University of Nebraska Medical Center
University of Nebraska Medical Center Research: DigitalCommons@UNMCNot a member yet
10909 research outputs found
Sort by
Culturally Tailored Interventions Enhance Diabetes Awareness and Management within the Karen Community
Get PDFhttps://digitalcommons.unmc.edu/com_fam_pres/1017/thumbnail.jp
Performance of Urine Reagent Test Strips in Detecting Schistosoma haematobium Infection in Individual and Pooled Urine Samples
Get PDFThis study evaluated the performance of urine reagent strips (URSs) in detecting Schistosoma haematobium infection in individual and pooled urine samples. Between June 2022 and April 2023, 2634 urine samples (10 mL each) from school-age children (5-15 years) in 15 villages across Ethiopia\u27s Afar, Benishangul-Gumuz, and Gambella regions were tested using urine filtration microscopy (UFM) and URSs for blood, a marker of S. haematobium eggs. Pooled samples from 5, 10, 20, and 40 individuals (one positive, others negative) were examined with both methods. UFM results were used to calculate URSs\u27 sensitivity, specificity, and predictive values for detecting infection. A total of 2634 children were screened for S. haematobium infection. UFM detected S. haematobium eggs in 370 samples, while URSs identified infection in 414 children. URSs showed 64% sensitivity and 92% specificity for individual samples. The positive and negative predictive values for individual samples were 57% and 94%, respectively. Sensitivity for pooled samples ranged from 47% (pools of 40) to 53% (pools of 20). In pools with one positive sample, URSs misclassified 220 (50%), 109 (49.5%), 52 (47.0%), and 28 (50.9%) pools as negative for S. haematobium eggs for pool sizes 5, 10, 20, and 40, respectively. Sensitivity for individual samples was higher in children with heavy infection (92.5%) compared to light infection (55.9%), and sensitivity in pooled samples increased with infection intensity (p \u3c 0.001). In conclusion, URSs may misclassify S. haematobium infection in children when samples are examined individually or in pools, potentially leading to unnecessary treatment or missed cases. However, URSs shows promise as a screening tool for detecting S. haematobium infection in areas with high infection intensit
Safety of Healthcare Workers in Acute Care during Patient Mobilization: A Systematized Review
No full textAbstract synopsis
Evidence shows that low-tech aids and lifting equipment promote safe patient handling in acute care, with the most consistent support found for lifting equipment in reducing worker injuries. There was mixed evidence to support ergonomic training.
Abstract
The aim of this study was to identify interventions within the scope of occupational therapy that enhance safety during patient mobilization for healthcare workers in acute care settings.
This systematized review of safe patient handling interventions included peer-reviewed studies that target healthcare worker safety during patient mobilization in acute care settings.
A medical librarian performed searches in Medline, CINAHL, and Scopus. We extracted data on intervention type, population, outcomes, and results. Articles underwent screening by four researchers.
Quality of evidence was appraised using the Oxford Center for Evidence-Based Medicine levels and graded using U.S Preventive Services Task Force Guidelines. Interventions were sorted thematically into 3 themes and assessed for outcomes.
Seven studies met criteria (two level 1A, two level 1B, two level 2B, one level 3B). Across studies, ergonomic training programs with hands-on, context-specific practice and individualized risk assessments were associated with improvements in worker confidence and safety behaviors. Low-tech aids and mechanical lifting equipment showed moderate effects in reducing low back pain, fatigue, and muscle strain. One study found that low back pain was reduced in participants with pre-existing injuries in the lower back but not those without pre-existing injuries. Across themes, consistent access to equipment and refresher training emerged as important factors influencing intervention success.
Evidence shows that lifting equipment provides the most consistent protection against healthcare worker injuries in acute care. Ergonomic training and low-tech aids offer additional benefits with implemented alongside accessible equipment and refresher training. Evidence supports ensuring reliable lifting equipment, a comprehensive safe patient-handling programs with contextual hands-on training to maximize worker safety. OT practitioners are well positioned to contribute through contextual training, risk assessment, and integrating ergonomic strategies into work tasks.
Implementation of OT interventions that focus on safe patient handling programs and the use of assistive devices can reduce work injuries and lead to safe patient handling, highlighting the importance of the OT role in ergonomics.https://digitalcommons.unmc.edu/cahp_ot_sysrev/1032/thumbnail.jp
Role of NADPH Oxidase 4 in Murine Cancer-Associated Fibroblast
No full textBreast cancer is the second leading cause of cancer deaths in women in the United States. Frontline hormone therapies for breast cancer prove ineffective in triple negative breast cancer tumors wherein the hormones estrogen, progesterone, and HER2 are downregulated or absent; therefore, patients diagnosed with triple negative breast cancer are primarily limited to chemotherapies which carry a higher failure and resistance rate. Here we target cancer associated fibroblasts as potential drivers of chemoresistance in triple negative breast cancer. We investigated the mechanism by which Nox4 regulates the YAP/TAZ pathway in modulating DTX sensitivity and sought to determine if targeting Nox4 in TNBC cells will parallel the downregulation effects of the YAP/TAZ pathway as observed in CAFs. Our research involved the generation and manipulation of an immortalized mouse CAF line, and our results showed similarities in the results found in human breast cancer cells wherein Nox4 enhances YAP/TAZ-mediated paracrine signaling, thereby promoting a chemo-resistant tumor microenvironment, and that targeting Nox4-expressing CAFs will sensitize tumors to chemotherapy
Cooperative Role of Distinctive TP53 and PTEN Combined Loss in the Peripheral T Cell Lymphoma-GATA3 Molecular Subgroup
No full textPeripheral T cell lymphoma (PTCL) is a heterogeneous group of postthymic T cell neoplasms, with ~40% classified as PTCL-not otherwise specified (PTCL-NOS). PTCL-GATA3, a molecularly defined subtype, associated with T helper 2 (TH2)-like differentiation and poor prognosis, has frequent co-occurrence of TP53 loss/mutation and heterozygous PTEN loss. CD4+ T cell conditional mouse models with Trp53 mutation/deletion and Pten loss demonstrated mature T cell lymphomas (mTCLs) with TH2-like transcriptomic and immunophenotypic profiles. Molecular studies revealed that codeletion of Trp53/Pten induced T cell receptor and Janus kinase-signal transducer and activator of transcription signaling, promoting TH2 differentiation while inhibiting TH1 differentiation. These findings were validated by CRISPR editing of TP53/PTEN loss in human CD4+ T cells and mechanistically evaluated the p53 binding region in intron-3 of GATA3, resulting in transcriptional repression. Transcriptomic profiles of m-TCLs recapitulated human-PTCL-GATA3 transcriptome and distinguished PTCL-NOS subtypes. Preclinical assessment of m-TCLs with PI3Kγ/δ inhibitors significantly improved survival, supporting a therapeutic approach for the p53-aberrant PTCL-GATA
Perspective on Alcohol-Induced Organ Damage via Autophagy-Dependent Cellular Changes
No full textAlcohol-induced organ damage is a major global health concern and a leading cause of disability and mortality. In addition to the liver, chronic alcohol consumption adversely affects multiple organ systems, including the cardiovascular and neuromuscular systems, the gastrointestinal tract, adipose tissue, kidneys, pancreas, and the brain. Organ damage begins with necrosis (cell death) followed by tissue injury, which triggers immune responses aimed at tissue repair. However, with continued heavy drinking, these reparative responses transition into inflammatory responses which exacerbate tissue injury and accelerate disease progression. Macroautophagy, commonly referred to as autophagy, is a vital and evolutionarily-conserved digestive process in eukaryotic cells. While autophagy is well known for degrading obsolete proteins, and damaged organelles to prevent their accumulation, autophagy also plays critical roles in regulating innate and adaptive immunity and in modulating inflammation. This review describes evidence that chronic alcohol exposure and chronic alcohol consumption impair autophagy, contributing to dysfunction across multiple organ systems. We and others have explored the mechanisms by which alcohol disrupts autophagy to cause organ damage. This review aims to establish a cohesive understanding of these intracellular processes, which is essential for guiding future research toward targeting autophagy as a therapeutic strategy for alcohol-induced tissue injury. In summary, this comprehensive review integrates evidence from preclinical studies to present a unified perspective on how alcohol induces autophagy dysregulation and contributes to organ damage. It also highlights evidence-based recommendations from leading researchers in the field, offering valuable insights to advance autophagy-targeted therapies for mitigating the effects of alcohol-induced organ injury
1 Impact of the Growing Expertise in E-health Knowledge and Skills (GEEKS) Program in Reducing Immunization Defaulters and Enhancing Timeliness of Vaccine-Preventable Disease Case Investigations in Uganda
No full textBackground: Vaccine-preventable diseases (VPDs) continue to be a major cause of illness and death in low- and middle-income countries, where system inefficiencies lead to missed vaccinations and delays in VPD case investigations. In Uganda, these problems persist despite high vaccine coverage rates. This dissertation assessed two innovations within the Growing Expertise in E-Health Knowledge and Skills (GEEKS) program: the tickler system, a paper-based tool for tracking immunization defaulters, and the electronic Integrated Disease Surveillance and Response (eIDSR) system, a digital surveillance platform. The study aimed to evaluate their effects on completing multidose vaccines and the timeliness of VPD case investigations.
Methods: A convergent parallel mixed-methods design was used to combine quantitative and qualitative data. The quantitative part utilized a quasi-experimental pre–post analysis to compare immunization completion rates (DTP1–DTP3) before and after implementing the tickler system in 10 health facilities, and to assess the timeliness of acute flaccid paralysis (AFP) case investigations before and after introducing the eIDSR platform. The qualitative part involved semi-structured interviews with stakeholders to identify implementation barriers, facilitators, and user experiences. Descriptive statistics, inferential testing, and thematic analysis were performed to evaluate system performance and contextual factors. Findings were integrated using the Consolidated Framework for Implementation Research (CFIR) and aligned with the Expert Recommendations for Implementing Change (ERIC) to develop evidence-based strategies for sustainable implementation and scale-up.
Results: The tickler system increased DTP3 completion from 61.8% to 71.1% (p \u3c 0.0001), with children 42% more likely to complete the vaccine series post-intervention (aOR = 1.42; 95% CI: 1.13–1.80). Improvements were most substantial in small, rural facilities supported by mentorship and community engagement. Barriers included staffing shortages, documentation burdens, and limited funds for follow-up. The eIDSR system improved the odds of timely AFP investigations nearly fourfold (aOR = 3.78; 95% CI: 2.16–6.67; p \u3c 0.0001). Users cited faster alerts and better coordination, but noted ongoing challenges of workflow duplication, unreliable SMS notifications, and reduced field incentives.
Conclusion: Both systems demonstrated measurable gains in immunization completion and surveillance timeliness. Sustainability requires integrating training, financing follow-up activities, addressing workforce capacity, and reinforcing accountability mechanisms. These interventions, when institutionalized, can strengthen Uganda’s progress toward the goals of the Immunization Agenda 2030 and the International Health Regulations (2005), advancing national and regional health security through more comprehensive and timely vaccination and disease surveillance systems
Acceptability of Corticosteroid Use in the Treatment of Infant Bronchiolitis: Utilizing the Theoretical Framework of Acceptability to Design Research Instruments
No full textBronchiolitis is the leading cause of hospitalization among infants under six months, yet treatment remains largely supportive due to clinical guidelines that discourage pharmacologic intervention. Recent research suggests that bronchiolitis is not a uniform condition, and a subgroup of infants (those classified within “Profile A”) may benefit from targeted corticosteroid therapy. However, these treatments remain outside current clinical guidelines, and their successful adoption depends on stakeholder acceptability. This Capstone project developed and refined four data collection instruments- two questionnaires and two interview guides- designed to assess how healthcare providers and caregivers perceive the acceptability of corticosteroid treatment for Profile A bronchiolitis using the Theoretical Framework of Acceptability (TFA). Four subject matter experts provided feedback on questionnaire clarity, comprehensiveness, and appropriateness by completing both the provider and caregiver versions. The project chair offered additional feedback on interview guide structure and flow through pilot testing. Findings from the expert review informed substantive revisions to both instruments, including educational scaffolding, structural refinements, and stakeholder-specific construct operationalization. The refined instruments are now ready for implementation in a planned multi-site pilot study pending grant funding. This project contributes to early-stage implementation research on phenotype-guided bronchiolitis treatment by ensuring that acceptability assessment tools are theoretically grounded and feasible for real-world use
MUC16 Rewires Metabolic Key Factors Through HKDC1 in the Progression of Pancreatic Ductal Adenocarcinoma
No full textPancreatic ductal adenocarcinoma (PDAC) is the most prevalent and aggressive type of pancreatic cancer, accounting for over 90% of pancreatic cancer cases. As of 2025, it has a 5-year survival rate of 13% and is predicted to become the 2nd leading cause of cancer-related deaths by the year 2030. Several key metabolites are altered in the progression of PDAC, including MUC16. MUC16 is a large transmembrane glycoprotein that aids in PDAC tumor cell growth and survival, immune evasion, metastasis, and chemoresistance. Additionally, MUC16 is involved in the metabolic rewiring of PDAC cells by improving motility and invasiveness and increasing glycolytic activity. A previous study indicates that MUC16 plays a role in the metabolic rewiring of PDAC cells, but the mechanisms of rewiring remain largely unknown. By utilizing both human and mouse cell lines, as well as mouse tissue samples, this study determined that MUC16 increases the glycolytic rate and decreases oxidative phosphorylation in PDAC cells, contributing to an increase in tumorigenic and metastatic potential. Furthermore, we identified that MUC16 alters the expression of hexokinase domain-containing 1 (HKDC1) through the upregulation of transcription factor MNT. Overall, this study suggests that MUC16’s regulation of MNT increases the expression of metabolic key enzyme HKDC1, resulting in an increased glycolytic rate in PDAC cells. Therefore, targeting HKDC1 may be a potential therapeutic option to slow the progression of PDAC and prolong the life expectancy of PDAC patients