Medicine and Health Sciences Commons^™

A Complete Approach To Predict Biodistribution Of Nanomaterials Within Animal Species From In-Vitro Data, Edward Price

Electronic Theses and Dissertations

Smart drug-design for antibody and nanomaterial-based therapies allows for optimization of drug efficacy and more efficient early-stage pre-clinical trials. The ideal drug must display maximum efficacy at target tissue sites, but to track and predict distribution to these sites, one must have a mechanistic understanding of the kinetics involved with the individual cells of the tissue itself. This process can be tracked through biological simulations coupled with in-vitro approaches, which result in a rapid and efficient in-depth understanding of drug transport within tissue vasculature and cellular environment. As a result, it becomes possible to predict drug biodistribution within live animal …

Role Of Tnfα Antagonists And Genetic Polymorphisms In Modulating Susceptibility To Mycobacterial Infection Among Patients With Crohn's Disease, Ahmad Qasem

Electronic Theses and Dissertations

Tumor Necrosis Factor alpha antagonists (anti-TNFα) have been extensively used for Crohn's disease (CD) treatment. Even though they may control CD symptoms initially, treatment response varies among patients, which seems to depend on single nucleotide polymorphisms (SNPs) in TNFα receptors superfamily 1A and 1B (TNFRSF1A/B). Most importantly, M. tuberculosis infection has been strongly associated with these medications, but no studies have elucidated the effects of anti-TNFα on CD associated with MAP (Mycobacterium avium subspecies paratuberculosis; a possible causative agent of CD, and closely related to M. tuberculosis). Here, we investigated the effects of recombinant inflammatory cytokines and anti-TNFα therapeutics on …

Electronic Reminders To Improve Medication Adherence In Diabetes: A Quality Improvement Project, Lisa Wilson

DNP Scholarly Projects

BACKGROUND: Diabetes often contributes to many co-morbid conditions and their complications. Non-adherence to medications is common in patients with chronic disease. The project aimed to improve medication adherence through the implementation of electronic messaging. The project was set in a private medical practice within a critical access hospital. Participants were patients of the practice with diabetes.

METHODS: Baseline assessment included review and documentation of HgBA1cs, prescription requests, and past medical history. The development of an intervention to improve medication adherence utilizing electronic reminders was based on Bandura’s (1989) Social Cognitive Theory and Ajzen’s (1991) Theory of Planned Behavior.

INTERVENTION: The …

The Effects Of Eicosapentaenoic Acid (Epa) And Docosahexaenoic Acid (Dha) On Brown Adipogenesis In Stem Cell Culture, Darynne A. Dahlem, Yan Huang

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Polyunsaturated fatty acids (PUFAs), especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are major maternal dietary supplements due to their positive benefits on neurological tissue growth during the first 12 weeks of gestation. Previous studies show that EPA and DHA inhibit muscle formation but promote adipogenesis. However, no research has addressed the question whether high intake of EPA and DHA affects brown fat development during gestation. The objective of this study was to measure the effect of EPA and DHA supplement on brown adipogenesis and potential pathways related to mitochondrial biosynthesis using fibroblasts as in vitro model. Using Oil-Red-O staining …

Strategies To Increase Human Immunodeficiency Virus Testing In Rural Areas Of The United States: A Systematic Review, Avery Petrucci, Kristen Custer, Eric C. Nemec

Physician Assistant Studies Student Publications

Purpose: HIV incidence continues to increase, with a large portion of new diagnoses found in rural areas of the United States. The worsening statistics in rural areas may be attributed to stigma alone and contribute to the lack of testing available for patients. The objective of this systematic review is to identify accessible and feasible strategies to increase HIV testing within the rural communities in the United States. Methods: A systematic literature search of CINAHL Complete, MEDLINE with Full Text, and PsycINFO with restrictions of the English language and rural communities outside of the United States through August 2, 2018. …

Effects Of International Service Learning On Development Of Intercultural Competence, Sharon M. Mccloskey

Occupational Therapy Faculty Publications

As the United States becomes an increasingly multicultural society (Colby & Ortman, 2014; Perez & Hirschman, 2009), there are greater opportunities for cross-culture interactions, especially in settings for healthcare practitioners. The profession of occupational therapy demands future practitioners understand culture and become skilled in the delivery of culturally competent care (AOTA, 2014). The purpose of this study was to examine the effects of international service learning (ISL) on the development of intercultural competence in graduate occupational therapy students. Inquiry for this research followed a mixed-methods explanatory sequential design. Study participants were graduate occupational therapy students who engaged in an international …

Conformational Studies Of Glucose Transporter 1 (Glut1) As An Anticancer Drug Target, Suliman Almahmoud, Xiaofang Wang, Jonathan L. Vennerstrom, Haizhen A. Zhong

Journal Articles: Pharmaceutical Sciences

Glucose transporter 1 (GLUT1) is a facilitative glucose transporter overexpressed in various types of tumors; thus, it has been considered as an important target for cancer therapy. GLUT1 works through conformational switching from an outward-open (OOP) to an inward-open (IOP) conformation passing through an occluded conformation. It is critical to determine which conformation is preferred by bound ligands because the success of structure-based drug design depends on the appropriate starting conformation of the target protein. To find out the most favorable GLUT 1 conformation for ligand binding, we ran systemic molecular docking studies for different conformations of GLUT1 using known …

Spontaneous Self-Assembly Of Amyloid Β (1–40) Into Dimers, Mohtadin Hashemi, Yuliang Zhang, Zhengjian Lv, Yuri L. Lyubchenko

Journal Articles: Pharmaceutical Sciences

The self-assembly and fibrillation of amyloid β (Aβ) proteins is the neuropathological hallmark of Alzheimer's disease. However, the molecular mechanism of how disordered monomers assemble into aggregates remains largely unknown. In this work, we characterize the assembly of Aβ (1–40) monomers into dimers using long-time molecular dynamics simulations. Upon interaction, the monomers undergo conformational transitions, accompanied by change of the structure, leading to the formation of a stable dimer. The dimers are stabilized by interactions in the N-terminal region (residues 5–12), in the central hydrophobic region (residues 16–23), and in the C-terminal region (residues 30–40); with inter-peptide interactions focused around …

Death With Dignity For The Seemingly Undignified: Denial Of Aid In Dying In Prison, Kathleen Messinger

Journal of Criminal Law and Criminology

The medical community has fundamentally changed how we think about life and death. Humans in privileged parts of the world are living longer and have access to life-saving treatment. The focus on quantity of life then has shifted to emphasizing quality of life and questioning whether longevity should at the expense of comfort or satisfaction. The conversation surrounding quality of life, and by extension end-of-life care, has included whether a competent adult has a right, or should have a right to end their own life on their own terms. The history of aid in dying is wrought with political ideology, …

Predictors Of Incomplete Evaluation Among Pediatric Household Contacts Of Pulmonary Tuberculosis Patients In Kampala, Uganda: A Secondary Analysis, Giyoung Lee

Public Health Theses

Background: Contact investigation is an active approach to identifying new TB cases by screening contacts of known patients for symptoms and risk factors. This is particularly important for child contacts of TB patients because young children are at higher risk of progressing to severe disease compared to adults. Moreover, children are unable or unlikely to travel to clinics for evaluation independently, so their access to TB evaluation may depend on the adults in their household.

Objective: To evaluate the association between individual- and household-level characteristics and completion of TB evaluation for children under 15 years.

Setting: Seven public tuberculosis (TB) …

Evaluating Clostridioides Difficile Infection (Cdi) Risk Factors By Comparing The Use Of Piperacillin/Tazobactam, Cefepime, And Ceftazidime, Shardul Rathod

Public Health Theses

Introduction: Over the past several years, Clostridioides difficile infection (CDI) incidence has been rising. The primary risk factor for CDI is antibiotic use. Many studies indicate that penicillin drugs are among the low-risk antibiotic classes associated with CDI whereas cephalosporin drugs are among the high-risk antibiotic classes. However, there is variation in studies evaluating the healthcare-associated CDI (HA-CDI) risk associated with antibiotics within a class and limited data comparing the use of penicillin versus cephalosporin drugs.

Methods: An observational cohort study was performed using patient data from BH and YNHH. Minitab (Version 18) was used to perform survival analysis and …

Single-Cell Transcriptomics In The Protozoan Parasite Trypanosoma Brucei During Acquisition Of Infectivity, Trisha Kaye Ramsdell

Public Health Theses

Single cell RNA-sequencing (scRNA-seq) is a recent innovation that allows sequencing of transcriptomes from a vast number of single cells, thus providing an unbiased view of cell-to-cell variability in gene expression within a population of cells. The Tschudi laboratory has previously established an in vitro differentiation system based on the inducible expression of the RNA-binding protein 6 (RBP6) in cultured non-infective procyclics, which recapitulates Trypanosoma brucei developmental stages that have been previously described in tsetse fly vector. Thus, I aimed to utilize scRNA-seq in this system to describe the potential heterogeneity in transcript abundance of known and suspected T. brucei …

Influenza Hospitalizations And Census Tract Ses In Ct 2013-2018, Nicole Elizabeth Torigian

Public Health Theses

Background: Influenza hospitalizations are a costly outcome of influenza infection. Socioeconomic status (SES) is not typically collected through routine public health surveillance methods, but understanding SES allows for targeted interventions.

Methods: Surveillance data from the CT Emerging Infections Program’s US Influenza Hospitalization Surveillance Network (FluSurv-Net) component was used to identify cases of laboratory confirmed influenza-associated hospitalizations in the 5 influenza seasons from 2013-2018. Case-patient home addresses were geocoded and linked to census tract level factors from the U.S. Census Bureau. Both census tract level poverty and crowding were broken into 4 categories: low, medium low, medium high, and high. Trends …

Differential Effects Of Medicaid Expansion On Racial/Ethnic Disparities In Primary Care Access, Janet Yim

Public Health Theses

By providing health insurance to low-income and disabled children and adults, the United States’ Medicaid program increases health care access and utilization by those with limited access to affordable private insurance. To increase coverage, the Affordable Care Act (ACA) helped fund state expansions of Medicaid’s eligibility criteria to include low-income adults with incomes up to 138% of the Federal Poverty level. This paper examines the differential effects of Medicaid expansion on racial/ethnic disparities in primary care access using a quasi-experimental differences-in-differences design. Regression analyses consider low income adults (defined as below 138% FPL) ages 19-64. When analyzing both short term …

Diagnosed Diabetes Prevalence And Risk Factor Rankings, By State, 2014-2016: A Ring Map Visualization, Ana Lopez-De Fede, John E. Stewart

Publications

Background In the United States, diabetes is a leading cause of adult-onset blindness, kidney failure, and death (1). Efforts to prevent and control diabetes must consider geographic variation in disease prevalence and risk factors such as obesity, sedentary lifestyle, and low educational attainment (2). Maps are essential to our understanding of geographic differences in population health and disease vulnerability. Comparing geographic patterns of disease and population risk across multiple maps, however, can be cumbersome. Ring mapping is an innovative geovisualization method that permits the display of multiple spatially referenced variables on a single map (3). We used a ring map …

Considerations For Implementing A Telerehabilitation Treatment Program For Individuals With Chronic Aphasia, Elena Pivek, Jennine Harvey-Northrop Phd Ccc-Slp, Kimberly Adelman Ms Ccc-Slp

Graduate Independent Studies - Communication Sciences and Disorders

The purpose of this research project is to identify the considerations that speech-language pathologists (SLPs) need to review before beginning to use telerehabilitation services to treat patients with chronic aphasia. This research will specifically target therapy treatments for patients with chronic aphasia and the technology adaptations and adjustments necessary for this population. This research project includes a systematic literature review as well as an in-service presentation. As telerehabilitation will continue to develop and grow, practicing SLPs need to have a foundational understanding of what teletherapy is, the patients suitable for services, and the benefits it has the potential to provide. …

The National Institute On Aging—Alzheimer’S Association Framework On Alzheimer’S Disease: Application To Clinical Trials, Jeffrey L. Cummings

Integrated Health Sciences Faculty Research

Introduction: The National Institute on Aging—Alzheimer’s Association Research Framework on Alzheimer’s disease (AD) represents an important advance in the biological characterization of the AD spectrum. Methods: The National Institute on Aging—Alzheimer’s Association Framework is considered as it applies to clinical trials. Results: Using the combination of amyloid (A), tau (T), and neurodegeneration (N) biomarkers, the Framework provides a means of defining the state of patients with regard to Alzheimer pathologic change. The Framework is relevant to clinical trials of disease-modifying agents, allowing participants to be characterized biologically at baseline. The ATN Framework can also inform trial outcomes. The preclinical phase …

Enrichment Factors For Clinical Trials In Mild-To-Moderate Alzheimer’S Disease, Clive Ballard, Alireza Atri, Neli Boneva, Jeffrey L. Cummings, Lutz Frolich, Jose Luis Molinuevo, Pierre N. Tariot, Lars Lau Raket

Integrated Health Sciences Faculty Research

Heterogeneity of outcomes in Alzheimer’s disease (AD) clinical trials necessitates large sample sizes and contributes to study failures. This analysis determined whether mild-to-moderate AD populations could be enriched for cognitive decline based on apolipoprotein (APOE)ε4 genotype, family history of AD, and amyloid abnormalities.

Assistive Devices For Communication Use With The Elderly, Corrine Koepsell, Antony Joseph

AuD Capstone Projects - Communication Sciences and Disorders

Hearing loss is one of the prevalent medical conditions in older adults. Although it has been documented that hearing loss is associated with various aspects of social and physical health, hearing assistive technologies and audiologic rehabilitation have been infrequently tapped clinical solutions. Cost and user problems in background noise are two common reasons why hearing aids are underutilized by seniors, and by younger age groups as well. Alternative tools, such as assistive listening devices, may be helpful for older listeners, even though they are used less frequently than hearing aids. To identify if assistive listening devices are satisfactory, a pilot …

Differentiated Social Skills Curriculum For Individuals With Cognitive Impairments, Morgan Bails, Tricia Larkin, Ann Beck

Graduate Independent Studies - Communication Sciences and Disorders

While communication may seem simple and inherent to many individuals while interacting with family, friends, or co-workers, communication may be more challenging for individuals with cognitive impairments. Whether the difficulty is related to expressive language, receptive language, semantics, pragmatics, etc., any deficits in these areas can create difficulty for individuals while socializing with others in their environment. Social skills intervention for individuals with cognitive impairments is imperative so that these individuals are able to communicate as effectively as possible in numerous settings with various communication partners. Individuals with Autism Spectrum Disorder (ASD) may have difficulty with social skills in particular …

A Resource Manual For Speech-Language Pathology Graduate Students On Culturally Relevant Therapy Materials, Anna Yates, Heidi M. Harbers, Ciera M. Lorio

Graduate Independent Studies - Communication Sciences and Disorders

This literature review will discuss the effects of shared book reading interventions on the language outcomes of young children from mainstream and diverse backgrounds. The first three studies will identify parent-child shared book reading interventions with children from the dominant culture. The next three studies will discuss the effects of providing shared book reading interventions to children who are bilingual. The final four studies will examine the use of culturally relevant materials in bilingual shared book reading interventions.

Case-Based Perspective-Taking As A Mechanism To Improve Metacognition And Higher-Level Thinking In Undergraduate Speech-Language Pathology Students, Lisa Vinney, Jennifer C. Friberg, Mary Smyers

Faculty Publications – Communication Sciences and Disorders

This case study addressed the authors’ efforts to design an 8-week small-group independent study (IS) experience that facilitated undergraduate speech-language pathology students’ (n=19) higher-level thinking and overall metacognitive awareness. We hoped to encourage both in order to improve students’ overall cognitive growth while enhancing their reflection about and knowledge of professional perspectives regarding the assessment and treatment of laryngeal cancer. To take on this challenge, we combined case-based learning (CBL) and perspective-taking (PT) pedagogies across the IS. Students completed the Metacognitive Awareness Inventory (MAI) pre- and post-IS, and written reflections after each of eight weekly discussion meetings. The MAI was …

Pilot Gwas Of Caries In African-Americans Shows Genetic Heterogeneity, E. Orlova, J. C. Carlson, M. K. Lee, E. Feingold, D. W. Mcneil, R. J. Crout, R. J. Weyant, M. L. Marazita, J. R. Shaffer

Faculty & Staff Scholarship

Background

Dental caries is the most common chronic disease in the US and disproportionately affects racial/ethnic minorities. Caries is heritable, and though genetic heterogeneity exists between ancestries for a substantial portion of loci associated with complex disease, a genome-wide association study (GWAS) of caries specifically in African Americans has not been performed previously.

Methods

We performed exploratory GWAS of dental caries in 109 African American adults (age > 18) and 96 children (age 3–12) from the Center for Oral Health Research in Appalachia (COHRA1 cohort). Caries phenotypes (DMFS, DMFT, dft, and dfs indices) assessed by dental exams were tested for association …

Comparison Of Intestinal Ischemia After On-Pump Versus Off-Pump Coronary Artery Bypass Grafting Surgery, Lütfi̇ Soylu, Oğuz Uğur Aydin, Mehmet Yildiz, Hacer Serdaroğlu, Murat Kurtoğlu, Sedat Karademi̇r

Turkish Journal of Medical Sciences

Acute mesenteric ischemia (AMI), one of the gastrointestinal system complications, which occurs following cardiac surgery, is challenged in the literature with a diminished incidence of AMI by heart surgery without cardiopulmonary bypass (CPB) or with pulsatile CPB. This study aims to compare the incidence and mortality rate of mesenteric ischemia in a series of consecutive patients undergoing coronary artery bypass grafting (CABG) through on-pump and off-pump techniques.Materials and methods: This study included patients who underwent CABG between 1 January 2010 and 31 June 2016. All patients were divided into two groups: Group 1 comprised 6396 CABG patients operated on with …

Colostrum Immunoglobulins And Oxidative Capacity May Be Affected By Infant Sex And Maternal Age And Parity, Davut Si̇nan Kaplan, Cahi̇t Bağci, Mustafa Örkmez, Özge Kömürcü Karuserci̇, Seyhun Sucu, Haki̇m Çeli̇k, Seyi̇than Taysi

Turkish Journal of Medical Sciences

The aims of this study were to determine the levels of the total antioxidant status (TAS), the total oxidant status (TOS), the oxidative stress index (OSI), and the concentration of immunoglobulin A (IgA) and M (IgM) in colostrum, and evaluate relationships between these parameters and maternal age, maternal parity, and infant sex. Materials and methods: The analysis was performed in serum samples of colostrum which were collected from 90 mothers on the first day of lactation between 10:00 and 12:00 AM.Results: The measurements established that no significant association existed between the TAS level of colostrum and parity, maternal age, or …

8-Hydroxy-2'-Deoxyguanosine As A Biomarker Of Oxidative Stress In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease, Xing Liu, Kaili Deng, Sixia Chen, Yunshi Zhang, Jing Yao, Xiaoqin Weng, Yang Zhang, Tianming Gao, Ganzhu Feng

Turkish Journal of Medical Sciences

8-Hydroxy-2'-deoxyguanosine (8-OHdG) is a biomarker of oxidative stress and has been implicated in many diseases. The aim of this study was to investigate the clinical value of plasma 8-OHdG level in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Materials and methods: A total of 154 subjects were enrolled in this study, including 20 healthy volunteers, 24 COPD patients in the stable phase, and 110 AECOPD patients. Peripheral blood samples, demographic information, and clinical characteristics were collected from all subjects at the time of being recruited into the study. Plasma 8-OHdG level was detected by enzyme-linked immunosorbent assay.Results: 8-OHdG …

Serum Adropin Levels In Psoriasis Vulgaris And Its Relation With Metabolic Parameters, Selma Korkmaz, Gülben Sayilan Özgün

Turkish Journal of Medical Sciences

Adropin is a peptide-structure hormone that plays a role in preventing the development of insulin resistance, which has been linked to obesity and metabolic regulation. The purpose of this study is to assess serum adropin levels and their relationship with metabolic parameters in psoriasis vulgaris patients both with and without metabolic syndrome (MetS).Materials and methods: Fifty-three patients and 26 healthy controls were included in this study. Serum adropin levels, fasting blood glucose, fasting serum insulin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, and triglyceride levels of all participants were analyzed. Enzyme-linked immunosorbent assay was used to measure serum adropin …

Comparison Of Conventional And Modern Methods In Determining Ischemic Stroke Etiology By General And Stroke Neurologists, Refi̇k Kunt, Mustafa Kürşad Kutluk, Bedi̇le İrem Ti̇fti̇kci̇oğlu, Nazi̇re Efser Yeşi̇m Afşar Fak, Ali̇ Kemal Erdemoğlu, Muhteşem Gedi̇zli̇oğlu, Vesi̇le Öztürk

Turkish Journal of Medical Sciences

This study aimed to investigate the consistency between stroke and general neurologists in subtype assignment using the Trial of ORG-10172 in Acute Stroke Treatment (TOAST) and Causative Classification of Stroke (CCS) systems.Materials and methods: Fifty consecutive acute ischemic stroke patients admitted to the stroke unit were recruited. Patients were classified by two stroke and two general neurologists, each from different medical centers, according to TOAST followed by the CCS. Each neurologist was assessed for consistency and compliance in pairs. Concordance among all four neurologists was investigated and evaluated using the kappa (ĸ) value.Results: The kappa (ĸ) value of diagnostic compliance …

Role Of Iliac Crest Tangent In Correct Numbering Of Lumbosacral Transitional Vertebrae, Nesri̇n Gündüz, Gülci̇n Durukan Günaydin, Mehmet Bi̇lgi̇n Eser, Ahmet Aslan, Adnan Kabaali̇oğlu

Turkish Journal of Medical Sciences

The iliac crest tangent (ICT) has recently emerged as a reliable landmark to correctly number the lumbosacral transitional vertebrae (LSTV). We retrospectively evaluated the reproducibility and accuracy of the ICT as a landmark in subjects without disc degeneration.Materials and methods: Fifty-eight patients with LSTV [19 female, 41 (26-52) years] and 55 controls without LSTV [23 female, 40 (26-55) years] who had undergone spinal computed tomography were included. The ICT was drawn on the coronal images, with the cursor in the sagittal view set to the posterior ⅓ of the vertebral body located one level above the LSTV. When more than …

Evaluation Of Myocardial Dispersion Of Repolarization In Patients With Heart Transplantation, Cengi̇z Burak, Erkan Baysal, Muhammed Süleymanoğlu, Çağri Yayla, Serkan Çay, Ümi̇t Kervan

Turkish Journal of Medical Sciences

The number of patients with heart transplantation has dramatically increased in the last decade. Considerable studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. We analyzed the dispersion of myocardial repolarization using electrocardiographic Tp-e interval and Tp-e/QTc ratio in patients with heart transplantation. Materials and methods: This observational study included 38 patients (12 female and 26 male) with heart transplantation and 38 well-matched controls. From electrocardiograms, Tp-e interval and Tp-e/QTc …