Medicine and Health Sciences Commons^™

Post–Modern Epidemiology: When Methods Meet Matter, George Davey Smith

United States Public Health Resources

In the last third of the 20th century, etiological epidemiology within academia in high-income countries shifted its primary concern from attempting to tackle the apparent epidemic of noncommunicable diseases to an increasing focus on developing statistical and causal inference methodologies. This move was mutually constitutive with the failure of applied epidemiology to make major progress, with many of the advances in understanding the causes of noncommunicable diseases coming from outside the discipline, while ironically revealing the infectious origins of several major conditions. Conversely, there were many examples of epidemiologic studies promoting ineffective interventions and little evident attempt to account for …

Durvalumab In Combination With Olaparib In Patients With Relapsed Sclc: Results From A Phase Ii Study, Anish Thomas, Rasa Vilimas, Christopher Trindade, Rebecca Erwin-Cohen, Nitin Roper, Liqiang Xi, Venkatesh Krishnasamy, Elliot Levy, Andy Mammen, Samantha Nichols, Yuanbin Chen, Vamsidhar Velcheti, Faye Yin, Eva Szabo, Yves Pommier, Seth M. Steinberg, Jane B. Trepel, Mark Raffeld, Howard A. Young, Javed Khan, Stephen Hewitt, Jung Min Lee

United States Public Health Resources

Purpose: Despite high tumor mutationburden, immune checkpoint blockade has limited efficacy in SCLC. We hypothesized that poly (ADP-ribose) polymerase inhibition could render SCLC more susceptible to immune checkpoint blockade. Methods: A single-arm, phase II trial (NCT02484404) enrolled patients with relapsed SCLC who received durvalumab, 1500 mg every 4 weeks, and olaparib, 300 mg twice a day. The primary outcome was objective response rate. Correlative studies included mandatory collection of pretreatment and during-treatment biopsy specimens, which were assessed to define SCLC immunephenotypes: desert (CD8-positive T-cell prevalence low), excluded (CD8-positive T cells in stroma immediately adjacent/within tumor), and inflamed (CD8-positive T cells …

Perceptions Of Immigration Among Nonmetropolitan Nebraskans: Nebraska Rural Poll Research Report 19-2, Rebecca Vogt, Cheryl Burkhart-Kriesel, Randolph Cantrell, Bradley Lubben, L. J. Mcelravy, Timothy Meyer, Jason L. Weigle

Rural Futures Institute: Publications

The percent of Nebraska’s population that is foreign born has steadily increased during the past decade. In fact, its growth in foreign born population since 2010 ranks in the top 10 among all states. Given these changes, are rural Nebraskans aware of recent immigrants in their community? How do they perceive immigrants and their impacts on rural Nebraska? How do they view various immigration policies? This paper provides a detailed analysis of these questions. This report details 1,776 responses to the 2019 Nebraska Rural Poll, the 24th annual effort to understand rural Nebraskans’ perceptions. Respondents were asked a series of …

Leaving Against Medical Advice From In-Patients Departments Rate, Reasons And Predicting Risk Factors For Re-Visiting Hospital Retrospective Cohort From A Tertiary Care Hospital, Obada Hasan, Muhammad Adil Samad, Hamza Khan, Maryam Sarfraz, Shahryar Noordin, Tashfeen Ahmad, Gul Nowshad

Section of Orthopaedic Surgery

Background: Approximately 1% to 2% of hospitalized patients get discharged or leave from the hospital against medical advice and up to 26% in some centers. They have higher readmission rate and risk of complications than patients who receive complete care. In this study we aimed to determine the rate of leave against medical advice (LAMA) and reasons for the same across different in-patient departments of a tertiary care hospital.
Methods: Retrospective cohort study on patients admitted in all departments at our institute over a 1-year period. All patients who were admitted to an in-patient ward at the hospital and who …

Predictors Of An Increased Length Of Stay Following Total Knee Arthroplasty: Survey Report, Azeem Tariq Malik, Syed Hamza Mufarrih, Arif Ali, Shahryar Noordin

Section of Orthopaedic Surgery

Objective: To find various preoperative, intraoperative and postoperative factors that predict an increased length of stay in patients following total knee arthroplasty.
Methods: The retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised record of patients regardless of gender, co-morbids and age who had undergone a unilateral or bilateral total knee arthroplasty between January 2007 and December 2015. An increased length of stay was defined as ≥75th centile (≥11 days).
Results: Of the 577 patients, 448(77.6%) were women. Overall, 311(53.9%) patients were aged 56-70 years. Of the total, 100(17.3%) patients stayed for at least 11 …

Timing Of Postoperative Magnetic Resonance Imaging (Mri) Following Glioma Resection: Shattering The 72 Hour Window, Syed Sarmad Bukhari, Muhammad Shahzad Shamim, Fatima Mubarak

Section of Neurosurgery

Extent of enhancing tumour resection is correlated with progression free survival following glioma surgery. Historically, a contrast enhanced MRI has been recommended within 72 hours following surgery to evaluate for residual disease. This theoretical window was established amidst conflicting evidence to avoid reactive enhancement. Recent studies with better designs and better imaging quality have sought to challenge this window with a more pragmatic method of evaluating residual disease.

Proteomic Evaluation And Cytotoxicity Of Red Maple (Acer Rubrum) Leaves, Saud Alshammari

Pharmaceutical Sciences (MS) Theses

Red maple (Acer rubrum), also known as swamp, water or soft maple, is endemic to eastern and central North America and was widely used as traditional medicine by the first peoples. Commercially, its well-known products include maple syrup and high-quality lumber. The potential medicinal benefits of phenolic compounds extracted from the red maple plant, such as glucitol-core containing gallotannins, include antioxidant, and antiglycation effects as well as their importance in cosmetic applications. Plant-derived proteins and peptides are important biomolecules; however to date, there is no published data on the identification of proteins/peptides from red maple leaves. Therefore, the …

Altering The Regiospecificity Of C6 Indole Prenyltransferase Enzymes Towards Drug Development, Ahmed R. Aoun

Pharmaceutical Sciences (MS) Theses

Prenyltransferase (PT) biocatalysts are late-stage tailoring enzymes that modify natural products. PTs catalyze the attachment of prenyl moieties to natural product acceptors using pyrophosphate donors. This prenyl modification in small molecules leads to changes in structural and biological activities. Understanding the structural insights as well as the mechanisms by which PTs function allows us to utilize PTs as a unique approach towards drug development. PriB PT is an example of aromatic PTs that has been characterized previously as a L-tryptophan (L-Trp) C6 C-prenyltransferase (C6-C-PT). Analysis of PriB binding pocket, highlighted key residues that might play an important …

Cancer Cell Population Growth Kinetics At Low Densities Deviate From The Exponential Growth Model And Suggest An Allee Effect., Kaitlyn E Johnson, Grant Howard, William Mo, Michael K Strasser, Ernesto A B F Lima, Sui Huang, Amy Brock

Articles, Abstracts, and Reports

Most models of cancer cell population expansion assume exponential growth kinetics at low cell densities, with deviations to account for observed slowing of growth rate only at higher densities due to limited resources such as space and nutrients. However, recent preclinical and clinical observations of tumor initiation or recurrence indicate the presence of tumor growth kinetics in which growth rates scale positively with cell numbers. These observations are analogous to the cooperative behavior of species in an ecosystem described by the ecological principle of the Allee effect. In preclinical and clinical models, however, tumor growth data are limited by the …

Identification Of Policy Priorities To Address The Burden Of Smokeless Tobacco In Pakistan: A Multimethod Analysis, Kamran Siddiqi, Ziauddin Islam, Zohaib Khan, Faraz Siddiqui, Masuma Mishu, Omara Dogar, Vandana Shah, Javaid Khan, Subhash Pokhrel, Romaina Iqbal

Section of Pulmonary & Critical Care

Introduction: We assessed the magnitude of smokeless tobacco (ST) use in Pakistan and identified policy gaps to help ascertain short-, medium-, and long-term priorities. We then elicited stakeholders' views as to which of these identified priorities are most important.
Methods: In a multimethod study, we: analyzed Global Tobacco Surveillance System data sets to estimate ST consumption and disease burden; conducted a documentary review to identify gaps in policies to control ST in comparison with smoking; elicited stakeholders' views in an interactive workshop to identify a set of policy options available to address ST burden in Pakistan; and ranked policy …

Appropriate Therapeutic Drug Monitoring Of Biologic Agents For Patients With Inflammatory Bowel Diseases., Konstantinos Papamichael, Adam S. Cheifetz, Gil Y. Melmed, Peter M. Irving, Niels Vande Casteele, Patricia L. Kozuch, Laura E. Raffals, Leonard Baidoo, Brian Bressler, Shane M. Devlin, Jennifer Jones, Gilaad G. Kaplan, Miles P. Sparrow, Fernando S Velayos, Thomas Ullman, Corey A. Siegel

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND & AIMS: Therapeutic drug monitoring (TDM) is widely available for biologic therapies in patients with inflammatory bowel disease (IBD). We reviewed current data and provided expert opinion regarding the clinical utility of TDM for biologic therapies in IBD.

METHODS: We used a modified Delphi method to establish consensus. A comprehensive literature review was performed regarding the use of TDM of biologic therapy in IBD and presented to international IBD specialists. Subsequently, 28 statements on the application of TDM in clinical practice were rated on a scale of 1 to 10 (1 = strongly disagree and 10 = strongly agree) …

Yoga To Decrease The Stress Response: Gentle Yoga Encourages Faster Decline In Salivary Cortisol Concentrations Following Participation In Tsst, Tabetha Gaile Hopke

Graduate Theses/Dissertations

Short-term, activation of the human stress response system is beneficial as it prepares the body to deal with stressors at hand (McEwen & Stellar, 1993). If this system is overactive or chronically active however, it can negatively impact health and longevity (Cohen, Janicki-Deverts, & Miller, 2007). According to a review conducted by Ross & Thomas (2010) implementation of a yoga practice has been shown to down-regulate the stress response system. The present study aimed to expand on current research involving yoga for stress reduction by exploring whether participation in gentle yoga could decrease the stress response more quickly than naturally …

Elucidating Immune Signaling Of Influenza A Virus And Aspergillus Fumigatus Co-Infections Through Pioneered Model Development, Meagan Danyelle Rippee-Brooks

Graduate Theses/Dissertations

Bacterial co-infections with influenza A virus (IAV) are extremely serious and life-threatening. However, there exists limited understanding about the importance of fungal infections with IAV. Clinical case reports indicate that fungal co-infections do occur and suggest the IAV pandemic of 2009 had a propensity to predispose patients to secondary fungal infections more than previous IAV strains. IAV-fungal co-infections are marked by high mortality rates of 47 to 61% in previously healthy individuals between the ages of 20 and 60. Yet, the variables involved in this co-infection remain undetermined. I achieved effective recapitulation of this co-infection using a C57Bl/6 murine (mouse) …

Transfusion Ratios Following Activation Of A Massive Transfusion Protocol: An Evidence Based Practice Project, Cody Woodbury, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Accidental injury is one of the leading causes of death in the United States and worldwide. Severe hemorrhage from injury is the leading cause of preventable death. Effective management of hemorrhaging trauma patients has been evolving since the early 1900’s. Recent studies have demonstrated the benefits of using a balanced resuscitation technique, revolving around the goal of recreating whole blood. The purpose of this project was to identify what ratios of blood products are being transfused at Providence Sacred Heart Medical Center (PSHMC) and Providence Holy Family Hospital (PHFH).

Methods A literature review was performed identifying seven high quality …

Knowledge And Practices Among Nurses Regarding Patients’ Care Following Cardiac Catheterization At A Tertiary Care Hospital In Karachi, Pakistan, Adnan Yaqoob, Rubina Barolia, Ahmed Noor, Afshan Nazar

School of Nursing & Midwifery

Aims: The purpose of this study was to assess the knowledge and practices among nurses regarding patient care, following cardiac catheterization, at a tertiary care hospital in Karachi, Pakistan.
Background: Cardiovascular diseases (CVDs) are the major cause of morbidity and mortality, globally. Nurses are the largest body of health care professionals who attempt to reduce the burden of cardiovascular diseases. Design: This study employed a descriptive analytical cross-sectional study design to answer the research questions.
Methodology: The data were collected from 70 participants using two instruments. Knowledge was assessed through a 50-multiple-choice questions-based questionnaire, whereas, to assess the practices, an …

Cancer Cell Population Growth Kinetics At Low Densities Deviate From The Exponential Growth Model And Suggest An Allee Effect., Kaitlyn E Johnson, Grant Howard, William Mo, Michael K Strasser, Ernesto A B F Lima, Sui Huang, Amy Brock

Articles, Abstracts, and Reports

Most models of cancer cell population expansion assume exponential growth kinetics at low cell densities, with deviations to account for observed slowing of growth rate only at higher densities due to limited resources such as space and nutrients. However, recent preclinical and clinical observations of tumor initiation or recurrence indicate the presence of tumor growth kinetics in which growth rates scale positively with cell numbers. These observations are analogous to the cooperative behavior of species in an ecosystem described by the ecological principle of the Allee effect. In preclinical and clinical models, however, tumor growth data are limited by the …

Ashtanga For Addiction: A Qualitative Web-Based Open-Ended Survey To Assess Outcomes From Ashtanga Yoga Practice In Individuals In Long-Term Recovery From Substance Abuse Disorder, Shaun M. Jones

Dissertations and Theses (Open Access)

Over 72,000 people die from overdose or secondary health issues related to substance use disorder (SUD) annually. Studies support mind-body interventions in reducing stress, anxiety, depression, and craving symptoms. There is a growing body of literature supporting yoga as a mind-body intervention for individuals recovering from SUD. These interventions promote improved physical awareness, greater awareness of mental states, non-reactivity, and reduced perception of pain, allows for more successful coping with cravings. Ashtanga yoga (AY) is a tradition of yoga wherein students work on a one-on-one basis with highly qualified teachers following an invariant sequence of yoga postures. AY is characterized …

Commentary: Recognizing Pupillary Dysfunction In Diabetic Autonomic Neuropathy, Padmaja Sudhakar

Ophthalmology and Visual Science Faculty Publications

No abstract provided.

Older Adult Hospital Readmission Outcomes Of Transitional Care Model Compared With Home Based Primary Care Practice, Kellie L. Kahveci

Nursing Dissertations - Archive

Background: Thirty-day hospital readmission is a significant quality of care and economic problem for adults aged 65 years and older in the United States. The diagnoses most commonly problematic include heart failure (HF), pneumonia (PNE), and chronic obstructive pulmonary disease (COPD). Review of Literature: Multiple factors have been found to influence thirty-day hospital readmissions. Patient specific contributing factors include: depression, cognitive function, level of functional mobility, socioeconomic forces, and race. Exogenous factors include: patient education, pharmacologic agents, and health care providers quality of care. Interventions most effective in decreasing thirty-day hospital readmission include utilization of a team approach and a …

Predictors Of Perceived Faculty Support In Pre-Licensure Registered Nursing Students, Megan Marshall Mariveles

Nursing Dissertations - Archive

There is an increased demand for nurses in the United States contributing to a nursing shortage that is compounded by decreased student retention in pre-licensure registered nursing (PLRN) programs. Faculty support is a form of social support for nursing students resulting from interactions between teacher and student that involve the development of trust and a therapeutic, working relationship. Increased faculty support helps to mediate stressors. Students who perceive higher levels of faculty support are more likely to be successful academically and choose to remain enrolled in nursing programs. There were no studies found in which researchers examined factors that contribute …

After The Supreme Court Decision Relative To The Citizen Question In The Census: What Are The Options?, Alfredo Morabia

Publications and Research

No abstract provided.

Factors Influencing Indonesian Male Partners’ Support In The Postpartum Period, Hilda M. Agil, Kumi Watanabe, Emiko Tanaka, Yati Afiyanti, Tokie Anme

Makara Journal of Health Research

Background: Lack of male partners’ postpartum support can cause postpartum depression (PPD), a serious mood disorder, in women. Thus, to prevent PPD, it is important to clarify the factors influencing male partners’ postpartum support. Methods: In total, 62 male partners of postpartum women at 1 week–6 months after delivery, living in South Jakarta, were invited by assistance from community volunteers. Focus group interviews were employed; participants were grouped depending on their residences and asked about their behaviors in supporting postpartum women. Interviews were documented using two voice recorders and two video recorders. The content analysis method and Bertalanffy’s system theory …

Protection Against Neutrophil Extracellular Trap (Net) Toxicity By Antioxidant Monoher, Puji Astuti, Danielle M A Beurskens, Tanja Vajen, Gerry A F Nicolaes, Ming Zhang, Guido R M M Haenen

Makara Journal of Health Research

Background: Neutrophil extracellular traps (NET) are extracellular fibers produced by activated neutrophils to kill bacteria. NET was recently found to be associated with several diseases, such as autoimmune diseases. NET formation, called NETosis, is reactive oxygen species (ROS) dependent, thereby, prompting us to study its inhibition by potent antioxidant monoHER as well as to study monoHER protection against NET toxicity caused by NET constituent histone 3 on endothelial cells. Methods: Freshly isolated neutrophils from male donors were stimulated with PMA to induce NET formation. The effect of monoHER (50 µM) on oxidative burst (O2●− production) and NET formation was determined …

Understanding The Axonal Response To Injury By In Vivo Imaging In The Mouse Spinal Cord: A Tale Of Two Branches., Binhai Zheng, Ariana O Lorenzana, Le Ma

Department of Neuroscience Faculty Papers

Understanding the basic properties of how axons respond to injury in the mammalian central nervous system (CNS) is of fundamental value for developing strategies to promote neural repair. Axons possess complex morphologies with stereotypical branching patterns. However, current knowledge of the axonal response to injury gives little consideration to axonal branches, nor do strategies to promote axon regeneration. This article reviews evidence from in vivo spinal cord imaging that axonal branches markedly impact the degenerative and regenerative responses to injury. At a major bifurcation point, depending on whether one or both axonal branches are injured, neurons may choose either a …

Taste Manipulation And Swallowing Mechanics In Trauma-Related Sensory-Based Dysphagia, Angela M. Dietsch, H. Duncan Dorris, William Pearson, Katie E. Dietrich-Burns, Nancy Pearl Solomon

Department of Special Education and Communication Disorders: Faculty Publications

Purpose: This study explored the effects of highconcentration taste manipulation trials on swallow function in persons with sensory-based dysphagia.

Method: Dysphagia researchers partnered with clinical providers to prospectively identify traumatically injured U.S. military service members (N = 18) with sensorybased dysphagia as evidenced by delayed initiation and/or decreased awareness of residue/penetration/ aspiration. Under videofluoroscopy, participants swallowed trials of 3 custom-mixed taste stimuli: unflavored (40% weight/volume [wt/vol] barium sulfate in distilled water), sour (2.7%wt/vol citric acid in 40% wt/vol barium suspension), and sweet–sour (1.11% wt/vol citric acid plus 8% wt/vol sucrose in 40% wt/vol barium suspension). Trials were analyzed …

Longitudinal Quantification Of Adenovirus Neutralizing Responses In Zambian Mother-Infant Pairs: Impact Of Hiv-1 Infection And Its Treatment, Sara R. Privatt, Brianna L. Bullard, Eric A. Weaver, Charles Wood, John T. West

Nebraska Center for Virology: Faculty Publications

Vaccination offers the most cost-effective approach to limiting the adverse impact of infectious and neoplastic diseases that reduce the quality of life in sub-Saharan Africa (SSA). However, it is unclear what vaccine vectors would be most readily implementable in the setting and at what age they should be applied for maximal efficacy. Adenoviruses (Ad) and Ad-based vectors have been demonstrated to induce effective humoral and cellular immune responses in animal models and in humans. However, because immunity associated with Ad infection is lifelong, there exists a debate as to whether pre-existing immunity might decrease the efficacy of Ad vectored vaccines. …

Outcomes Of Participation In A Community-Based Physical Activity Program, Michelle Arnett, Sarah E. Toevs, Laura Bond, Elisabeth Hannah

Public and Population Health Faculty Publications and Presentations

Fit and Fall Proof^TM (FFP) program, established in 2004, is a peer volunteer-led collaboration between state and local public health organizations. The goal is to bring sustainable physical activity programs to underserved populations, including those in rural and frontier communities. FFP program is designed to help older adults maintain independence by improving mobility and function and providing opportunities for social engagement. The aim of this study was to evaluate the impact of participation in the program. A 6-month longitudinal study evaluated physical, social, and emotional outcomes among participants. The FES-I, SF-36v2, and Timed Up and Go (TUG) were collected. …

Pathophysiology Of Osteoporosis, Sarah Orr

Nursing Student Class Projects (Formerly MSN)

Out of all the potential disease that may impact bones, osteoporosis is the most common. Over time it compromises the strength and integrity of the bone. As the bone becomes more compromised fragility fractures will result. A significant portion of the growing elderly population will be impacted by the disease current research indicates this is a growing drain on healthcare resources with a significant impact on morbidity and mortality for those who suffer fractures related to compromised bone integrity from osteoporosis. The disease is a world wide problem that will affect all countries and populations. While medications exist to help …

Takotsubo Syndrome, Lindsay Kerr

Nursing Student Class Projects (Formerly MSN)

Takotsubo Syndrome is a disorder that has many names and is widely misunderstood. The symptoms mimic Acute coronary syndrome, but the treatment differs. Symptoms include chest pain, shortness of breath, and/or syncope. Takotsubo Syndrome can happen to anyone, but there are those who are most at risk. They include: anyone with acute psychological or physical distress, females, elderly, postmenopausal, postoperative, those with neurological or psychiatric disorders and individuals with disorders like pheochromocytoma, chemotherapy, and malignancy. Diagnosis includes evaluating the history of the patient so see if they have risk factors, serum cardiac enzymes, EKG, echocardiogram, and heart cath. Treatment includes …

Applying Bootstrap Quantile Regression For The Construction Of A Low Birth Weight Model, Ferra Yanuar, Hazmira Yozza, Firdawati Firdawati, Izzati Rahmi, Aidinil Zetra

Makara Journal of Health Research

Background: Most investigators use ordinary least squares (OLS) methods to model low birth weight. When the data are non-normal or contain outliers, OLS become ineffective. However, the quantile method of forecasting low birth weight has not been fully evaluated, although it has good potential for overcoming problems associated with linear regression. Methods: The present study reports our comparison between the OLS and quantile regression methods for modeling low birth weight when the data are right skewed and outliers are presented. Additionally, we evaluated the performance of the associated algorithm in recovering the true parameter using the bootstrap method. Results: Our …