonstrates the inherent limitation of molecular targeted …

Ventral Tegmental Area Neuronal Responses To Methylphenidate Correlated To Behavioral Responses Of Adolescent And Adult Rats, Zachary Jones

Dissertations and Theses (Open Access)

Methylphenidate (MPD) is a psychostimulant used in the treat treatment of attention deficit hyperactivity disorder and more recently is being used as a cognitive enhancement and recreational drug. Its therapeutic effects are not fully understood, nor are the long term effects of the drug on brain development. The ventral tegmental area (VTA) is a site of psychostimulant action thought to be involved in behavioral sensitization. The aim of the this study was to first determine if there are differences in neuronal responses between individuals, with respect to neuronal firing patterns in the ventral tegmental area (VTA), and whether these differences …

C-Jun N-Terminal Kinases Regulate Adenovirus-Mediated Autophagy And Antigen Presentation, Sarah R. Klein

Dissertations and Theses (Open Access)

Targeted immunotherapy with recombinant, oncolytic adenoviruses is under investigation for the treatment of cancer. Evidence indicates adenoviruses induce autophagy that is required for oncolysis, but the molecular regulation of autophagy in infected cells remains under investigation. Our data suggested the canonical pathway regulating starvation-induced autophagy was not implemented in adenovirus-induced autophagy; however, adenovirus infection triggered phosphorylation of c-Jun N-terminal kinases (JNK) that was essential for autophagy. Adenoviral replication within the host cell elicited JNK pathway activation leading to B cell lymphoma-2 (Bcl-2) phosphorylation. JNK-dependent Bcl-2 phosphorylation stimulated the dissociation of Bcl-2/beclin 1 heterodimers, enabling beclin 1 to initiate autophagy. Moreover, …

Basis For Targeting Met Activation Mediated Resistance To Pi3k Inhibition In Breast Cancer, Ana M. Gonzalez-Angulo

Dissertations and Theses (Open Access)

The identification of resistance mechanisms to emerging therapies, such as those targeting the PI3K pathway and the MET receptor, has the potential to benefit a significant number of patients with breast cancer. In this study we hypothesized that concurrent aberrations in PI3K and MET will render breast cancers resistant to therapies targeting each pathway, and that combination therapy targeting the PI3K and MET pathway will optimize therapy-effect by preventing the acquisition of resistance.

We analyzed cMET and phospho-cMET levels in 257 breast cancer samples and found that high levels of both the proteins were seen in all breast cancer subtypes, …

Neural Correlates Of Audiovisual Speech Perception In Aphasia And Healthy Aging, Sarah H. Baum

Dissertations and Theses (Open Access)

Understanding speech in face-to-face conversation utilizes the integration of multiple pieces of information, most importantly the auditory vocal sounds and visual lip movements. Prior studies of the neural underpinnings of audiovisual integration in the brain have provided converging evidence to suggest that neurons within the left superior temporal sulcus (STS) provide a critical neural hub for the integration of auditory and visual information in speech. While most studies of audiovisual processing focus on neural mechanisms within healthy, young adults, we currently know very little about how changes to the brain can affect audiovisual integration in speech. To examine this further, …

Association Between In Utero Arsenic Exposure, Placental Gene Expression, And Infant Birth Weight: A Us Birth Cohort Study, Dennis Liang Fei, Devin C. Koestler, Zhigang Li, Camilla Giambelli, Avencia Sanchez-Mejias, Julie Gosse, Carmen J. Marsit, Margaret R. Karagas, David J. Robbins

Dartmouth Scholarship

Epidemiologic studies and animal models suggest that in utero arsenic exposure affects fetal health, with a negative association between maternal arsenic ingestion and infant birth weight often observed. However, the molecular mechanisms for this association remain elusive. In the present study, we aimed to increase our understanding of the impact of low-dose arsenic exposure on fetal health by identifying possible arsenic-associated fetal tissue biomarkers in a cohort of pregnant women exposed to arsenic at low levels.

Methods: Arsenic concentrations were determined from the urine samples of a cohort of 133 pregnant women from New Hampshire. Placental tissue samples collected from …

Periprosthetic Knee Infection: Ten Strategies That Work., Javad Parvizi, Md, Priscilla Ku Cavanaugh, Claudio Diaz-Ledezma

Department of Orthopaedic Surgery Faculty Papers

Periprosthetic joint infection (PJI) is one of the most serious complications following total knee arthroplasty (TKA). The demand for TKA is rapidly increasing, resulting in a subsequent increase in infections involving knee prosthesis. Despite the existence of common management practices, the best approach for several aspects in the management of periprosthetic knee infection remains controversial. This review examines the current understanding in the management of the following aspects of PJI: preoperative risk stratification, preoperative antibiotics, preoperative skin preparation, outpatient diagnosis, assessing for infection in revision cases, improving culture utility, irrigation and debridement, one and two-stage revision, and patient prognostic information. …

Securing Information Technology In Healthcare, Denise Anthony, Andrew T. Campbell, Thomas Candon, Andrew Gettinger, David Kotz, Lisa A. Marsch, Andrés Molina-Markham, Karen M. Page, Sean W. Smith, Carl A. Gunter, M. Eric Johnson

Dartmouth Scholarship

Information technology (IT) has great potential to improve healthcare quality while also improving efficiency, and thus has been a major focus of recent healthcare reform efforts. However, developing, deploying and using IT that is both secure and genuinely effective in the complex clinical, organizational and economic environment of healthcare is a significant challenge. Further, it is imperative that we better understand the privacy concerns of patients and providers, as well as the ability of current technologies, policies, and laws to adequately protect privacy. The Securing Information Technology in Healthcare (SITH) workshops were created to provide a forum to discuss security …

The Effect Of Cell Culture Environment On Expression Of Cd44+, Ki67, And Foxo3a And Its Implications On The Role Of Foxo3a In Triple Negative Breast Cancer, Erin Vegter

All Theses

Triple negative breast cancer (TNBC) is a highly aggressive cancer, which is known for a high rate of metastasis and poor prognosis. TNBC cells are hypothesized to undergo the cellular processes epithelial-to-mesenchymal transition (EMT) and mesenchymal-to-epithelial transition (MET). The known prognostic markers CD44+ and Ki67 as well as the transcription factor and proposed tumor suppressor FoxO3a are thought to be indicators of EMT and MET activity in cancer cells. In order to better understand these processes an effective cell culture technique to mimic the tumor environment needs to be established. The purpose of this study was to determine if changing …