Medicine and Health Sciences Commons^™

Pharmacological Treatment Options For Nonalcoholic Steatohepatitis: Resmetirom Vs Glp-1 Receptor Agonists, Debbie Zabel

Physician Assistant Scholarly Project Posters

Incidence of nonalcoholic steatohepatitis (NASH) is rising and becoming a leading cause of cirrhosis requiring liver transplantation (Maurice et al., 2018). • Historic management with lifestyle changes and treatment of comorbidities. • March 2024: FDA approved resmetirom, the first medication specifically for the treatment of NASH. • Comparison of GLP-1 receptor agonists and dual GLP/GIP/GCGR receptor agonists with resmetirom for hepatic fat reduction. • Database search of PubMed and Embase yielded 11 studies from an initial 698 articles after filter application for randomized controlled trials and studies published no earlier than 2014. • Resmetirom is superior to GLP-1 agonists for …

A Neuroimmune Circuit Mediates Chemo Brain Pathology, Daniel Ahmadi

McKelvey School of Engineering Graduate Student Theses & Dissertations

Chemotherapeutic agents, while effective in targeting malignant tumors, often reduce the patients’ quality of life by inducing fatigue, pain, and motivational deficits. These symptoms are collectively referred to as “chemo brain.” The mechanisms underlying these adverse effects, and specifically whether fatigue and motivational impairments share a common etiology, remain poorly understood. The neural–immune substrates of these symptoms remain obscure, in part because standard preclinical regimens either bypass key systemic signals or introduce local toxicity confounds. Here, I establish and validate a three‑day, low‑dose intravenous cisplatin protocol that avoids peritoneal inflammation and severe renal injury yet produces robust, reversible fatigue and …

Implementation Of The American College Of Cardiology And American Diabetes Association Clinical Practice Guidelines For Statin Therapy In Reducing Cardiovascular Risk Among Patients With Type 2 Diabetes, Edward Eloy Iruegas

Doctor of Nursing Practice

The incidence of type 2 diabetes has significantly increased over the past decade, making it a risk factor for cardiovascular disease (Banach et al., 2022). Individuals with type 2 diabetes are four times more likely to develop atherosclerotic cardiovascular disease, accounting for up to a 75% mortality rate. Despite this, the risk for atherosclerotic cardiovascular disease remains underestimated and undertreated in this population (Banach et al., 2022). The purpose of this project was to enhance adherence to the American College of Cardiology 2019 and the American Diabetes Association 2023 clinical practice guidelines regarding statin therapy for patients with type …

Exploring The Biasing Effects Of Gender On Personality Disorder Diagnoses Formulated By Artificial Intelligence, Zoe Colclough

Student Theses

Gender bias is prevalent in personality disorder assessments, and while artificial intelligence has been posited as a solution to improve diagnostic objectivity and accuracy, the potential for such technologies to propagate human gender bias in mental health contexts remains underexplored. This study investigated the influences of gender bias on the diagnostic performance of ChatGPT-4o for personality disorders using three factorial research designs, which involved experimentally manipulating patient gender in a combined sample of 360 vignettes and case studies. Vignettes were synthesized through a novel artificial intelligence-assisted methodology established for this research, and case studies were identified from the literature. Significant …

Clinical Implications Of Mismatch Repair Deficiency In Pancreatic Ductal Adenocarcinoma, Zachary Kaplan, Elizabeth Prezioso, Aditi Jain, Harish Lavu, Charles Yeo, Wilbur Bowne, Avinoam Nevler

Kimmel Cancer Center Faculty Papers

BACKGROUND: Pancreatic cancer is a highly aggressive and lethal disease, characterized by a limited response to chemotherapy and overall poor prognosis. Pancreatic cancers with a distinct mismatch repair deficiency, although relatively rare, have been shown to be associated with markedly better outcomes in comparison. Furthermore, whereas pancreatic cancers are generally unresponsive to current immunotherapy, this specific group of tumors has been shown to have a notable susceptibility to immune checkpoint inhibitors.

AIMS: In this review, we aim to summarize the relevant literature regarding mismatch-repair associated pancreatic cancers, the impacted biological mechanisms, and the resulting vulnerabilities for potential opportunistic immunotherapeutic treatment …

User-Centered Design Of A Weight Loss Mobile App, Sunaina Advani

Honors Scholar Theses

Obesity, the excessive accumulation of body fat, increases risk for chronic disease and affects 34% of U.S. adults (10). Lifestyle interventions are effective but heavily rely on calorie tracking, while adherence to this behavioral strategy is low (6). An alternative to calorie tracking is to simply track instances of overeating. In a pilot trial, obese individuals used Habit app, a mobile app that assists users in tracking overeating episodes. Users were asked to identify, record, and reflect on dietary slips, or deviations from the recommended diet. Following 6 months of use, in a focus group session, 20 participants were asked …

The Politics Of The Black Womb: How Education And Power Reinforce The U.S. Black Maternal Health Crisis, Foluke Akinkunmi

Honors Scholar Theses

This study investigates the alarming maternal mortality rates among Black women in the U.S. today first by exploring the historical exploitation of Black maternal bodies during enslavement and with the rise of professionalized gynecology. It challenges the narrative that attributes these outcomes to individual choices or supposedly inherent biological factors, arguing instead that the devaluing of Black women’s well-being and authoritative knowledge have been constructed along with the United States itself. To advance a constructive response, the paper analyzes curriculum competencies for obstetric and midwifery healthcare providers, surveys of Black women's birthing experiences in the previous 20 years, and interviews …

Serological Evaluation For Leptospirosis On Samples Received By The Connecticut Veterinary Medical Diagnostic Laboratory (Cvmdl), Hayden R. Samuels

Honors Scholar Theses

Leptospirosis is a globally distributed zoonotic disease caused by pathogenic species of Leptospira, motile spirochetes capable of infecting humans and animals. Transmission typically occurs through contact with water or soil contaminated by the urine of reservoirs or infected animals. Although leptospirosis is considered a neglected tropical disease, its geographic range is expanding due to climate change and urbanization. Surveillance remains limited in many regions, especially in the United States. This study aimed to assess the seroprevalence and serovar diversity of Leptospira exposure in a variety of domestic and wild animals submitted to the Connecticut Veterinary Medical Diagnostic Laboratory (CVMDL). …

Mechanistic Investigation Of Ring-Opening Polymerization Of Polycaprolactone Using Tin(Ii) Catalysts: Ligand Effects And Biomedical Applications, Eva-Larue M. Barber

Honors Scholar Theses

This research explores the mechanistic aspects of ring-opening polymerization (ROP) of ε-caprolactone (CL) to produce polycaprolactone (PCL), a biodegradable polymer widely used in biomedical applications. The study investigates how light exposure and catalyst concentration influence polymerization efficiency, using tin(II) 2-ethylhexanoate [Sn(Oct)₂] as the catalyst in a non-polar toluene solvent at 90 °C. Reactions were conducted under either ambient light or black light bulb (BLB) illumination, with monomer-to-catalyst ratios of 1:1 and 200:1.

Proton nuclear magnetic resonance (¹H NMR) spectroscopy was used to analyze conversion efficiency by tracking the disappearance of monomer signals and appearance of characteristic PCL peaks. Results revealed …

Efficacy Of Single Joystick-Operated Ride-On-Toy Navigation Training Program To Promote Increased Spontaneous Use And Motor Function In The Affected Arm In Children With Unilateral Cerebral Palsy, Neha Samuel

Honors Scholar Theses

The purpose of this study is to assess the adjunctive effects of a home-based single joystick-operated ride-on-toy navigation program to conventional care on affected upper extremity (UE) use and motor function in children with hemiplegia. Wrist-worn accelerometers were worn by children on both their affected and unaffected extremities at baseline (i.e., prior to start of the training program) and during ride-on toy training sessions to measure affected and unaffected arm activity, resulting in measurements of percent duration of time in every session that children engaged in sedentary, light, and moderate-to-vigorous activity (MVPA) using their affected and unaffected arms at baseline …

The Impact Of Cocaine On Inflammatory Markers In Sim-A9 Microglial Cells, Tyler Vaglivelo

Honors Scholar Theses

Substance use disorders are conditions in which an individual continues to use a drug or other substance despite adverse consequences to their health and well-being. It has been hypothesized that inflammation within the central nervous system plays a critical role in the development of substance use disorders. The resident macrophages in the brain, also known as microglia, release markers of inflammation in response to injury or infection. A better understanding of the inflammatory response mediated by microglia in response to drugs of misuse can validate this hypothesis and help guide drug development. In the current studies, the microglia cell line …

Exercise As An Intervention For Postpartum Depression (Ppd), Kylie P. Mistretta

Honors Scholar Theses

Objective: To illustrate the applications of exercise for preventing the development of postpartum depression (PPD) and addressing associated risk factors identified in the literature. Data Sources: PubMed and EBSCO: Academic Search Premier were accessed using the search terms exercise OR physical activity OR yoga AND postpartum depression OR postnatal depression. A secondary search of PubMed was conducted using the search terms exercise AND pregnancy AND depression OR gestational diabetes OR weight gain OR sleep quality.

Study Selection: Studies selected for inclusion were peer-reviewed, published after January 2012, written in English, and relevant to the PPD risk factors examined. Only clinical …

Nurse-Physicians: From Nursing School To Practicing Physician, Tobias Fraedrich

Honors Scholar Theses

Nurse-physicians are healthcare professionals who have obtained both a nursing degree and a medical degree, transitioning from Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN) to a licensed physician, including Medical Doctor (MD), Doctor of Osteopathic Medicine (DO), or Naturopathic Doctor (ND). Research on this phenomenon conducted to date is limited to a single study. Some nonresearch sources indicate a small presence of this topic online. Yin’s (2018) descriptive, multiple-case study approach was employed to investigate the phenomenon using oral history interviews and a survey of the online platform YouTube as data sources. For the intention of pursuing this …

Age-Dependent Mineralization And Osteogenesis In Intact & Injured Murine Bones: A Histological And Immunochemical Study, Amogh Chittajallu

Honors Scholar Theses

Bones function as living organs through their mineralized matrix and specialized cell populations, which provide structural support and enable movement, while storing minerals and creating a space for blood cell production in the marrow¹. As individuals age, hormonal changes reduce osteoblast activity while osteoclast-mediated bone resorption persists, resulting in lower mineral density and heightened fracture risk². We examined how aging impacts young and old murine femurs because these models display bone structure and cellular organization that closely resemble human long bones. This research study used six distinct histological stains to observe essential features of bone tissue …

Developing A Small Molecule To Inhibit Hsf1 Expression In Cancer And Evaluating Natural Genetic Variation In Small Molecule Toxicity., Michaela Kendal Foley

Theses and Dissertations

Each year cancer affects nearly 20 million people worldwide and genetic differences across populations can impact cancer onset and progression. Specifically, tumors with high levels of HSF1, the master regulator of the cytoprotective heat shock response (HSR), are correlated with poor patient outcomes in multiple cancers such as prostate, breast, and melanoma. Subsequently, the development of pharmacological inhibitors of HSF1 represents a promising strategy for anticancer therapeutics. Using a luciferase-based transcriptional reporter, two small molecule libraries were screened for inhibitors of HSF1 expression in human embryonic kidney cells, yielding ten compounds that decrease HSF1 expression. To identify if cancer lines …

Preclinical Evaluation Of Closed Incisional Negative Pressure Therapy On Post-Surgical Oedema And Lymphatic Activity, John C Rasmussen, Marisa Schmidt, Janelle E Morton, Samantha Mann, Kristine Kieswetter, Eva M Sevick-Muraca

Faculty, Staff and Student Publications

Closed incisional Negative Pressure Therapy (ciNPT) has demonstrated improved post-surgical healing with reduced oedema and hematoma/seroma formation in patients. The underlying mechanism of action is poorly understood, although evidence indicates that lymphatics play a role. The effects of ciNPT on oedema and lymphatic recovery were assessed following bilateral, surgical undermining of swine mammary tissues. One incision was treated with ciNPT, and the control covered with clear dressing. Near-infrared fluorescence imaging was used to visualise lymphatic activity. Oedema and lymph node size were measured using ultrasound. LYVE-1 and podoplanin were quantified with ELISA. Analysis of lymphatic activity revealed a contralateral effect …

From Trauma To Treatment: Chronic Neurobehavioral Consequences And Emerging Treatments, Moriah E. Mcguier

Dartmouth College Ph.D Dissertations

Severe trauma exposure related to traumatic brain injury (TBI) or psychiatric disorders like post-traumatic stress disorder (PTSD) leads to neurobehavioral and physiological impairments that reduce the quality of life of individuals and remain difficult to treat with current therapeutic options. Further, these conditions are highly comorbid, notably in PTSD with blast-traumatic brain injury (bTBI) commonly experienced by military members via explosive forces, leading to complex and heterogenous outcomes. To address this, preclinical models have been developed to recapitulate aspects of TBI and PTSD. This thesis utilizes two such models in rats, bTBI and the single prolonged stress (SPS) model for …

An Exploration Of Bedside Critical Care Nurses’ Attitudes Towards The Teleicu, Theresa Marie Drucker

Theses & Dissertations

Background

Acute care facilities are seeing an increased demand for critical care resources, given the increasing aging population with more complex health problems, retiring healthcare professionals, and subsequent decreasing supply of new expertise (Shahpori et al., 2011). Telehealth in the ICU is a valuable resource that some hospitals have employed to bridge this gap. The use of the teleICU has been associated with improved outcomes for patients (Williams et al., 2019), and reduction in failure to rescue (FTR) events. Despite the increasing availability of teleICU programs and the associated potential benefits, there continue to be inconsistencies in terms of usage …

Exploring The Effects Of Serotonin And Selective Serotonin Reuptake Inhibitors On The Neurological, Behavioral, And Cardiovascular Systems Using The Animal Model Of The Syrian Hamster (Mesocricetus Auratus), Ariana Vianey Hinojosa

Theses and Dissertations

Serotonin is a neurotransmitter widely recognized for its role in neuropsychological processes, particularly in regulating mood, cognition, and emotional responses. However, its influence extends beyond the central nervous system (CNS), playing a crucial role in various physiological functions, including metabolism, the gastrointestinal system, reproductive processes, and cardiovascular regulation. As a key modulator of homeostasis, serotonin contributes to maintaining equilibrium within these systems, ensuring proper function and response to environmental stimuli. Despite its well-documented effects on mood and behavior, the broader physiological implications of serotonin remain less understood, particularly in the context of its interactions among neural, behavioral, and cardiovascular systems. …

Implementing And Evaluating An Ai-Powered Visual Decision Support System To Improve Antibiotic Usage Among Physicians With A Built-In Early Warning System, Akua Sekyiwaa Osei-Nkwantabisa

Theses and Dissertations

The widespread misuse and excessive prescription of antibiotics have played a pivotal role in the emergence and proliferation of antibiotic-resistant bacteria, posing a critical global public health crisis. Addressing this challenge necessitates innovative solutions that enhance antimicrobial stewardship. This study presents the development and implementation of a visual decision support system designed to monitor and optimize antibiotic usage among healthcare providers. The proposed system integrates advanced machine learning algorithms with real-time data analytics to provide a dynamic, evidence-based decision support tool. Specifically, a neural network model was developed after evaluating multiple machine learning approaches, including Random Forest, Logistic Regression and …

Acute Metabolic, Physiological, And Perceptual Responses To Different Set And Rep Schemes In The Back Squat, Shawn Wayland

Electronic Theses and Dissertations

The purpose of this study was to examine the acute effects of ecologically valid schemes of sets and repetitions in the back squat during the bout and into recovery. Such understanding is expected to contribute to knowledge of the strength-endurance continuum and differential responses to various training emphases in practical settings. Eleven participants completed back squat protocols consisting of a warm-up followed by either 3 x 2 at 90% of 1RM, 3 x 5 at 82.5% of 1RM, and 3 x 10 at 62.5% of 1RM in a randomized and counterbalanced design. VO2, heart rate (HR), lactate, and RPE were …

Peer-Led Support Groups For People With Early Onset Parkinson's Disease, Linnea Tabaka

Electronic Theses and Dissertations

Introduction: Early onset Parkinson’s Disease (EOPD) is a diagnosis of Parkinson’s Disease when diagnosed between the ages of 21 and 50. This population faces unique challenges due to family, social, and career demands that correlate with the age of diagnosis. Support groups have been utilized frequently for people with traditional PD and their caregivers but may not meet the unique needs people with EOPD face. This study explores the existing benefits of a peer-led support group (group led by members of the group) for persons with EOPD. Methodology: This is a qualitative case study of an established support …

Channeling Relaxation Through Multiple Means: Tmem16a Antagonism For Asthma, Arun K. Jannu, Raymond B. Penn

Center for Translational Medicine Faculty Papers

No abstract provided.

The Effects Of Retrieval Practice On Knowledge Acquisition And Durable Learning In Undergraduate Nursing Students, Jessica Everritt Gay

Dissertations

Recent reports of unpreparedness and failure to rescue incidents among new graduate nurses are concerning for nurse educators and health care. New graduates must retrieve and apply learned knowledge to make sound clinical decisions, emphasizing the need for durable learning and knowledge acquisition. Durable learning, which involves understanding and recalling learned information days, weeks, or months later is crucial for clinical judgment. Nurse educators should facilitate durable learning through effective, evidence-based learning techniques such as retrieval practice (RP), which has shown promise in health professions education but is underutilized in nursing education.

This study explored the impact of RP on …

Is There A Relationship Between Motivation And Nursing Student Engagement? A Quantitative, Cross-Sectional, Correlational Study, Angela Coes

Dissertations

Nursing education is concerned with helping to alleviate the nursing shortage in the United States; this can be done by graduating safe competent novice nurses. Motivation and engagement levels in nursing students have been tied to better academic outcomes including graduation rates, transition to practice, and first time National Council Licensure Examination for Registered Nurses pass rates. There was a gap in prelicensure nursing education research in the United States concerning the relationship among motivation, engagement, and possible influential variables.

The purpose of this study was to investigate the relationship between motivation and academic engagement among prelicensure nursing students in …

Therapeutic Applications Of A Novel Humanized Monoclonal Antibody Targeting Chemokine Receptor Ccr9 In Pancreatic Cancer, Hannah G. Mcdonald, Anna M. Reagan, Charles J. Bailey, Mei Gao, Muqiang Gao, Angelica L. Solomon, Michael J. Cavnar, Prakash Pandalai, Mautin Barry-Hundeyin, Megan Harper, Justin A. Rueckert, Ángela Turrero, Araceli Tobio, Anxo Vidal, Daniel Roca-Lema, Elia Álvarez-Coiradas, Pablo Garrido, Laureano Simón, Joseph Kim

Markey Cancer Center Faculty Publications

The relative failure of immune checkpoint inhibitors in pancreatic ductal adenocarcinoma (PDAC) despite having a dense, immunosuppressive tumor microenvironment highlights the need to target alternate/escape pathways. We have previously examined C–C chemokine receptor type 9 (CCR9) as a candidate immune checkpoint and developed a targeted, humanized monoclonal antibody (SRB2). Cytotoxicity of SRB2 was evaluated in vitro and in vivo. CCR9 expression on PDAC cells/tissues, immune components of patient-derived organoids (PDOs), and antibody-dependent cell-mediated cytotoxicity were examined. In PANC-1 and MIA PaCa-2 cell lines, we demonstrated highest CCR9 expression; however, no direct cytotoxic effect was observed with SRB2 treatment. In PANC-1 …

An Agrin-Yap/Taz Rigidity Sensing Module Drives Egfr-Addicted Lung Tumorigenesis., Reza Bayat Mokhtari, Divyaleka Sampath, Paige Eversole, Melissa Ong Yu Lin, Dmitriy A. Bosykh, Gandhi T. K. Boopathy, Aravind Sivakumar, Cheng-Chun Wang, Ramesh Kumar, Joe Yeong Poh Sheng, Ellen Karasik, Barbara A. Foster, Han Yu, Xiang Ling, Wenjie Wu, Fengzhi Li, Zoë Weaver Ohler, Christine Fillmore Brainson, David W. Goodrich, Wanjin Hong, Sayan Chakraborty

Markey Cancer Center Faculty Publications

Despite epidermal growth factor receptor (EGFR) is a pivotal oncogene for several cancers, including lung adenocarcinoma (LUAD), how it senses extracellular matrix (ECM) rigidity remain elusive in the context of the increasing role of tissue rigidity on various hallmarks of cancer development. Here it is shown that EGFR dictates tumorigenic agrin expression in lung cancer cell lines, genetically engineered EGFR-driven mouse models, and human specimens. Agrin expression confers substrate stiffness-dependent oncogenic attributes to EGFR-reliant cancer cells. Mechanistically, agrin mechanoactivates EGFR through epidermal growth factor (EGF)-dependent and independent modes, thereby sensitizing its activity toward localized cancer cell-ECM adherence and bulk rigidity …

The Role Of Ucp2 In Pancreatic Cancer Metabolism And Its Potential As A Radiosensitizer, Emily Rieff

Dissertations and Theses (Open Access)

Uncoupling protein 2 (UCP2) is a mitochondrial protein that regulates the flow of protons down the gradient established by the electron transport chain (ETC) without generating ATP, thus uncoupling the proton gradient from ATP generation. In tumors, specifically pancreatic cancer (PDAC), the ETC is highly stimulated to generate the copious ATP needed by the tumor to grow. However, extended ETC use increases reactive oxygen species (ROS), and if left unchecked, results in cell death. To evade this, PDAC employs antioxidant strategies, including upregulating UCP2 in tumor cells. In addition to its uncoupling function, UCP2 indirectly controls ROS levels by maintaining …

Perception Of Mental Health Among Students In Higher Education, Kasibah Baig, Leia Aguilar

Electronic Theses, Projects, and Dissertations

Mental health in higher education environments is a topic that has the need for exploration and discussion. Students with poor mental health face additional stressors and challenges in their academic and personal areas of life. It is critical for colleges and universities to address the topic of mental health and understand how it can affect students, as well as to be able to provide the proper support and services. By having more conversations about mental health on campus and providing easily accessible and inclusive resources for students, it can create a comfortable environment on campus for students to be able …

The Impact Of Attachment Education On Families With Children Diagnosed With Autism Spectrum Disorder: A Proposed Workshop, Sabrina S. Stone-Smith

Electronic Theses, Projects, and Dissertations

For young children with autism spectrum disorder, one important determinant of later social and emotional functioning is the development of a secure attachment. While there is extensive literature outlining the benefits of attachment security, there is a limited number of studies specifically examining programs intended to increase attachment security in this population. This project aims to create a four-session workshop designed to provide caregivers of children in this population with information about attachment theory and parental sensitivity in order to increase the amount of positive and emotionally validating experiences in child-caregiver interactions while reducing parental stress. Future research is necessary …