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- Genre: Academic theses
- Resource Type: Text
While the COVID-19 pandemic continues to evolve, America’s nursing work force continue to work in the most challenging of circumstances. While expected to hold the fort and continue on, deep inside, they bury an unprecedented level of acute stress, anxiety and depression. Peer support groups have been posed as a possible coping behavior. This cross-sectional designed project was developed to assess the worth and feasibility of a virtual peer support group with a focus on healthcare provider wellness during a period of surge of the COVID-19 pandemic. Overwhelmed staff, technology/documentation changes and challenges, competing clinical demands, short-staffing and Zoom fatigue were identified as the limiting factors for this project’s completion within its given timeframe. These findings informed of current barriers, providing a basis for future program development to mitigate the impact of psychological distress among healthcare providers. Evolving literature on this topic supports recommendations for further study and action by individual health care providers, organizations and at the state and national levels.
AAbs provide value in identifying individuals at risk, stratifying patients with different clinical courses, improving our understanding of autoimmune destructions, identifying antigens for cellular immune response and providing candidates for prevention trials in T1D. A two-stage serological AAb screening against 6,000 human proteins was performed. A dual specificity tyrosine-phosphorylation-regulated kinase 2 (DYRK2) was validated with 36% sensitivity at 98% specificity by an orthogonal immunoassay. This is the first systematic screening for novel AAbs against large number of human proteins by protein arrays in T1D. A more comprehensive search for novel AAbs was performed using a knowledge-based approach by ELISA and a screening-based approach against 10,000 human proteins by NAPPA. Six AAbs were identified and validated with sensitivities ranged from 16% to 27% at 95% specificity. These two studies enriched the T1D “autoantigenome” and provided insights into T1D pathophysiology in an unprecedented breadth and width.
The rapid rise of T1D incidence suggests the potential involvement of environmental factors including viral infections. Sero-reactivity to 646 viral antigens was assessed in new-onset T1D patients. Antibody positive rate of EBV was significantly higher in cases than controls that suggested a potential role of EBV in T1D development. A high density-NAPPA platform was demonstrated with high reproducibility and sensitivity in profiling anti-viral antibodies.
This dissertation shows the power of a protein-array based immunoproteomics approach to characterize humoral immunoprofile against human and viral proteomes. The identification of novel T1D-specific AAbs and T1D-associated viruses will help to connect the nodes in T1D etiology and provide better understanding of T1D pathophysiology.