Medicine and Health Sciences Commons^™

Mathematical Evaluation Of Ulnar Nerve Somatosensory Evoked Potentials (Sseps), Maribel Carmen Gomez

Theses and Dissertations

As the number of individuals suffering with low back and neck pain rises, we find people undergoing spinal procedures more often. In means, of safeguarding the patient and their neurological structures during the procedure intraoperative neuro-physiological monitoring (I.O.M) has been more widely used amongst surgeons orthopedic and neuro alike. During these procedures, a modality widely used for both low back and neck surgery is somatosensory evoked potentials (SSEPs). The aim of neuro-technicians is to obtain a baseline waveform that can be considered present and reliable. When obtaining SSEPs the technician can encounter obstacles with ’noisy’ wave-forms due to …

The Impacts Of Caregiving And Social Support On Stress For Multiple Sclerosis: A Study On Informal Caregivers, Jacqueline Mercado

Theses and Dissertations

The purpose of the present quantitative study was to gain an increased understanding of the impacts of caregiving and social support on stress for unpaid informal caregivers of persons with Multiple Sclerosis. Caregiving for MS can be rewarding yet stressful. Informal caregivers are the primary source of ongoing home care for family members or friends with MS. Due to the complexity of care, caregivers are especially vulnerable to higher strain as they often feel unprepared for this role. This study examined perceived social support and demographic variables on caregivers' stress to gain insight into mediating caregiver psychosocial challenges. …

Using Plastinated Cadaveric Models For Anatomical Study Of Dorsalis Pedis Artery And Its Variation, Steven Bolton, Ifunanya Monube, Hooman Tabatabai-Mir

School of Podiatric Medicine - Student Research

The dorsalis pedis artery is a main artery of the dorsum of the foot. It directly arises from the anterior tibial artery and travels distally to the base of the 1st metatarsal. Its main function includes supplying oxygenated blood to the dorsal surface of the foot. A weak dorsalis pedis pulse is an indication of underlying circulation issue, such as peripheral vascular disease. Anatomical variations of the artery are not uncommon, including the total absence of the artery. Branching variations occur in approximately 10% of the population. Knowledge of these variations is critical for surgeons to prevent surgical complications

Intestinal Microbiome, Fecal Fermentation Profile, And Health Indices In Hiv Infected Men Versus Non-Infected Controls, Mary Andreae, Mary C. Andreae Mrs

Electronic Theses and Dissertations

Many HIV-positive (HIV+) males on Highly Active Anti-Retroviral Therapy (HAART) experience metabolic abnormalities, including Non-Alcoholic Fatty Liver Disease (NAFLD) and lipodystrophy. The intestinal microbiota and short chain fatty acids (SCFA), participate in bidirectional communication with their host. Dysbiosis in HIV+ males on HAART demonstrate a Prevotella-rich enterotype shaped by multiple factors including, medications, adiposity, diet, intestinal permeability, and lifestyle; our objective was to investigate these factors. 19 HIV+ and 21 HIV- males were enrolled. BMI and hip-to-waist ratio (H:W) were obtained, and FibroScan for liver health. Intestinal permeability markers Claudin-21, flagellin, and intestinal fatty acid binding protein (IFABP) in …

School Nurses And The Sexual Health And Education Of Public-School Students In Tennessee, Amy Wake

Electronic Theses and Dissertations

Tennesseans have been experiencing increasing rates of sexually transmitted diseases since the year 2000. Those rates are highest among those 15- to 24-year-olds. At the same time, Tennessee policy requires the teaching of abstinence as the primary form of sexual health education and emphasized the use of abstinence-only curriculum. The school nurse represents an available resource in the Tennessee public schools. The purpose of the qualitative study was to explore, describe, and interpret the perceptions and experiences of public-school nurses from rural, suburban, and urban areas of Tennessee related to the sexual health and sexual health education of students. School …

Simultaneous 7q36 And 13q32 Deletions In A Newborn, Brooke Laudenslager Do, Kayle Barndt

Department of Pediatrics

No abstract provided.

Nurses’ Awareness Regarding Patients’ Safety Receiving Vasoactive Medication In Critical Care Units, Gehad Diaa

Nursing

Background: Critical care nurses are responsible for managing the preparation, timing of initiation, administration, titration, and weaning of vasoactive infusions based on the prescriptions of the physician so; to ensure patient safety, they must have adequate knowledge about medication, goals of drug therapy, and interventions to minimize adverse reactions. Aim of the study: This study was conducted to assess nurses’ awareness regarding patients’ safety receiving vasoactive medication in critical care units Design: A descriptive exploratory was utilized to achieve the aim. Setting: This study was conducted at two ICUs as follows (Cardiovascular Care Unit, and Chest Care Unit) affiliated with …

Effect Of Animated Stories On Pain Intensity And Physiological Parameters Among Post-Operative Children., Sara Sayed Abdalla

Nursing

No abstract provided.

Sprouty4 Is Epigenetically Upregulated In Human Colorectal Cancer, Alexei J. Stuckel, Shuai Zeng, Zhen Lyu, Wei Zhang, Xu Zhang, Urszula Dougherty, Reba Mustafi, Tripti Khare, Qiong Zhang, Trupti Joshi, Marc Bissonnette, Sharad Khare

Biomedical Sciences

Sprouty4 (SPRY4) has been frequently reported as a tumor suppressor and is therefore downregulated in various cancers. For the first time, we report that SPRY4 is epigenetically upregulated in colorectal cancer (CRC). In this study, we explored DNA methylation and hydroxymethylation levels of SPRY4 in CRC cells and patient samples and correlated these findings with mRNA and protein expression levels. Three loci within the promoter region of SPRY4 were evaluated for 5mC levels in CRC using the combined bisulfite restriction analysis. In addition, hydroxymethylation levels within SPRY4 were measured in CRC patients. Lastly, DNA methylation and mRNA expression data were …

Cyclin D1 Extensively Reprograms Metabolism To Support Biosynthetic Pathways In Hepatocytes, Heng Wu, Betsy T. Kren, Andrew N. Lane, Teresa A. Cassel, Richard M. Higashi, Teresa Whei-Mei Fan, George S. Scaria, Laurie L. Shekels, Mark A. Klein, Jeffrey H. Albrecht

Markey Cancer Center Faculty Publications

Cell proliferation requires metabolic reprogramming to accommodate biosynthesis of new cell components, and similar alterations occur in cancer cells. However, the mechanisms linking the cell cycle machinery to metabolism are not well defined. Cyclin D1, along with its main partner cyclindependent kinase 4 (Cdk4), is a pivotal cell cycle regulator and driver oncogene that is overexpressed in many cancers. Here, we examine hepatocyte proliferation to define novel effects of cyclin D1 on biosynthetic metabolism. Metabolomic studies reveal that cyclin D1 broadly promotes biosynthetic pathways including glycolysis, the pentose phosphate pathway, and the purine and pyrimidine nucleotide synthesis in hepatocytes. Proteomic …

Immunization With The Amino-Terminus Region Of Dense Granule Protein 6 (Gra6) Of Toxoplasma Gondii Activates Cd8+ Cytotoxic T Cells Capable Of Removing Tissue Cysts Of The Parasite Through Antigen Presentation By Human Hla-A2.1, Rajesh Mani, Corinne Mercier, Marie-France Delauw, Yasuhiro Suzuki

Markey Cancer Center Faculty Publications

CD8þ T cells from HLA-A2.1-transgenic mice, but not wild-type mice, immunized with the amino- terminus region (aa 41e152) of dense granule protein 6 (GRA6Nt) of Toxoplasma gondii secreted large amounts of perforin and granzyme B in response to GRA6Nt through antigen presentation by HLA-A2.1 in vitro. When those CD8þ T cells were transferred into chronically infected HLA-A2.1-expressing NSG mice deficient in T cells, cerebral cyst burden of the recipients of HLA-A2.1-transgenic T cells, but not of WT T cells, became significantly less than that of control mice with no cell transfer. Furthermore, the significant reduction of the cyst burden by …

Magnetic Resonance Imaging Of Macrophage Response To Radiation Therapy, Harrison Yang, Brock Howerton, Logan Brown, Tadahide Izumi, Dennis C. Cheek, Jason Anthony Brandon, Francesc Marti, Roberto Gedaly, Reuben Adatorwovor, Fanny Chapelin

Markey Cancer Center Faculty Publications

Background: Magnetic resonance imaging (MRI) is a non-invasive imaging modality which, in conjunction with biopsies, provide a qualitative assessment of tumor response to treatment. Intravenous injection of contrast agents such as fluorine (19F) nanoemulsions labels systemic macrophages, which can, then, be tracked in real time with MRI. This method can provide quantifiable insights into the behavior of tumor-associated macrophages (TAMs) in the tumor microenvironment and macrophage recruitment during therapy.

Methods: Female mice received mammary fat pad injections of murine breast or colon cancer cell lines. The mice then received an intravenous 19F nanoemulsion injection, followed by a baseline 19F MRI. …

Md_Harmonize: A Python Package For Atom-Level Harmonization Of Public Metabolic Databases, Huan Jin, Hunter N. B. Moseley

Markey Cancer Center Faculty Publications

A major challenge to integrating public metabolic resources is the use of different nomenclatures by individual databases. This paper presents md_harmonize, an open-source Python package for harmonizing compounds and metabolic reactions across various metabolic databases. The md_harmonize package utilizes a neighborhood-specific graph coloring method for generating a unique identifier for each compound via atom identifiers based on a compound’s chemical structure. The resulting harmonized compounds and reactions can be used for various downstream analyses, including the construction of atom-resolved metabolic networks and models for metabolic flux analysis. Parts of the md_harmonize package have been optimized using a variety of computational …

Design And Characterization Of A Novel Eef2k Degrader With Potent Therapeutic Efficacy Against Triple-Negative Breast Cancer, Changxin Zhong, Rongfeng Zhu, Ting Jiang, Sheng Tian, Xiaobao Zhao, Xiaoya Wan, Shilong Jiang, Zonglin Chen, Rong Gong, Linhao He, Jin-Ming Yang, Na Ye, Yan Cheng

Markey Cancer Center Faculty Publications

Dysregulated eEF2K expression is implicated in the pathogenesis of many human cancers, including triple-negative breast cancer (TNBC), making it a plausible therapeutic target. However, specific eEF2K inhibitors with potent anti-cancer activity have not been available so far. Targeted protein degradation has emerged as a new strategy for drug discovery. In this study, a novel small molecule chemical is designed and synthesized, named as compound C1, which shows potent activity in degrading eEF2K. C1 selectively binds to F8, L10, R144, C146, E229, and Y236 of the eEF2K protein and promotes its proteasomal degradation by increasing the interaction between eEF2K and the …

Androgen Receptor: A Complex Therapeutic Target In Breast Cancer, Sarah Tinuade Asemota

Theses and Dissertations (ETD)

Breast cancer is classified based on the expression of three markers estrogen receptor (ER), progesterone receptor, and human epidermal growth factor receptor (HER2). Breast cancers that express these targets are classified as hormone receptor (HR) positive breast cancer and the tumors that lack the expression of these markers are classified as triple negative breast cancer (TNBC). Though HR-positive breast cancer is treated with hormonal and cyclin-dependent kinase 4/6 targeted therapies, the cancer relapses and becomes resistant to the treatment options. Androgen receptor (AR) that is expressed in over 90\% of ER-positive breast cancer and in 20\% of TNBC is a …

Cortical Tracking Of Syntax In Post-Stroke Aphasia: An Eeg Investigation Of Disrupted Sentence Comprehension, Matthew Blake Rafferty

Theses and Dissertations (ETD)

Purpose. People with aphasia following stroke commonly exhibit marked difficulties in sentence comprehension, referred to as receptive agrammatism. However, theories of receptive agrammatism differ in their assumptions regarding the underlying mechanisms of impairment. Representation-based theories ascribe receptive agrammatism to a loss of grammatical knowledge. Processing-based theories suggest that individuals with receptive agrammatism have intact grammatical knowledge but may possess insufficient neurocognitive resources to apply this knowledge within cognitively demanding contexts. In this study, we used electroencephalography (EEG) to investigate whether these perspectives may be disambiguated by the neural activity profiles of people with aphasia during comprehension. For this purpose, we …

The Therapeutic Role Of Lm11a-31 (A P75ntr Modulator) In The Outcome Of Ischemic Stroke And Hiv-1 Pathogenesis, Golnoush Mirzahosseini

Theses and Dissertations (ETD)

The objective of this research project is to explore the potential therapeutic role of LM11A-31 in both ischemic stroke and human immunodeficiency virus-1 (HIV-1) infection. There are limited treatment options for ischemic stroke, with tissue plasminogen activator (tPA) being the only effective medication and a narrow administration window, which is also accompanied with the high incidence of ischemic stroke in HIV-1 infected individuals. Therefore, it is critical to explore an effective therapeutic agent to address the urgent medical need. LM11A-31 is a p75 neurotrophin receptor (p75NTR) modulator and is orally bioavailable, and it can penetrate the intact blood-brain barrier (BBB). …

The Exploration Of Perceptions Of Patient-Clinician Communication In Black Mothers Diagnosed With An Acute Post-Partum Hypertensive Crisis, Melanie P. Fant

Theses and Dissertations (ETD)

For Black American mothers, postpartum stressors are magnified as about half of this population are single mothers, and many suffer from inadequate social and healthcare needs. Expected postpartum stressors, coupled with social stressors that Black American mothers face, can mask or influence patient reporting of early postpartum hypertensive crisis symptoms. Patients diagnosed with preeclampsia risk developing even more severe complications, such as cardiovascular disease, which is the leading cause of pregnancy-related deaths in the United States. Black American women face the challenge of inadequate communication with their healthcare providers, medical mistrust, and perceived discrimination when accessing health care. Pregnant women, …

Improving Estimation Of Coronary Artery Disease Risk Using Haptoglobin Genotyping, Emily Kate Mewborn

Theses and Dissertations (ETD)

Atherosclerotic cardiovascular disease (ASCVD) continues to be the leading cause of death worldwide. While several risk factors contributing to disease progression are well-known, pitfalls and limitations exist for estimating if or when an individual will develop the disease. Coronary artery disease (CAD), a subtype of ASCVD, causes myocardial infarction, contributing to significant morbidity and mortality. Current ASCVD risk estimator calculators lack comprehensiveness and do not include genetic or social determinants of health information, which are known to affect ASCVD risk.

Haptoglobin (Hp) genotype also influences CAD risk. Hp is a protein that binds free hemoglobin released from physiologic or pathologic …

A Multi-Faceted Approach To The Alzheimer’S Disease Proteome: From Human To Mouse Models, Jay M. Yarbro

Theses and Dissertations (ETD)

Amyloid pathology is the central hallmark of Alzheimer’s disease (AD) and related dementias (ADRD). We analyzed the dementia with Lewy bodies disease (DLBD) proteome, a disorder also associated with amyloid pathology, and compared to the AD proteome, identifying conserved alterations in amyloid pathology and shared components in amyloid plaques, including MDK and NTN1. We additionally evaluated major AD mouse models to determine their relevance to human disease and identify shared proteomic alterations. We observed alterations in several highly conserved matrisomal components consistently im- plicated in proteomic analyses of human amyloidosis disorders. We additionally identified several pathways influenced by amyloid-pathology that …

The Long-Term Cognitive And Psychological Effects Of Mild Traumatic Brain Injury (Mtbi), Leah L. Somerville

Theses and Dissertations (ETD)

Mild Traumatic Brain Injury (mTBI), commonly referred to as a concussion, is a prevalent injury in the United States, with several million occurring every year. Many of these injuries take place while playing a sport, particularly in those activities that have higher rates of impact with another person, such as hockey, soccer, or football. While most recover quickly from an mTBI, some individuals may have longer term effects. Recent literature has provided some evidence for long-term dysfunction in head injured individuals, with these dysfunctions appearing as changes in cognition or psychological well-being. Some of the most frequently reported cognitive symptoms …

Discovery Of Inhibitors Of Inhibitors Of Apoptosis Proteins And Novel Tubulin Polymerization Inhibitors As Potential Anticancer Agents, Najah Ghazi Albadari

Theses and Dissertations (ETD)

The global impact of cancer as a significant public health concern is undeniable. According to the annual report by the American Cancer Society, projections for 2023 estimate 1,958,310 new cancer cases and 609,820 cancer-related deaths in the US. Recent years have seen significant progress in cancer treatment; however, existing therapies face several challenges. Cytotoxic agents-based chemotherapy often has low therapeutic index and encounters drug resistance shortly after initiation, while immunotherapies exhibit low response rates that vary between patients. As a result, there is a pressing need for the development of novel and effective cancer treatment. The work presented here focuses …

Design And Synthesis Of Novel Small Molecule Drugs For The Treatment Of Cancer And Osteoporosis, Hanxuan Li

Theses and Dissertations (ETD)

Cancer and osteoporosis are two commonly diagnosed disease around the world which poses major health threat. In this thesis, we provide the background information to two types of cancers, namely ovarian cancer and liver cancer, as well as osteoporosis, and our approach for the treatment of the diseases. In chapter one, we discussed the background information about the diseases. The cause and the current treatment options are discussed, providing the basis for the chapters written later. In chapter two, we focused on the treatment of hepatocellular carcinoma. To construct the drug, we utilized a technique called small molecule drug conjugate, …

T Cell Responsiveness Through The Ages: Functional Diversity Of Age-Dependent Antiviral Responses, Brandi L. Clark

Theses and Dissertations (ETD)

An organism’s age impacts its susceptibility to disease, which varies according to the type of insult or causal pathogen. Much work remains to delineate these complexities, especially within younger individuals. Indeed, pediatric disease-driven immunity is less characterized than adult and aging populations due to two main factors: 1) descriptions through multiple stages of development are required, as the immune system undergoes massive changes from gestation through the end of adolescence, and 2) the complex nature of pediatric research decreases the availability of robust and comprehensive studies. Importantly, studying the immune system in relation to age requires a foundational knowledge within …

The Role Of Tcr Engagement Strength In Antitumor Cd8 T Cell Exhaustion, Xin Lan

Theses and Dissertations (ETD)

Durability of an antitumor immune response is mediated in part by the persistence of progenitor exhausted CD8 T cells (Tpex). Tpex serve as a source for the pool of effector T cells that tend to have a short lifespan or eventually become dysfunctional in uncleared tumors. In contrast to the short-lived feature of their daughter cells, Tpex are able to preserve their quantity and developmental potential through a process of self-renewal. Previous research has demonstrated that Tpex can even self-renew in the absence of their cognate antigen. However, it remains unknown how T cell receptor (TCR) engagement impacts the self-renewal …

Understanding The Host Cellular Response To Astrovirus Infection, Theresa Mary Taggart Bub

Theses and Dissertations (ETD)

Astrovirus is a non-enveloped positive-sense single-stranded RNA virus that infects the small intestine and causes gastrointestinal disease in most hosts. However, in immunocompromised patients, astrovirus can infect the brain, causing encephalitis and death. Here, we characterize astrovirus induction of replication organelles and dysregulation of cellular processes. It is known that autophagy can play a key role in the viral lifecycle, from entry to egress, and can be either pro-virus or pro-host depending on the virus. RNA viruses often exploit autophagy machinery to create double membrane vesicles (DMVs) as sites of replication and to protect viral RNAs from detection by innate …

Shifting Emergency Department Utilization Patterns Among Vulnerable Populations During The Covid-19 Pandemic, Leigh A. Mccormack

Theses and Dissertations (ETD)

Background: COVID-19 is a contagious respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of March 10, 2023, the virus infected nearly 104 million Americans. Many individuals were wary of seeking medical attention for issues unrelated to COVID-19 for fear of infection inside healthcare facilities. This hesitation caused a drop in emergency department (ED) visits for non-COVID-19 conditions. It is essential to ensure that individuals with critical healthcare needs receive the care they require and to mitigate the potential long-term consequences of delayed or deferred care. Objectives: The primary aim of this study is to examine …

Exogenous Mitochondrial Transfer And Il-6: Modulating Adipocyte Metabolism In Obesity-Associated Dysregulation, Soumi Mazumdar

Theses and Dissertations (ETD)

Obesity, a global health epidemic, poses significant challenges to public well-being due to its complex interplay of metabolic dysregulation, inflammation, and associated comorbidities. Mitochondria, central to ATP production, lipid metabolism, and thermogenesis, play a crucial role in modulating white adipose tissue metabolism. This thesis explores an innovative strategy for addressing mitochondrial dysfunction in obesity which is a critical aspect of this multifactorial problem. The research findings presented herein uncover the impact of introducing exogenous mitochondria into NIH3T3-L1 adipocytes on various aspects of adipocyte function. The key discoveries of this study include a remarkable upregulation of energy expenditure genes, notably Ucp1, …

Investigating Potential Quantitative Trait Loci For Susceptibility To Experimental Autoimmune Encephalomyelitis In The Bxd Family Of Mice, Margaret Caroline Danehy

Theses and Dissertations (ETD)

Multiple Sclerosis is an autoimmune inflammatory condition that causes disability, axonal damage in the central nervous system, and eventual paralysis. One of the main risk factors for developing MS is genetics, with recent studies identifying multiple risk alleles associated the major histocompatibility complex. By utilizing the BXD family of mice, we investigated genetic factors that affect a BXD strain’s susceptibility to EAE, an inducible disease model for MS. We induced EAE in several BXD mice strains via an emulsion of complete Freund’s adjuvant and MOG35-55, and then measured disease severity in each strain. From there, we measured incidence rate of …

Impact Of Medicaid Expansion On Adherence To Antidiabetic Medications Among Low-Income Adults, Okoia Stoddard

Theses and Dissertations (ETD)

Purpose. Low-income adults are disproportionately afflicted with diabetes and are more likely to suffer from advanced forms of diabetes related sequelae. Uninterrupted therapy on antidiabetic medications can postpone or prevent the damaging and costly complications associated with the progression of diabetes; however, many low-income individuals face significant barriers adhering to drug regimens. Medicaid, the primary source of health insurance among low-income people, mitigates access and cost barriers by providing access to health services and prescription drugs at a reduced cost. In 2014, Medicaid expansion, a provision of the Patient Protection and Affordable Care Act (PPACA), would have had the potential …