Medicine and Health Sciences Commons^™

Reliability Of Popliteal Artery Flow-Mediated Dilation In The Seated Position, Taskina Akhter

Rehabilitation Sciences Theses & Dissertations

Flow-mediated dilation (FMD) is a noninvasive measurement of endothelial function, which is a useful prognostic tool for cardiovascular disease risk. Despite its widespread use since 1992, the reproducibility of FMD varies widely between studies. This variability in reproducibility is especially significant in the case of the popliteal artery due to different methodological approaches. Studies perform popliteal FMD in various body positions, with the prone and seated positions most common. However, no studies have examined the reproducibility of both the seated and prone positions of the popliteal artery FMD. Therefore, the aim of this study is to examine the test-retest and …

Structural Insights Into The Cl-Par-4 Protein: Ionic Requirements, Conformational Transitions, And Interaction With Cisplatin, Krishna Kumar Raut

Chemistry & Biochemistry Theses & Dissertations

Cancer continues to be the leading global cause of death, with challenges in early diagnosis, drug resistance, non-specific drug targeting, and cancer recurrence and metastasis posing formidable obstacles in cancer therapy. In this context, Prostate Apoptosis Response-4 (Par-4), a pro-apoptotic tumor suppressor protein, emerged as a promising therapeutic target due to its ability to selectively induce apoptosis in cancer cells, thereby minimizing the drug-associated adverse effects. However, a comprehensive understanding of the structural features of Par-4, specifically the caspase-cleaved fragment (cl-Par-4), is crucial for therapeutic advancements.

This dissertation investigated the effects of various ions, both monovalent and divalent, on the …

A Reflection Of Experiences Of Adults With Type 1 Diabetes In Integrated Physical Education Classes, Kalleigh West

Human Movement Sciences & Special Education Theses & Dissertations

The purpose of this study was to gain an understanding of the experiences of type 1 diabetics in integrated physical education classes. In this study, we interviewed young type 1 diabetic adults and asked them to reflect on their school-based physical education experiences. An interpretative phenomenological analysis (IPA) approach was adopted to guide data collection, analysis, and interpretation for this retrospective study. Eight participants (ages 19 to 32) were enrolled in this study, and semi-structured interviews focused on their physical education experiences acted as the primary data. Transcribed interview data were analyzed using an IPA approach. Three interrelated themes emerged …

Investigation Of Nanosecond Pulsed Electric Fields (Nspef) Induced Anti-Cancer Mechanism And Enhanced B16f10 Melanoma Cancer Treatment, Kamal Asadipour

Biomedical Engineering Theses & Dissertations

The use of nanosecond pulsed electric fields (nsPEF) has emerged as a promising area of research with vast implications across various scientific disciplines. The ability to generate ultra-short, high-voltage electric pulses has paved the way for numerous applications, ranging from fundamental investigations of biological phenomena to the development of innovative medical therapies. The aim of this thesis is to highlight the importance of nsPEF in two critical areas: 1) Understanding the impact of subtle postpulse waveforms through a comprehensive analysis of two common pulse generators and 2) using this knowledge to advance melanoma treatment by enhancing the therapeutic effect of …

Opensim-Based Musculoskeletal Modeling: Foundation For Interactive Obstetric Simulator, Bahador Dodge

Electrical & Computer Engineering Theses & Dissertations

The use of mathematical and computational models to understand complex biological systems, such as the human birth process, is a rapidly growing field in medicine. These models can be used to optimize and personalize medical treatments for individual patients, enhance training, and aid in educational efforts. While recent advancements in healthcare, particularly in obstetrics, have improved care for mothers and babies, studies and government reports indicate a rising rate of maternal mortality in the United States.

Despite this rising trend, there is a lack of detailed studies concerning the use of modeling and simulation to develop an interactive obstetrics simulator …

Utilization Of Finite Element Analysis Techniques For Adolescent Idiopathic Scoliosis Surgical Planning, Michael A. Polanco

Mechanical & Aerospace Engineering Theses & Dissertations

Adolescent Idiopathic Scoliosis, a three-dimensional deformity of the thoracolumbar spine, affects approximately 1-3% of patients ages 10-18. Surgical correction and treatment of the spinal column is a costly and high-risk task that is consistently complicated by factors such as patient-specific spinal deformities, curve flexibility, and surgeon experience. The following dissertation utilizes finite element analysis to develop a cost-effective, building-block approach by which surgical procedures and kinematic evaluations may be investigated. All studies conducted are based off a volumetric, thoracolumbar finite element (FE) model developed from computer-aided design (CAD) anatomy whose components are kinematically validated with in-vitro data. Spinal ligament stiffness …

Sleeping With The Enemy: Examining The Relationship Between Sleep And Pain In Post-9/11 Veterans, John L. Schwartz Jr.

Psychology Theses & Dissertations

United States veterans are a diverse group of individuals, yet as a result of their service, they share a unique set of customs, traditions, and values. Post-9/11 veterans are more likely to experience elevated levels of pain and poor sleep quality compared to their civilian counterparts; however, little is known about how beliefs related to veterans’ pain impact their sleep and how levels of pain acceptance influence the sleep-pain association. This study examined relationships between sleep and pain in a sample of 102 post-9/11 veterans. Results support associations between pain and sleep identified in other populations. Positive correlations were found …

Generation, Analysis, And Evaluation Of Patient-Specific, Osteoligamentous, Spine Meshes, Austin R. Tapp

Biomedical Engineering Theses & Dissertations

Scoliosis, an abnormal curvature of the spine, is traditionally corrected with bracing treatments or by a highly invasive posterior spinal fusion (PSF) operation. These correction strategies are constrained by current imaging modalities, which fail to elucidate the soft tissue anatomy that is known to play a critical role in spinal stiffness and overall structure. Osteoligamentous segmentations of the spinal column offer a foundation for downstream finite element (FE) studies seeking to optimize bracing treatments or determine ideal surgical approaches.

This thesis presents methods for automatically and semi-automatically segmenting vertebrae and surrounding soft tissues of the spinal column using X-ray computed …

Biophysical Characterization Of The Par-4 Tumor Suppressor: Evidence Of Structure Outside The Coiled Coil Domain And Interactions With Platinum Chemotherapeutics, Andrea Megan Clark

Chemistry & Biochemistry Theses & Dissertations

Prostate apoptosis response-4 (Par-4) is an apoptosis-inducing tumor suppressor protein. Full-length Par-4 has previously been shown to be a predominantly intrinsically disordered protein (IDP) under neutral conditions, with significant regular secondary structure evident only within the C-terminal coiled coil domain. However, IDPs can gain ordered structure through the process of induced folding, which often occurs under non-neutral conditions. Previous work has shown that the Par-4 leucine zipper, which is a subset of the C-terminal coiled coil domain, is disordered under neutral conditions, but forms a dimeric coiled coil at acidic pH. Increase in ionic strength was also shown to increase …

Determination Of The Presence Of Rickettsia Spp. And Borrelia Spp. Carried By Tortoise Ticks From Madagascar, Anna Phan

Biological Sciences Theses & Dissertations

Ticks were removed from three species of Malagasy tortoises, Astrochelys yniphora, A. radiata, and Pyxis arachnoides (comprising two subspecies P. a. arachnoides and P. a. oblonga), between 2012 and 2015. The ticks were presumed to be from the genus Amblyomma. Ticks were morphologically identified and then checked molecularly to confirm their classification or identify any ticks that could not be morphologically identified. Molecular identification was done via end-point PCR that amplified tick cytochrome oxidase (CO1) and tick 12S rRNA genes. Ticks were screened via a real-time polymerase chain reaction assay for the presence of Rickettsia spp. …

The Determinants Of Physical Activity, Self-Monitoring Of Blood Glucose, And Poor Glycemic Control Among Individuals Diagnosed With Type 2 Diabetes In Saudi Arabia: A Cross-Sectional Study Based On The Saudi Health Interview Survey (Shis), Mohammed Abdulrahman S. Alsuliman

Health Services Research Dissertations

The prevalence of diabetes and poor glycemic control in Saudi Arabia has increased that contributed to the growing number of deaths in Saudi Arabia. It is known that type 2 diabetes (T2DM) can be prevented but there is a lack information about the magnitude of the of diabetes at national level as well as the risk factors for physical activity (PA), self-monitoring of blood glucose (SMBG), and poor glycemic. Thus, through utilizing Health promotion model (HPM), the aims are to examine the personal factors, cognitive-perceptual, and behavioral determinants of three outcomes; physical activity, SMBG, and poor glycemic control. A secondary …

Investigating A Multimodal Approach To Clinical Diagnosis Of Mild Cognitive Impairment And Alzheimer’S Disease, Sean M. Flannery

Psychology Theses & Dissertations

An estimated 5.8 million Americans suffer from dementia due to Alzheimer’s disease (AD), with that number projected to grow to 13.8 million by mid-century (Alzheimer’s Association, 2019). Mild cognitive impairment (MCI) describes the stage between normal cognitive decline that comes with aging and a dementia diagnosis (Peterson, 1999). Due to a lack of a cure or particularly effective treatment, a major goal of treatment is to focus on improving quality of life (Budson & Solomon, 2016). An early and accurate diagnosis can address this goal in a variety of ways. Despite the high prevalence and immense amount of research in …

Exosomes In Transmission And Blocking Of Arthropod-Borne Flaviviral Infection And Pathogenesis, Wenshuo Zhou

Biomedical Sciences Theses & Dissertations

Vector-borne diseases (VBDs) are human illnesses that are transmitted by vectors such as ticks, mosquitoes, and fleas. These arthropods transmit infectious pathogens such as viruses, protozoa, and bacteria, to humans during their blood-feeding. According to the estimation of the WHO, billions of people are affected by VBDs worldwide, and about 700,000 deaths are reported annually. Currently, very few reliable VBDs control approaches and vaccines available to treat various VBDs. Additionally, approaches to control arthropod’ proliferation and migration are difficult to develop. Furthermore, molecular determinants and mechanisms for the transmission are poorly understood. This work describes two studies identifying the novel …

Impedance Analysis Of Tissues In Nspef Treatment For Cancer Therapy, Edwin Ayobami Oshin

Biomedical Engineering Theses & Dissertations

Nanosecond pulsed electric field (nsPEF) for cancer therapy is characterized by applications of high voltage pulses with low pulsed energy to induce non-thermal effects on tissues such as tumor ablation. It nonthermally treats tissues via electroporation. Electroporation is the increase in permeabilization of a cell membrane due to the application of high pulsed electric field. The objective of this study was to investigate the effect of nsPEF on tissue by monitoring the tissue’s impedance in real-time. Potato slices (both untreated and electroporated), and tumors extracted from female BALBc mice were studied. 100ns, 1-10kV pulses were applied to the tissues using …

Understanding Young Adult Survivors Of Childhood Cancers’ Participation In Late Effects Screening: A Mixed Methods Approach, Kristen Trost Mantlo

Health Services Research Dissertations

Significant advancements in the treatment of childhood cancers have helped to increase the 5-year survival rate from 56% in the early 1970s to approximately 80-85% in the early 2000s (Greenlee, Murray, Bolden, & Wingo, 2000; Hampton, 2005). Treatment modalities such as chemotherapy and radiation have led to many serious long-term side effects, known as late effects. Between 60% and 90% of survivors develop some form of long-term chronic condition due to their treatment and up to 40% of those conditions will be life-threatening (Howlader, N. et al., 2013). While the majority of young adult survivors of childhood cancer are at …

Usefulness Of An Expanded Health Belief Model With Added Constructs (Self-Efficacy And Ecological System Measures) In Modeling Compliance With Healthy Lifestyle Recommendations In Women With A Recent History Of Gestational Diabetes, Phyllis M. Woodson

Health Services Research Dissertations

Problem Statement: Gestational diabetes (GDM) has been reported to affect as many as 18% of all pregnancies in the U.S. This diagnosis is costly and presents health risks to both baby and mother. The main risk to the mother with a history of GDM is her increased risk for diabetes which has been estimated at 35% to 60% in the following 10 to 20 years; more recent studies report a 7 to 8 times occurrence in the following 3 to 6 years. It is recommended that lifestyle efforts of eating healthfully and exercise can reduce this risk

Methods: Subjects (n=153) …

Emergency Departments And Care For Marginalized Populations, Irvin B. Harrell

Institute for the Humanities Theses

Healthcare providers in emergency departments (EDs) face a daunting daily task: providing health care in a triage setting to a diverse group of patients many with complex medical issues. Many patients rely on ED services out of financial necessity, when their healthcare issues could be better suited for care from a primary care physician. Many of these already vulnerable patients – minorities, those health illiterate, low-income, uninsured and those with language barriers – must also deal with ED overcrowding and staffing conditions. In some cases, patients leave without being seen while others face bed shortages. This study explores healthcare provider …

The Impact Of Anterior Cruciate Ligament Reconstructive Surgery On Neuromotor Function, Cortney Noel Armitano

Rehabilitation Sciences Theses & Dissertations

The purpose of this dissertation was to examine the systemic neuromechanical implications in individuals who have had an ACL reconstruction (ACLR) compared to healthy controls. The specific aims addressed were to: 1) examine differences in inter-limb coordination during walking at different speeds, 2) examine differences in trunk, neck and head acceleration during gait, and 3) investigate whether the reaction time responses assessed during stepping are negatively affected by ACLR.

The findings of study 1 revealed that maximal coordination stability was achieved when walking at the person’s preferred gait speed. However, individuals with a previous ACLR exhibited reduced coordination stability between …

Comparing The Effects Of Mental Workload Between Visual And Auditory Secondary Tasks During Laparoscopy, James P. Corcoran

Psychology Theses & Dissertations

The purpose of this study was to test Wickens’ Multiple Resource Theory (MRT) by comparing performance and subjective workload on a visual-spatial secondary task with an auditory-spatial analog when paired with visual-spatial laparoscopic primary tasks. Two primary tasks were performed with a laparoscopic box trainer: a high workload task that consisted of transferring rings from one peg to another and a low workload task that consisted of grasping and placing large pencil erasers in a bowl. It was predicted that the visual-spatial secondary task would be more sensitive when paired with the laparoscopic primary task than the auditory analog. Findings …

Characterizing The Activity Of Antimicrobial Peptides Against The Pathogenic Bacterium Clostridium Difficile In An Anaerobic Environment, Adenrele Mojeed Oludiran

Chemistry & Biochemistry Theses & Dissertations

Clostridium difficile is an anaerobic Gram-positive pathogen with high treatment costs and mortality and very high antibiotic tolerance. Antimicrobial host-defense peptides (HDPs) produced naturally by animal immune systems are promising candidates to develop novel therapies for bacterial infection because they cause oxidative stress that damages multiple targets in bacterial cells, so it is difficult for bacteria to evolve resistance to these attacks.

Piscidins, fish-derived HDPs that can also form complexes with copper (Cu) to enhance their activities, are very active against multiple bacterial species in an aerobic environment. We examined their activity against C. difficile and other species in an …

Development And Validation Of A Hybrid Virtual/Physical Nuss Procedure Surgical Trainer, Mohammad F. Obeid

Computational Modeling & Simulation Engineering Theses & Dissertations

With continuous advancements and adoption of minimally invasive surgery, proficiency with nontrivial surgical skills involved is becoming a greater concern. Consequently, the use of surgical simulation has been increasingly embraced by many for training and skill transfer purposes. Some systems utilize haptic feedback within a high-fidelity anatomically-correct virtual environment whereas others use manikins, synthetic components, or box trainers to mimic primary components of a corresponding procedure.

Surgical simulation development for some minimally invasive procedures is still, however, suboptimal or otherwise embryonic. This is true for the Nuss procedure, which is a minimally invasive surgery for correcting pectus excavatum (PE) – …

Computational Modeling For Abnormal Brain Tissue Segmentation, Brain Tumor Tracking, And Grading, Syed Mohammad Shamin Reza

Electrical & Computer Engineering Theses & Dissertations

This dissertation proposes novel texture feature-based computational models for quantitative analysis of abnormal tissues in two neurological disorders: brain tumor and stroke. Brain tumors are the cells with uncontrolled growth in the brain tissues and one of the major causes of death due to cancer. On the other hand, brain strokes occur due to the sudden interruption of the blood supply which damages the normal brain tissues and frequently causes death or persistent disability. Clinical management of these brain tumors and stroke lesions critically depends on robust quantitative analysis using different imaging modalities including Magnetic Resonance (MR) and Digital Pathology …

Body Image And Quality Of Life Among Postsurgical Bariatric Patients, Amy Leigh White

Psychology Theses & Dissertations

In recent decades, bariatric surgery has become an increasingly popular intervention for the treatment of morbid obesity. Bariatric surgery leads to substantial improvements in physical health (e.g., weight loss, increased life expectancy) and psychological health (e.g., body image, quality of life). After bariatric surgery, many patients undergo subsequent surgical procedures to remove excess skin (“body contouring”), which are also associated with positive medical and psychological outcomes.

The present study sought to expand upon existing research into the psychosocial outcomes of bariatric surgery, investigate correlates of patients’ desire for body contouring, and determine whether presurgical motivations were associated with postsurgical outcomes. …

Response Shift And Functional Outcomes In Individuals With Chronic Ankle Instability, Cameron J. Powden

Health Services Research Dissertations

Ankle sprains are one of the most common injuries sustained by those who are physically active. One in three individuals will develop a condition known as chronic ankle instability (CAI) after suffering a single ankle sprain. These individuals suffer from recurrent bouts of ankle instability, residual symptoms, and a myriad of other mechanical and functional impairments as well as health-related quality of life (HRQL) deficits. Due to the abundance of health consequences associated with this condition it is imperative to establish evidence based interventions that are focused on restoring function and HRQL to pre-injury statuses.

The overarching purpose of this …

A Model To Predict Pre-Hospital Endotracheal Intubation Success, Leigh Ann Diggs

Health Services Research Dissertations

Background: Pre-hospital endotracheal intubation (ETI) is one of the most critical skills performed by paramedics and is considered the “gold standard” of airway management. Pre-hospital ETI success rates are variable, ranging from 33% to 100% across EMS systems in the U.S. Previous investigative efforts have identified factors associated with pre-hospital ETI success, but the generalizability of findings is limited. Few researchers have controlled for the concurrent effects of multiple factors when examining pre-hospital ETI success. Methods: In this retrospective exploratory study, we used national data from the National Emergency Medical Services Information System (NEMSIS) and data from a four state …

Neuropathy Detection, Quality Of Life Tools & Treatment For Type 2 Diabetes, Jennifer J. Brown

Human Movement Sciences & Special Education Theses & Dissertations

Type 2 diabetes (T2D) mellitus has become the epidemic of the new millennium, with an estimated 382 million people affected worldwide as of 2013, and statistics projected towards 592 million by the year 2035. With the development of diabetes, complications have risen, with diabetic neuropathy becoming one of the most prevalent, affecting between 10–90% of those with the disease. Diabetic peripheral neuropathy (DPN) is difficult to detect in early stages of pathology, yet devastating once significant damage has taken place. Cardiac autonomic neuropathy (CAN), which is often silent, is associated with autonomic nervous system (ANS) dysfunction and increased risk for …

Mobile Cloud Computing Based Non Rigid Registration For Image Guided Surgery, Arun Brahmavar Vishwanatha

Computer Science Theses & Dissertations

In this thesis we present the design and implementation of a Mobile Cloud computing platform for non-rigid registration required in Image Guided Surgery (MCIGS). MCIGS contributes in flexible, portable and accurate alignment of pre-operative brain data with intra-operative MRI, for image guided diagnosis and therapy and endoscopic skull base surgery. Improved precision of image guided therapy and specifically neurosurgery procedures is known to result in the improved prognosis for brain tumor patients. MCI GS system is tested with Physics Based Non-Rigid Registration method form ITK. Our preliminary results for brain images indicate that the proposed system over Wi-Fi can be …

Assessing The Effectiveness Of An Interval Estimation And A Visual-Spatial Secondary Task As Measures Of Mental Workload During Laparoscopy, Levi Parker Warvel

Psychology Theses & Dissertations

The goal of the present study was to compare two secondary workload tasks, specifically a time interval estimation and visual-spatial task, to determine which of these is most appropriate for the assessment of laparoscopic mental workload. Participants performed a peg transfer task in two conditions: a normal camera angle and a 90° camera angle intended to increase mental workload. Based on multiple resource theory, it was predicted the visual-spatial task would be more sensitive to the workload manipulation than the time estimation task because it draws upon the specific, as opposed to more general, attentional resources required by laparoscopy. Primary …

Categorizing Fetal Heart Rate Variability With And Without Visual Aids, Amanda Jane Ashdown

Psychology Theses & Dissertations

This present study examined the ability of clinicians and novices to correctly categorize fetal heart rate (FHR) variability with and without the use of exemplars. Clinicians and undergraduate students were asked to inspect FHR images and determine into which of four categories they belonged. Each participant took part in three conditions: one in which they were provided exemplars of prototypical FHR variability to use during their categorization task, another in which they were provided exemplars of nonprototypical FHR variability to use in their task, and a control condition in which no exemplars were available. The results showed that experts were …

Multi-Surface Simplex Spine Segmentation For Spine Surgery Simulation And Planning, Rabia Haq

Computational Modeling & Simulation Engineering Theses & Dissertations

This research proposes to develop a knowledge-based multi-surface simplex deformable model for segmentation of healthy as well as pathological lumbar spine data. It aims to provide a more accurate and robust segmentation scheme for identification of intervertebral disc pathologies to assist with spine surgery planning. A robust technique that combines multi-surface and shape statistics-aware variants of the deformable simplex model is presented. Statistical shape variation within the dataset has been captured by application of principal component analysis and incorporated during the segmentation process to refine results. In the case where shape statistics hinder detection of the pathological region, user-assistance is …