Medicine and Health Sciences Commons^™

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) …

Non-Viral Transfection Efficiencies For The Advancement Of Car-T Therapy., Emily M Murphy

Electronic Theses and Dissertations

Leukemias are the most common form of childhood cancer making up 30% of total pediatric oncological cases, and Acute Lymphoblastic Leukemia (ALL) makes up a significant portion (12%) of the total pediatric cancer diagnoses. In 2017, the FDA approved a successful immunotherapy called CAR-T therapy for the treatment of pediatric B-cell ALL. This therapy includes a CAR (chimeric antigen receptor) that is loaded into the T-cell and expressed. Currently, the loading of the CAR utilizes viral transduction, but consistency issues lead to adverse symptoms in the patients. Better methods of transduction/transfection are being studied in order to improve these consistency …

Characterizing The Role Of Extracellular Matrix In Non-Small Cell Lung Carcinoma Metastasis Using A 3d Microenvironment Mimetic In-Vitro Culture System., Douglas John Owulaku Saforo

Electronic Theses and Dissertations

Lung cancer is the leading cause of cancer related death in the United States and worldwide. Five-year survival rates for non-small cell lung carcinoma patients have not improved in decades, and a majority of patients succumb to metastasis. Identification of therapeutic targets for metastatic disease is essential for the development of novel therapies. However, current 2-dimensional (2D) in vitro models are not reflective of the tumor microenvironment (TME) and are inadequate in identifying therapeutic targets. We adapted a 3-dimensional (3D) extracellular matrix (ECM) in vitro model to a hypoxic incubator to approximate physiological hypoxia of the TME in a microenvironment …

Probability Of Conception After Fertility Counseling And The Association Of Sexually Transmitted Infections With Pregnancy In The Loussi Study., Lindsey Adelle Wood

Electronic Theses and Dissertations

This study interrogated predictors of pregnancy and the effect of a history of sexually transmitted infection (STI) on probability of conception among a cohort of women seeking fertility counseling (N=170), using multivariable logistic regression and Cox proportional hazards models. There were 76 (44.7%) total pregnancies. 32 (39.0%) were achieved spontaneously by women who never received ART (N=82). Among women who did receive ART (N=88), 35 (39.7%) were achieved by ART and 9 (10.2%) achieved spontaneously. Among the full cohort (N=170), obesity was a significant negative predictor of pregnancy while history of human papilloma virus was a significant negative predictor of …

Computed Tomography Imaging Findings Of Acute Aortic Pathologies, Elif S. Duran, Farhan Ahmad, Mohamed Elshikh, Irfan Masood, Cihan Duran

School of Medicine Publications

Acute aortic syndromes (AAS) encompass a spectrum of life-threatening conditions characterized by acute aortic pain. AAS include acute aortic dissection, intramural hematoma, penetrating atherosclerotic ulcer, and aneurysm rupture. The prognosis of AAS is clearly related to prompt diagnosis and appropriate management. The different types of AAS cannot be reliably differentiated solely based on clinical presentation since the clinical features are indistinguishable. Multidetector-row computed tomography (MDCT) with electrocardiographic gating (ECG-gated MDCT) has been used in the acute emergency setting as a powerful clinical tool, which enables rapid and specific diagnosis of aortic pathologies. ECG-gated MDCT significantly reduces motion artifact and avoids …

Role Of Naltrexone In Improving Compulsive Drinking In Psychogenic Polydipsia, Sukaina Rizvi, Jeffery Gold, Ali M. Khan

School of Medicine Publications

Psychogenic polydipsia or self-induced water intoxication is a potentially lethal condition seen in many chronic psychiatric patients. This is a literature review based on therapeutic significance of Naltrexone in improving compulsive water drinking behavior in chronic psychiatrically ill patients with psychogenic polydipsia. Naltrexone is an opioid antagonist approved by FDA for alcohol dependence. Extensive literature search provides a line of evidence that suggests correlation of opioid receptor with compulsive water ingestion in animals. However, there is limited data regarding clinical utility of naltrexone in improving psychogenic polydipsia in human species. This review highlights the necessity for further research and trials …

Next-Generation Paclitaxel-Nanoparticle Formulation For Pancreatic Cancer Treatment, Andrew Massey, Mohammed Sikander, Neeraj Chauhan, Sonam Kumari, Saini Setua, Advait B. Shetty, Hassan Mandil, Vivek K. Kashyap, Sheema Khan, Meena Jaggi, Murali M. Yallapu, Bilal B. Hafeez, Subhash C. Chauhan

School of Medicine Publications

Pancreatic cancer (PanCa) is a major cause of cancer-related death due to limited therapeutic options. As pancreatic tumors are highly desmoplastic, they prevent appropriate uptake of therapeutic payloads. Thus, our objective is to develop a next-generation nanoparticle system for treating PanCa. We generated a multi-layered Pluronic F127 and polyvinyl alcohol stabilized and poly-L-lysine coated paclitaxel loaded poly(lactic-co-glycolic acid) nanoparticle formulation (PPNPs). This formulation exhibited optimal size (~160 nm) and negative Zeta potential (−6.02 mV), efficient lipid raft mediated internalization, pronounced inhibition in growth and metastasis in vitro, and in chemo-naive and chemo-exposed orthotopic xenograft mouse models. Additionally, PPNPs altered nanomechanical …

Predicting Residency Match Outcomes For Fourth-Year Medical Students., Jacob Shreffler

Electronic Theses and Dissertations

An important goal for undergraduate medical education program leaders is to prepare their medical students to successfully match during the National Residency Match Program (Gauer & Jackson, 2017). Due to the recent increase in applications submitted during the residency process, it is critical for medical education programs to better understand the factors and attributes of those medical students who are successfully matching (Liang, Curtin, Signer, & Sawoia, 2017). As there is a larger number of medical students now enrolled than positions available for residency, the number of unmatched seniors is expected to rise (Bumsted, Schenider, & Deiorio, 2017). Additionally, the …

The Effect Of Spinal Cord Injury On Sexual Function., Casey J. Steadman

Electronic Theses and Dissertations

Spinal cord injury (SCI) causes severe neurological impairment with widespread motor, autonomic and sensory deficits, leading to a substantial quality of life impairment. The number of individuals with SCI increases by approximately 12,500 annually, and over 80% of individuals with SCI are males. SCI individuals rate sexual function as a top priority quality of life issue, and men with SCI likely suffer from sexual dysfunction, such as erectile and ejaculatory dysfunction, as well as infertility. Regardless of the high status of importance of sexual function, limited numbers of experimental studies in SCI animal models have focused on sexual function after …

Mobile-Based Technology App Used To Improve Self-Care Management Of Patients With Type 2 Diabetes Mellitus, Fred Allen Smith Jr

Doctoral Dissertations and Projects

Billions of dollars are spent on diabetes in healthcare each year. Patients with lower socio-economic-status tend to have poor glycemic control, higher associated diabetic complications, and higher associated mortality rates. In underserved patients with type 2 diabetes, does utilization of a Diabetes app, compared to previous self-care management and clinic education, lower the Hemoglobin A1c over a 3-month period? A 3-month scholarly project was conducted in a small rural town in Virginia with an average median income around $17,000. N=21 were selected for the scholarly project. Inclusive criteria consisted of adults aged 19-70 years with a diagnosis of type 2 …

Evaluation Of Patient Education To Facilitate Advance Directives Completion With Dialysis Patients, Xuesi Liu

Doctoral Dissertations and Projects

Completion of advance directives (ADs) is an important part of identifying a patient’s treatment preferences. Lack of patient understanding regarding the scope and importance of advance directives is a common barrier to AD completion. This project reports on the effectiveness of a patient education intervention in facilitating patient understanding in an outpatient dialysis facility in rural Virginia. Thirty patients were selected by convenience sampling to participate in a 10-minute verbal presentation based on a brochure entitled “Advance Care Planning: Tips from the National Institute on Aging” and completed two short questionnaires, one before and one after the education session. Patients …

Unimóvil: A Mobile Health Clinic Providing Primary Care To The Colonias Of The Rio Grande Valley, South Texas, Eron G. Manuosv, Vincent P. Diego, Jacob Smith, Jesus R. Garza Ii, John Lowdermilk, John Blangero, Sarah Williams-Blangero, Francisco Fernandez

School of Medicine Publications

Background: We describe a mobile unit (UniMóvil) designed to improve poor healthcare access delivery to residents in two South Texas underserved Colonias. The interprofessional team measured seven clinical outcomes [obesity, diabetes, hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C) levels, and depression], and using the Duke Health Profile, assessed the health-related quality of life (HrQoL).

Methods: The investigators used previously reported disease prevalence, an implementation model, and community needs-assessments to design an outreach healthcare delivery model. A retrospective review of the cohort provides data used to determine potential predictors of clinical variables, 11 domains of HrQOL, and inter/intra Colonia …

Association Of Office And Ambulatory Blood Pressure With Mortality And Cardiovascular Outcomes, Wen-Yi Yang, Jesus D. Melgarejo, Lutgarde Thijs, Zhen-Yu Zhang, José Boggia, Fang-Fei Wei, Tine W. Hansen, Kei Asayama, Gladys E. Maestre, Takayoshi Ohkubo

School of Medicine Publications

Importance Blood pressure (BP) is a known risk factor for overall mortality and cardiovascular (CV)-specific fatal and nonfatal outcomes. It is uncertain which BP index is most strongly associated with these outcomes.

Objective To evaluate the association of BP indexes with death and a composite CV event.

Design, Setting, and Participants Longitudinal population-based cohort study of 11 135 adults from Europe, Asia, and South America with baseline observations collected from May 1988 to May 2010 (last follow-ups, August 2006-October 2016).

Exposures Blood pressure measured by an observer or an automated office machine; measured for 24 hours, during the day or …

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) …

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 …