Medicine and Health Sciences Commons^™

Red Panda: A Novel Method For Detecting Variants In Single-Cell Rna Sequencing, Adam Cornish, Shrabasti Roychoudhury, Krishna Sarma, Suravi Pramanik, Kishor Bhakat, A T. Dudley, Nitish K. Mishra, Chittibabu Guda

Journal Articles: Genetics, Cell Biology & Anatomy

BACKGROUND: Single-cell sequencing enables us to better understand genetic diseases, such as cancer or autoimmune disorders, which are often affected by changes in rare cells. Currently, no existing software is aimed at identifying single nucleotide variations or micro (1-50 bp) insertions and deletions in single-cell RNA sequencing (scRNA-seq) data. Generating high-quality variant data is vital to the study of the aforementioned diseases, among others.

RESULTS: In this study, we report the design and implementation of Red Panda, a novel method to accurately identify variants in scRNA-seq data. Variants were called on scRNA-seq data from human articular chondrocytes, mouse embryonic fibroblasts …

A Transgenic Pig Model Expressing A Cmv-Zsgreen1 Reporter Across An Extensive Array Of Tissues., Amy T Desaulniers, Rebecca A Cederberg, Elizabeth P Carreiro, Channabasavaiah B Gurumurthy, Brett R White

Journal Articles: Pharmacology & Experimental Neuroscience

Since genetic engineering of pigs can benefit both biomedicine and agriculture, selecting a suitable gene promoter is critically important. The cytomegalovirus (CMV) promoter, which can robustly drive ubiquitous transgene expression, is commonly used at present, yet recent reports suggest tissue-specific activity in the pig. The objective of this study was to quantify ZsGreen1 protein (in lieu of CMV promoter activity) in tissues from pigs harboring a CMV-ZsGreen1 transgene with a single integration site. Tissue samples (

Stress Relaxation In Orthodontic Aligner Plastics; An In Vitro Comparison Study, Kristopher J. Keller

Theses & Dissertations

The purpose of this study was to ascertain if repeated stresses from extension cycling would result in accumulated damage in aligner materials and affect force delivery. A secondary goal was to identify potential differences in mechanical behavior present among orthodontic aligner polymers. Four thermoplastic polymers (Essix ACE, Taglus, Zendura, and Zendura FLX) were thermoformed, cut into strips, and extension cycled to 0.4 millimeters in a 37C water bath. Force decay, maximum and minimum force, and elastic modulus were measured during cycling. Additional samples were subjected to controlled tension until failure, allowing the measurement of yield strength, ultimate strength, and elastic …

Rilpivirine-Associated Aggregation-Induced Emission Enables Cell-Based Nanoparticle Tracking, Insiya Mukadam

Theses & Dissertations

Antiretroviral therapy (ART) has improved the quality and duration of life for people living with human immunodeficiency virus (HIV) infection. However, limitations in drug efficacy, the emergence of viral mutations and the paucity of cell-tissue targeting remain. We posit that to maximize ART potency and therapeutic outcomes newer drug formulations that reach HIV cellular reservoirs need to be created. In a step towards achieving this goal we discovered the aggregation-induced emission (AIE) property of the non-nucleoside reverse transcriptase inhibitor Rilpivirine (RPV) and used it as a platform for drug cell and subcellular tracking. RPV nanocrystals were created with endogenous AIE …

Mechanisms By Which Mnte-2-Pyp Suppresses Prostate Cancer Cell Growth, Yuxiang Zhu

Theses & Dissertations

Prostate cancer patients are often treated with radiotherapy. MnTE-2-PyP, is a superoxide dismutase (SOD) mimic and a known radioprotector of normal tissues. Our recent work demonstrates that MnTE-2-PyP also inhibits prostate cancer progression with radiotherapy; however, the mechanisms remain unclear. In this thesis, we identified that MnTE-2-PyP-induced intracellular H2O2 levels are critical in inhibiting growth of prostate cancer cells. We found that MnTE-2-PyP induced protein oxidations in PC3 cells and one major group of oxidized protein targets were involved in energy metabolism. The oxidative phosphorylation rates were significantly enhanced in both PC3 and LNCaP cells with MnTE-2-PyP treatment, but mitochondrial …

Joint Loading Factors Of Articular Cartilage Structure In Healthy And Acl-Injured Knees, Elizabeth Wellsandt

Theses & Dissertations

Articular cartilage structure and chondrocyte health are sensitive and reliant on dynamic joint loading during activities. The risk of osteoarthritis (OA) is high after anterior cruciate ligament (ACL) injury, but mechanisms underlying its development are poorly understood. The overall goals of this work were 1) to determine the association between measures of individual and cumulative knee joint loading with T2 relaxation times in the knee cartilage of young individuals without injury and 2) to determine if these same knee joint loading factors are associated with cartilage T2 relaxation time one month after ACL injury. The central hypotheses was that lower …

Polymeric Drug Delivery Systems For Cancer Therapy And Radionuclide Decorporation, Sameer A. Alshehri

Theses & Dissertations

The main objective of this body of work is to develop polymeric drug delivery systems for cancer radiotherapy and the decorporation of radiological materials. The polymeric systems for radiotherapy were evaluated in vitro and in vivo (in normal, prostate, and ovarian cancer mice models). The polymeric system for radionuclide decorporation was also evaluated in vitro and in a normal mouse model. Due to its attractive properties, the N-(2-Hydroxypropyl) methacrylamide (HPMA) copolymer was utilized as the main carrier for the developed systems.

Chapter 1 provides an overview of prostate and ovarian cancer, targeted radiopharmaceuticals, nanomedicine-based drug delivery for cancer, HPMA copolymers, …

Inflammatory Cytokine Expression Of Immune Cells On Exposure To Invisalign® Material: An In Vitro Pilot Study, Alaina M. Allen

Theses & Dissertations

The purpose of this study is to characterize the inflammatory cytokines that are expressed in peripheral blood mononuclear cells (PBMCs) and THP-1 monocytes exposed to Invisalign^® aligner material in vitro. Invisalign^® material was ground into particles, soaked in artificial saliva, and the eluate was collected. Commercially available cryopreserved pooled and individual human PBMCs and THP-1 monocytes were cultured with Invisalign^® material eluate and positive (lipopolysaccharide) and negative controls. The supernatants were collected and used with a BioLegend LEGENDplex^™ multi-analyte flow assay, a sandwich enzyme-linked immunosorbent assay (ELISA), to identify the expression of TNF-α, IL-6, IL-8, IL-10, …

Investigating The Relationship Between Unavoidable, Hospital Acquired Pressure Injury And Mortality: Is Unavoidable, Hospital Acquired Pressure Injury A Signal Of Increased One-Year Mortality Risk?, Eileen Jimenez

Theses & Dissertations

The purpose of this dissertation was to explore the strength of the relationship between unavoidable Hospital Acquired Pressure Injury (HAPI) and increased risk of one-year mortality for patients age 55 and older who were admitted to a hospital from 2015 to 2018. A quantitative, retrospective case-control study was designed to compare demographics, comorbid conditions, pressure injury risk, and living situation of those patients that developed unavoidable HAPI and hospitalized adults with similar physiological burdens that remained injury-free. The one-year mortality for the HAPI group was 27 of 48 (56%), and 26 of 47 patients (55%) for the Control group. The …

Cardioprotective Roles Of Hydrogen Sulfide Donor Treatment In Diabetic Cardiomyopathy, Sumit Kar

Theses & Dissertations

Diabetes mellitus (DM) increases the risk of heart failure 2-4-fold. Intensive glycemic control does not abate this risk in DM patients, suggesting that DM-induced heart failure is beyond hyperglycemia. DM silently induces cardiac muscle disorder termed diabetic cardiomyopathy (DMCM), which progresses to heart failure. The objective of this dissertation is to understand the mechanistic underpinnings of DMCM to develop new solutions to diagnose and treat heart failure in DM.

The heart pumps blood due to the contraction and relaxation of terminally differentiated cardiomyocytes with limited regenerative capacity. The DM environment of hyperglycemia, hyperlipidemia, and inflammation causes cardiomyocyte death and leads …

Pandemic Driven Innovation: Development Of An Alternative Respiratory Pathogen Self-Collection Device, Thang Nguyen

Theses & Dissertations

The SARS-CoV-2 virus outbreak has underscored numerous weak links in our biodefense countermeasures against highly communicable diseases. Many believe it was our lack of an effective testing model that allowed the virus to become a global pandemic within a short period. The gold standard collection method for the SARS-CoV-2 virus involves mechanical debridement of the nasopharyngeal cavity with a stiff swab applicator, which has been known to cause pain and injury to patients, subsequently resulting in low patient acceptance of the procedure. Due to the invasive nature of the nasopharyngeal swab collection method, it may not be conducive to the …

Beyond The Eye: The Neural Signature Of Cerebral Visual Processing In Children With Cerebral Palsy, Jacy R. Hannan

Theses & Dissertations

Cerebral palsy (CP) is a permanent, non-progressive neuromuscular disorder diagnosed early in childhood. Frequently the lesion that causes the motor impairments in individuals with CP concurrently disrupts the visual networks, placing them at a high risk of cerebral visual dysfunctions. Cerebral visual impairment (CVI) often remains unrecognized or misdiagnosed in people with CP. Despite the crucial role of visual function in the development of movement and cognition, the neurophysiological basis of the cerebral visual dysfunctions is almost entirely unknown. This investigation aimed to examine the neurophysiological mechanisms underlying cerebral visual dysfunction in children with CP. Specifically, this research used magnetoencephalographic …

Glycemic Variability In Patients With Stage Ii-Iii Colon Cancer, Natalie Mandolfo

Theses & Dissertations

Patients with cancer experience metabolic changes such as hypoglycemia, hyperglycemia, and glycemic variability; collectively termed malglycemia. Glycemic variability, defined as fluctuations in glucose, is a marker of metabolic instability. Higher glycemic variability is associated with adverse health outcomes in the general population and in those with diabetes. Little is known about glycemic variability in patients with cancer, especially those with solid tumor malignancies. Glycemic variability is associated with increased infection, shorter periods of remission, and higher mortality in patients with hematological cancer. This body of work describes the concept and measurement of glycemic variability to assess glycemic control in patients …

Anti-Muc4Β Antibodies As A Novel Therapeutic Modality For The Treatment Of Pancreatic Cancer, Catherine Orzechowski

Theses & Dissertations

The deregulation of cell surface glycoproteins, such as mucins, is a hallmark of many tumors of epithelial origin. The transmembrane mucin MUC4, is differentially overexpressed in several malignancies, including pancreatic, breast, ovarian, lung, cervical, and head and neck cancers. Of all the aforementioned cancers, the role of MUC4 has been the most thoroughly in pancreatic cancer (PC), which is the 4th leading cause of cancer-related deaths in the United States. While MUC4 is undetectable in the normal or inflamed pancreas (pancreatitis), its expression progressively increases during PC progression and its higher expression correlates with poor survival. The role of MUC4 …

Long-Acting Nanoformulated Antivirals For The Treatment And Prevention Of Hiv-1 And Hbv Infections, Dhruvkumar M. Soni Dr.

Theses & Dissertations

While antiretroviral therapy (ART) has revolutionized treatment and prevention of human immunodeficiency virus type one (HIV-1) infection, regimen adherence, viral mutations, drug toxicities, stigma and pill fatigue are limitations. These have led to the development of long acting (LA) ART. These include, but are not limited to, implantable devices, new chemical entities, prodrug modifications and nanoformulations. To these ends, this thesis focues on the transformation of nucleoside reverse transcriptase inhibitors (NRTIs) into LA parenterals, While elusive, data from our laboratories demonstrated that modifications to the PROdrug and nucleoTide technology (ProTide) enables improvements in drug apparent half-life and tissue and cell …

Outcomes Of Unilateral Alveolar Clefts Grafted Using Recombinant Human Bone Morphogenetic Protein-2: A Retrospective Volumetric Analysis Using Cbct, Landon Robert Peterson

Theses & Dissertations

Purpose of this study is to evaluate the success rates of secondary alveolar grafts using recombinant human bone morphogenetic protein with CBCT and to evaluate the effects of several variables on these outcomes. After our inclusion/exclusion criteria, records of 24 patients receiving secondary alveolar grafts at the University of Nebraska Medical Center were evaluated. Pre-graft and 6-month post-graft cleft volumes were measured using ITK-SNAP 3.8.0 software to determine a percent residual defect following surgery. Of the 24 patients, one was excluded as the graft surgery was deemed a failure. The patients’ gender, age, side of cleft, cleft side canine root …

Spare Parts Surgery For Oncologic Reconstruction To Preserve Local Advancement Flap For Decubitus Ulcer Reconstruction: A Case Report, Emily Zurbuchen, Nathan Foje, Sean Figy

Graduate Medical Education Research Journal

A 58-year-old male presented to our institution with synchronous large left thigh sarcoma and sacral decubitus ulcer requiring oncologic resection and reconstruction. Due to extensive tumor involvement, use of local flap for reconstruction was not feasible. Therefore, a spare parts free fillet flap from the disarticulated lower leg was utilized for reconstruction following oncologic resection. The benefits of this spare parts approach include no donor site morbidity, sufficient tissue padding for later use of prosthesis, and preservation of other flaps for future reconstruction of his sacral decubitus ulcer.

Multi-Digit Auto-Amputation In Setting Of Mixed Connective Tissue Disease, Kishan P. Patel, Jennifer L. Medlin, Michelene Hearth-Holmes

Graduate Medical Education Research Journal

Raynaud’s disease is a cutaneous manifestation often present in various connective tissue and vascular diseases. Depending on the age of onset and acuity of symptoms, the phenomenon can provide clinicians with some insight as to the severity of underlying disease, including the distinction between primary and secondary Raynaud’s. However, this diagnostic approach seems to have its limitations regarding efficacy and timing of treatment. Traditionally, treatment of Raynaud’s has focused on reestablishing blood perfusion to affected tissue, which has previously been achieved with vasodilatory medications and site-specific surgical intervention. In lieu of the severe sequelae of Raynaud’s in the setting of …

Nontuberculous Mycobacterium (Ntm) Infection In Aquatic Workers With Purified Protein Derivative (Ppd) And Gold Quantiferon Tests., Lavanya Ravipati, Sarah A. Howard

Graduate Medical Education Research Journal

Background: Nontuberculous mycobacteria (NTM) infections are commonly caused by Mycobacterium marinum and fortuitum with M. marinum more likely to cause skin infections. Aquatic environments are a potential source of contact with M. marinum and fortuitum. Patients with NTM infections may present with positive tuberculin purified protein derivative (PPD) and/or gold QuantiFERON tests. However, PPD cannot differentiate between NTM infection and other tuberculous infections caused by different mycobacterial strains. We present a patient a marine biologist who was asymptomatic and presented for further evaluation as she has a h/o positive PPD and gold QuantiFERON test.

Methods: Patient informed consent was …

Costs Associated With Recurrent Epistaxis In A Patient With A Ventricular Assist Device, Eric T. Rohe, Evan M. Ryan, Jayme R. Dowdall, Dwight T. Jones

Graduate Medical Education Research Journal

Mucosal bleeding is a well-known complication of having a ventricular assist device and commonly presents with epistaxis. Although the frequency of epistaxis as a complication in patients with a ventricular assist device has been documented in the literature, to our knowledge the cost of this complication has not been reported. This case report examines the financial burden of ventricular assist device-associated epistaxis in a single patient from September 2018 to December 2019 using ICD 10 diagnostic codes. The patient was found to have accumulated $138,020 in costs over 38 encounters. This case report not only highlights the recurrent nature and …

A Case Of Carcinoid Heart Disease And Echocardiographic Findings, Brandon Alex, Jeffrey Songster, Helenmari L. Merritt, Rebecca A. Aron

Graduate Medical Education Research Journal

Abstract: Carcinoid heart disease occurs in approximately 50% of patients with carcinoid syndrome. Right heart involvement resulting in tricuspid regurgitation, tricuspid stenosis, pulmonic regurgitation and pulmonic stenosis is most common. We report a case of tricuspid heart disease resulting in tricuspid regurgitation, tricuspid stenosis, pulmonic regurgitation and pulmonic stenosis.

Neurolytic Celiac Plexus Blockade In Patients With Upper Intraabdominal Malignancies: An Evidence-Based Narrative Review, Kevin Wong, Apollo A. Stack, Madhuri Are

Graduate Medical Education Research Journal

Background: Cancer-related abdominal pain is a common symptom associated with upper intra-abdominal carcinoma, especially in patients with advanced disease and it has posed a significant therapeutic challenge to medical practitioners. Typically, cancer pain can be managed by following the World Health Organization 3-step analgesic ladder. However, analgesic use of opioids, the mainstay treatment for moderate-to-severe cancer-related pain, may be ineffective in a subset of cancer patients. Escalation of dosage may be limited by opioid-induced side effects. The aim of this study was to review the literature addressing the effect of neurolytic celiac plexus block (NCPB) on the palliation of pain …

Internet Transparency Of Local Men’S Health Clinics In Nebraska, Jinfeng Jiang, Jordan Stegman, Christopher M. Deibert

Graduate Medical Education Research Journal

An overview of Men’s Health Clinics offering Testosterone Therapy in a Midwest State.

Introduction/ Background – Since 2001, there has been a 300% increase in the use of Testosterone therapy. However, there remains limited published data on the demographics of facilities and providers that advertise this service. This study aims to look at such demographics of advertised Men’s health clinics in Nebraska.

Methods/ Materials – An internet search was conducted with the phrases “Nebraska Male health clinics, Nebraska Low T/testosterone, Nebraska Hormone Replacement Therapy”. All clinics that were found offering Testosterone therapy with Men’s health in their mission statement were …

Personal Finance Skills Among Health Professionals: Piloting A Student-Led Finance Curriculum And A Review Of The Current Landscape, Jeremy Payne, Stephen Haller, Laura E. Flores, Jared Baxter, Walker Payton, Kari Nelson

Graduate Medical Education Research Journal

Introduction

Despite high costs of education, extended lengths of training, and rapidly increasing student debt, personal finance is an often-overlooked topic within professional school curricula. Due to the combination of high debt burden and poor financial literacy, professional students report low confidence and high stress regarding their personal finances. While some medical schools have begun to integrate financial education into their formal training, others provide little to no resources to combat this growing issue.

Methods

To address this gap and provide financial education opportunities, the Financial Development Club (FDC) was founded by students at the University of Nebraska Medical Center. …

Customized Blister Packaging For Patients Living With Hiv: Assessment Of Patient Attitudes And Satisfaction, Holly Groteluschen, Harlan Sayles, Rebecca Osborn, Joshua P. Havens, Sara Bares, Jasmine R. Marcelin

Graduate Medical Education Research Journal

Adherence to antiretroviral medication results in reduced HIV transmission and improved health outcomes, yet challenges with medication adherence remain. A Collaborative Care Program was developed with a community pharmacy integrating a multi-dose adherence packaging service. We surveyed program participants to assess their satisfaction with this program and found an overall positive sentiment toward the program, that the program helped with reducing missed doses, and all patients would recommend the program to others.

The Uncharted Waters Of Graduate Medical Education During A Pandemic, Chandrakanth Are

Graduate Medical Education Research Journal

No abstract provided.

Perceptions Of Voice Health, Voice Health Care, And Voice Health Education In The Performance Community, Katelyn Nelson

Capstone Experience

There is a medical consensus that proper voice health precautions can protect the voice and decrease the occurrence and severity of voice disorders in vocal performers. Similarly, seeking medical treatment for voice disorders can speed recovery time and preserve the voice. Voice disorders are common in performance students and professionals because of demanding curricula and frequent voice use, but little is known about their voice care needs, preferred voice care resources, and clinical care. The purpose of this study was to add to the research on voice health by interviewing faculty members in the College of Communication, Fine Arts, and …

A Preliminary Analysis Of Project Ag Aware: Sbirt In Agricultural Work Settings, Rachel L. Rutt

Capstone Experience

Background: An increasing number of individuals are being negatively affected by substance abuse in the U.S. and Nebraska communities. These communities are seeing immense increases in opioid prescribing rates, especially in rural areas. The aims of this study are to 1) describe the study population of agricultural workers in Nebraska; 2) estimate the prevalence of alcohol misuse, illegal drug use, and anxiety among agricultural workers in Nebraska; and 3) examine factors associated with alcohol misuse among agricultural workers in Nebraska.

Methods: Adult agricultural workers (N=1,206) completed a paper or online survey for Project Ag Aware. Alcohol misuse, illegal drug use, …

Agricultural Injuries Among Central State Region Operators Over A 5-Year Period: Cs-Cash Farm And Ranch Health And Injury Survey 2011-2015, Anthony Johnson Jr

Capstone Experience

Background The high risk of occupational fatalities in agriculture is well documented, but information on non-fatal injuries is lacking due to challenges in injury surveillance. This surveillance study explored the frequency, characteristics, and risk factors for non-fatal injuries among farmers and ranchers in the central United States.

Methods The Central States Center for Agricultural Safety and Health (CS-CASH), in collaboration with the USDA National Agricultural Statistics Service (NASS), conducted annual surveys (n=34,777 sent) during 2011-2015 covering a seven-state region (Iowa, Kansas, Minnesota, Missouri, North Dakota, Nebraska, and South Dakota).

Results The average response rate was 32% in the five consecutive …

A Qualitative Analysis Of Omaha Healthy Kids Alliance’S Client Educational Attainment, Shelby Larson

Capstone Experience

Housing and physical health are inextricably linked. Environmental hazards such as lead poisoning, radon, and mold negatively impact the health of a home’s occupants, particularly children. Omaha Healthy Kids Alliance (OHKA) was founded in 2006 to address these environmental hazards through education and construction interventions with the mission “to improve children’s health through healthy homes.” OHKA clients are primarily served through two direct service programs and are evaluated pre- and post-intervention for changes in educational attainment, behavioral outcomes, environmental characteristics, quality of life, and health. A program evaluation was conducted to 1) determine how OHKA clients utilize environmental education post-intervention, …