Medicine and Health Sciences Commons^™

Electronic Nicotine Delivery Systems (Ends): Reasons For Use And Associated Factors In Self-Selected Nicotine Concentrations, David D. Allen Iii

Electronic Theses and Dissertations

This study aimed to examine e-cigarette user reasons for use, changes in their nicotine concentrations, and factors associated with changes in their chosen nicotine concentrations.

Formulation Development, Preclinical Testing, And Primary Packaging Optimization For Cannabinoids And Other Therapeutics, Pranjal Taskar

Electronic Theses and Dissertations

Through the process of drug development, a molecule goes through discovery screening; lead selection and optimization, ADME testing, toxicity profiling, dosage form determination, preclinical testing in an in vitro and in vivo setup, folloby clinical research, FDA review and approval until eventually it is manufactured in the determined dosage form and reaches the patient. At every point through this process, scientists actively work towards a smoother transition and a quick and safe approval of the molecule towards the next step. The different chapters in this research would cover various phases of drug development; from discovery stage to fill-finish and primary …

Reward And Punishment: The Neural Correlates Of Reinforcement Feedback During Motor Learning, Christopher Mark Hill

Electronic Theses and Dissertations

‘By the carrot or the stick’ reward or punishment has been contemplated by instructors to motivate their pupils to learn a new motor skill. The reinforcements of reward and punishment have demonstrated dissociable effects on motor learning with punishment enhancing the learning rate and reward increasing retention of the motor task. However it is still unclear how the brain processes reward and punishment during motor learning. This study sought to investigate the role of reinforcement feedback in cortical neural activity associated with motor learning. A novel visuomotor rotation task was employed with reward punishment or null feedback as the participants …

Effects Of The Dual Orexin Receptor Antagonist Dora-22 On Sleep In 5xfad Mice, Marilyn J. Duncan, Hannah Farlow, Chairtra Tirumalaraju, Do-Hyun Yun, Chanung Wang, James A. Howard, Madison N. Sanden, Bruce F. O'Hara, Kristen J. Mcquerry, Adam D. Bachstetter

Neuroscience Faculty Publications

Introduction: Sleep disruption is a characteristic of Alzheimer's disease (AD) that may exacerbate disease progression. This study tested whether a dual orexin receptor antagonist (DORA) would enhance sleep and attenuate neuropathology, neuroinflammation, and cognitive deficits in an AD-relevant mouse model, 5XFAD.

Methods: Wild-type (C57Bl6/SJL) and 5XFAD mice received chronic treatment with vehicle or DORA-22. Piezoelectric recordings monitored sleep and spatial memory was assessed via spontaneous Y-maze alternations. Aβ plaques, Aβ levels, and neuroinflammatory markers were measured by immunohistochemistry, enzyme-linked immunosorbent assay, and real-time polymerase chain reaction, respectively.

Results: In 5XFAD mice, DORA-22 significantly increased light-phase sleep without reducing Aβ levels, …

Investigating Neurogenesis As A Veritable Epigenetic Endophenotype For Alzheimer's Disease, Layne Wells

Scripps Senior Theses

Alzheimer's disease (AD) is the most common neurodegenerative disease, characterized by progressive amyloid plaque aggregation, neurofibrillary tangles, and cortical tissue death. As the prevalence of AD is projected to climb in coming years, there is a vested interest in identifying endophenotypes by which to improve diagnostics and direct clinical interventions. The risk for complex disorders, such as AD, is influenced by multiple genetic, environmental, and lifestyle factors. Significant strides have been made in identifying genetic variants linked to AD through the genome-wide association study (GWAS). It has been estimated in more recent years, however, that GWAS-identified variants account for limited …

Oral Contraceptive Pills Are Not A Risk Factor For Deep Vein Thrombosis Or Pulmonary Embolism After Arthroscopic Shoulder Surgery, Austin V. Stone, Avinesh Agarwalla, Anirudh K. Gowd, Cale A. Jacobs, Jeffrey A Macalena, Bryson P. Lesniak, Nikhil N. Verma, Anthony A. Romeo, Brian Forsythe

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Worldwide, more than 100 million women between the ages of 15 and 49 years take oral contraceptive pills (OCPs). OCP use increases the risk of venous thromboembolism (VTE) through its primary drug, ethinylestradiol, which slows liver metabolism, promotes tissue retention, and ultimately favors fibrinolysis inhibition and thrombosis.

Purpose: To evaluate the effects of OCP use on VTE after arthroscopic shoulder surgery.

Study Design: Cohort study; Level of evidence, 3.

Methods: A large national payer database (PearlDiver) was queried for patients undergoing arthroscopic shoulder surgery. The incidence of VTE was evaluated in female patients taking OCPs and those not taking …

Lung Cancer Screening In A Community Setting: Characteristics, Motivations, And Attitudes Of Individuals Being Screened, Margaret M. Byrne, Sarah E. Lillie, Jamie L. Studts

Behavioral Science Faculty Publications

We describe the characteristics of individuals being screened in community settings including factors influencing screening decisions and the level of information sought prior to screening. Individuals from two community-based radiology clinics (N = 27) were surveyed after screening. Screening efficacy and salience were the most important factors in screening decisions, whereas healthcare provider recommendations were rated not important. Half of participants reported no or little conversation about screening with their primary care provider, and 61.5 percent had not sought any information on screening. Individuals being screened in a community setting are unlikely to have sufficient information for an informed …

Attending To The Not-So-Little "Little Things": Practicing Trauma-Informed Pediatric Health Care, Aimee K. Hildenbrand, Scottie B. Day, Meghan L. Marsac

Pediatrics Faculty Publications

No abstract provided.

General Philippine Hospital, Manila, Philippines, Cara Cecil

Posters

Describes her experience working in the Philippine General Hospital/University of the Philippines providing care in the pediatric ICU, neonatal ICU, and emergency department.

Pediatria En Panama: A Spanish International Health Experience, Vickie Blanco

Posters

Reports learning experiences while working with several pediatric care facilities in Panama.

Global Health Experience: Laos Friends Hospital For Children, Ashley Daniel

Posters

Outlines the learning experiences of a pediatric resident working within the Laos Friends Hospital for Children.

Panama: Exploration Of Multiple Health Care Settings And Spanish Immersion, Danielle Gonzales

Posters

Details how the urban and rural settings of Panama offer an unique opportunity for Spanish immersion and disease pathology learning experiences.

Rhabdomyolysis Associations With Antibiotics: A Pharmacovigilance Study Of The Fda Adverse Event Reporting System (Faers), Chengwen Teng Pharm.D., Ph.D., Courtney Baus, James P. Wilson, Christopher R. Frei

Faculty Publications

Introduction: Daptomycin, macrolides, trimethoprim-sulfamethoxazole, linezolid, fluoroquinolones, and cefdinir are known to be associated with rhabdomyolysis. Other antibiotics may also lead to rhabdomyolysis, but no study has systemically compared rhabdomyolysis associations for many available antibiotics.

Objectives: The objective of this study was to evaluate the association between rhabdomyolysis and many available antibiotics using the FDA Adverse Event Report System (FAERS).

Methods: FAERS reports from January 1, 2004 to December 31, 2017 were included in the study. The Medical Dictionary for Regulatory Activities (MedDRA) was used to identify rhabdomyolysis cases. Reporting Odds Ratios (RORs) and corresponding 95% confidence intervals (95%CI) for the …

Synthesis Of A Novel Surface Active, Light Sensitive Polymer For Encapsulation And Delivery Of Paclitaxel, Amit Raviraj Pillai

Electronic Theses and Dissertations

Melanoma and non-melanoma (basal cell and squamous cell carcinoma) skin cancer (NMSC) have been recognized as an epidemic as they happen to be the most comtype of cancers in the white population. Cancer cell targeting i.e. differentiating cancer cells from normal cells has been an area of active research to reduce the side effects of cancer chemotherapy. For this research project, we have developed a novel light sensitive Methylene Blue (MB)-Polyethylene glycol (PEG) conjugate with significant surfactant properties. The aim of this study was to synthesize a smart light sensitive polymer which activates and releases the encapsulated drug on exposure …

Investigation Of Theophylline Nicotinamide Pharmaceutical Co-Crystals Utilizing Hot Melt Extrusion, Priyanka Srinivasan

Electronic Theses and Dissertations

The objective of the current study was to investigate the feasibility of Theophylline and Nicotinamide pharmaceutical co-crystals by hot melt extrusion technology and to evaluate the processability by using HPMCAS-MG and PEO as polymer carriers. Theophylline, a BCS class I was chosen as a model drug and Nicotinamide, a vitamin B family was selected as a suitable co-former for the co-crystals study. HPMCAS-MG, a synthetic polymer and PEO, water-soluble polymer were chosen as polymer carriers for the study. To optimize the process parameters and formulations, a physical mixture of 1:1 molar ratio of theophylline and nicotinamide were prepared. Physical mixture …

Application Of Quality By Design And Process Analytical Technology Towards Hot-Melt Extrusion Processes, Priyanka Thipsay

Electronic Theses and Dissertations

Solid self-emulsifying drug delivery systems were developed instead of a conventional liquid system. Solid surfactants was chosen to emulsify lipids with different HLB properties. Type of surfactant, type of lipid, Lipid/surfactant L/S ratio, feed rate, screw speed and screw configuration, were the formulation and process parameters evaluated. Solid self-emulsifying drug delivery systems were successfully developed on the hot-melt extruder for the first time which is a continuous processing technology.

Novel Application Of Melt Extrusion And Additive Manufacturing On Developing Diverse Dosages, Jiaxiang Zhang

Electronic Theses and Dissertations

New drug product development is a time consuming and costly process. One of the significant challenges is the poor aqueous solubility of many active pharmaceutical ingredients (APIs). Among those techniques, hot-melt extrusion(HME) is optimal for pharmaceutical solid dispersion development because of it free of using an organic solvent, easy scale up, and suitable for continuous processing with ensured optimal quality control.

Comparative Effectiveness And Safety Of Non-Vitamin K Antagonists Oral Anticoagulants And Warfarin In Elderly Patients With Non-Valvular Atrial Fibrillation And Diabetes, Siddhi Korgaonkar

Electronic Theses and Dissertations

Results: The matched sample consisted of 4578 patients (2291 in each group). NOACs were found to significantly reduce the risk of stroke/SE compared to warfarin (Hazard Ratio (HR): 0.373, 95% confidence interval (CI): 0.247 - 0.564, p<0.001); but, no significant difference was seen between NOACs and warfarin in terms of reducing the risk of MI (HR: 0.864, CI: 0.594 – 1.257, p=0.446). NOACs were found to significantly reduce the risk of ICH (HR: 0.500, CI: 0.300 – 0.834, p=0.008) and OB (HR: 0.608, CI: 0.424 – 0.870, p=0.007); but no difference was seen in the risk of MGB (HR: 0.862, CI: 0.640 – 1.160, p=0.326) between NOACs and warfarin. NOACs were also found to reduce the risk of all-cause mortality (HR: 0.783, CI:0.656 – 0.873, p=0.007). The composite of effectiveness and safety outcomes, and all-cause mortality was statistically significant proving superior overall effectiveness and safety of NOAC therapy to warfarin therapy in terms of risk reduction (HR:0.685, CI:0.587 – 0.801, p<0.001).

Validation Of A Brief Screening Instrument For Psychopathology In Adults, Adam Sattler

Electronic Theses and Dissertations

Structured diagnostic interviews are generally considered to be the gold standard method of assessing mental health conditions; however clinicians rarely use such techniques in clinical practice. A major factor contributing to the infrequent use of structured interviews is the amount of time required for administration and interpretation. As such there is a need to develop assessment instruments that balance the objectivity and structure of evidence-based assessment techniques against personnel time and cost. To address this need the current study sought to validate a brief screening instrument for assessing 9 commental health conditions using a well-researched structured clinical interview to establish …

E-Cigarettes And Conventional Cigarettes: Perceived Risks And Benefits Among College Students, Evi Addoh

Electronic Theses and Dissertations

ABSTRACT Background: Accompanying the decline in cigarette smoking rates has been a rise in prevalence of electronic cigarette (e-cigarette) use. The ongoing investigations on the health impact of e-cigarettes have been accompanied by mixed messages and a lack of consensus which may lead college students to rely on their own perceptions of risk and benefits in deciding whether to use e-cigarettes. Conclusion: Considering the significant association of perceived risks and benefits with e-cigarette and cigarette use this study yields some findings that show the importance of appropriately addressing perceptions. It is paramount to keep the public updated on pertinent research …

Valuation Of Mentorship In Pharmacy Education And The Impact Of Perceived Personal Relevance, Ashley Stubblefield Crumby

Electronic Theses and Dissertations

Mentorship is an important component of personal and professional development for student pharmacists. This research measured the value of mentorship in this population examined potential influencing factors and the likelihood to participate in a mentoring relationship and identified preferences for the mentoring relationship. Data collection involved survey self-report of student pharmacists (P1-P4) at four participating universities. An adapted 29-item Mentoring Functions Scale (MFS) was used to measure value with functions divided into career and psychosocial categories. The highest ranked mentoring functions were psychosocial with an average score of 9 or greater on the 10-point scale. Perceived personal relevance measured using …

Pharmacy Value-Based Incentive Programs: An Evaluation Of Health Plan Strategies, Pharmacist Attitudes, And Financial Impact On Retail Stores, Tristen H. Jackson

Electronic Theses and Dissertations

Since the Affordable Care Act (ACA) in 2012 health plans serving Medicare beneficiaries have begun receiving sizeable incentives (>$1B) for demonstrating high ratings to quality performance scores in CMS’s Medicare star ratings program. Several of the quality measures can be directly impacted by retail pharmacists (e.g. medication adherence measures) resulting in health plans implementing programs designed to incentive retail pharmacies to work toward improving their own performance related to quality measures. While awareness of these value-based incentive (VBI) programs is growing there is still a significant lack of research which elucidates the nature of these programs and the potential …

Comparative Assessment Of Safety And Quality Of Tinospora Species-Tinospora Crispa And Tinospora Sinensis, Abidah Parveen

Electronic Theses and Dissertations

Tinospora crispa Miers ex Hook.f. & Thomson and Tinospora sinensis (Lour.) Merr. (Menispermaceae) are two species that have morphological similarities which makes distinction between the two of critical importance because T. crispa has been reported to cause hepatotoxicity. Comparative morpho-anatomy of the leaves and stems of Tinospora species indigenous to south and southeast Asia was undertaken to elaborate their distinguishing pharmacognostic features. Chemical characterization of the secondary metabolites of the two species may aid in elucidating their chemical diversity and hence help to resolve safety and quality issues. Phytochemical investigation of the stems led to the isolation of nineteen compounds …

African American Students In Physical Therapy: Enhancing Diversity, Kimberly Renee Willis

Electronic Theses and Dissertations

African Americans are motivated by early exposure to the profession and future expectations for their personal career path including stability work-life balance and helping others. The elimination of barriers such as finances lack of support and cultural microaggressions influences their career path. Following statistical analysis of admissions data conclusions were made that the current admissions criteria does not successfully predict first year success for any students including African American students. Lastly African American physical therapy graduates from UMMC reported excitement upon admission concerns over quotas lack of African American faculty students and physical therapists and the presence of microaggressions while …

Role Of Cardiolipin Remodeling In The Malignant Progression Of Breast Cancer, Jawaher H. Alkhamisy

Electronic Theses and Dissertations

In spite of the current advances in both radiotherapy and surgical techniques as well as molecularly targeted therapies, over 90 percent of cancer mortality rate is due to metastases. Considering the pivotal role of metabolism in cellular physiology, there is no doubt that metabolic alterations are critical for metastatic progression. Cardiolipin (CL), the signature phospholipid of mitochondria, is linked to a variety of vital mitochondrial processes, like oxidative phosphorylation. Cardiolipin is a unique dimeric phospholipid which contains four fatty acyl chains. Moreover, the CL remodeling process is believed to be responsible for generation of immature CL species that contribute to …

Unraveling Anticancer Activity And Pharmacokinetics Of Dihydroartemisinin Dimer Oxime, Lu Dai

Electronic Theses and Dissertations

Artemisinin is currently used as an antimalaria drug. Studies have shown its monomeric form exhibited promising anticancer effects by inhibiting the proliferation, inducing apoptosis, and increasing oxidative stress of tumor cells. Recently, several dimeric forms of artemisinin have been synthesized with more potent anticancer activity. In this study, nine dihydroartemisinin dimers with diversely functionalized linkers exhibited similar cytotoxicity against human breast adenocarcinoma MDA-MB-231 in vitro. Among these nine DHA dimers, DHA dimer oxime was selected for further anticancer activity and pharmacokinetic study. Our preliminary study shothat DHA dimer oxime displayed more than a 10-fold increase of antiproliferation effect over its …

End Of Life Costs In Medicare Beneficiaries With Parkinson’S Disease, Sasikiran Nunna

Electronic Theses and Dissertations

Parkinson's disease (PD) is a chronic and progressive neurodegenerative disorder which is characterized by motor and non-motor disorders. The prevalence of PD is high among elderly patients. Due to the chronic nature of PD, increasing prevalence and ageing population, it is important to understand the burden of PD at various stages of patient’s life so that value of PD therapies can be assessed. While direct healthcare costs during the life time of PD were assessed in previous studies, there is lack of information about end of life costs in PD patients. This dissertation aimed at filling the gap in literature …

Characterization Of Drug-Loaded Milled Extrudate Particles Produced By Hot Melt Extrusion Technology For Dry Powder Inhalers, Ahmed Almotairy

Electronic Theses and Dissertations

The aim of the current investigation is to develop a sustained-release dry powder inhalation (DPI) formulation through continuous Hot Melt Extrusion (HME) process and see the impact of Sodium Bicarbonate (SB) and Mannitol (MAN) on the hydrophobic Eudragit RL PO (ERLPO) polymer. Ball milling and air-jet milling were utilized to have powder with a particle size range that is required for inhalation. Air-jet milled formulations shopromising particle size results compared to ball milled formulations. All solid-state characterization studies revealed no change on Theophylline (TH) crystallinity or occurrence of drug-excipient interactions in physical mixtures and formulations. X2 formulation released TH constantly …

Recall Reading Intervention For Children In Preschool And Kindergarten With Moderate To Severe Language Delays, Rebekah Christine Bosley

Electronic Theses and Dissertations

Dialogic reading is a reading intervention method in which the adult prompts the child with questions and expansions. Previous research has documented that it has been effective in promoting engagement, increasing response rates, developing vocabulary knowledge, and increasing overall answer accuracy in children with Autism Spectrum Disorder (ASD) (Fleury, Miramontez, Hudson, & Schwartz, 2014; Fleury & Schwartz, 2016; Whalon, Martinez, Shannon, Butcher, & Hanline, 2015). The current study investigates whether children with moderate to severe language delays with or without Autism could increase their verbal and nonverbal responses and joint attention through the RECALL (Reading to Engage Children with Autism …

Progress Toward The Synthesis Of 3-Methoxyflavones As Potential Antioxidants, Neuroprotective Agents, And Trifluoromethylated 19f Nmr Probes, Reem Alkhodier

Electronic Theses and Dissertations

The total synthesis of polyhydroxylated flavones have proven to be challenging, due to the presence of more than one hydroxyl group. Direct cyclization was not successful in any of the attempts. However, by using a silyl protecting group, the cyclization was feasible. Other reactions like the Friedel-Crafts acylation and selective protection of phenols were also difficult.