Optimizing Dynamic Treatment Regimes With Q-Learning: Complications Due To Error-Prone Data And Applications To Covid-19 Data, Yasin Khadem Charvadeh

Electronic Thesis and Dissertation Repository

In this thesis, we employ statistical modeling and methods to examine COVID-19 data, and we develop new methods to address new issues that invalidate some standard methods.

In the first study, we employ semiparametric and nonparametric survival models as well as data visualization techniques to examine the epidemiological features of COVID-19. Based on our numerical results, the median incubation time is about 5 days, and the elders are more likely to have longer incubation periods.

In the second study, we use data from 175 countries and investigate possible factors associated with the case fatality rate (CFR) of COVID-19. The Q-learning …

Analyzing Pseudomonas Aeruginosa With Bacteriophage Tags Using Photoacoustic Flow Cytometry, Jennifer C. Schinke

Electronic Theses and Dissertations

The number of daily bacterial infections is climbing and the CDC explains that this is due to the antibiotic-resistant threat in the United States. Finding a faster way of bacterial identification is necessary as it currently takes 1-4 days for a medical lab to culture and identify bacteria. Photoacoustic flow cytometry (PAFC) can be used as an alternative method resulting in swift identification within an hour (Edgar, 2019). Pseudomonas aeruginosa, cell line PA01, will be coated in up to a few hundred red dyed phages making it detectible by the photoacoustic flow cytometry system. Bacteriophages (phages) are viruses that …

Investigation Of Orthohantavirus Genetics In Rodent Reservoirs And Clinical Samples, Samuel M Goodfellow

Biomedical Sciences ETDs

Orthohantaviruses are negative-sense, single stranded RNA viruses with trisegmented genomes that can cause severe disease in humans and are carried by several host reservoirs throughout the world. In the United States, Sin Nombre orthohantavirus (SNV) is the primary cause of hantavirus cardiopulmonary syndrome (HCPS) with a fatality rate of ~36% and the highest cases occuring in the southwest region. The primary SNV host reservoir is thought to be the western deer mouse, Peromyscus maniculatus, however it has been shown that other rodents can carry different orthohantaviruses. We designed a pan-orthohantavirus detection tool to survey several small mammal populations throughout New …

Early Career Special Education Teacher Lived Experiences During Covid-19, Sydney Parks

Graduate Student Dissertations, Theses, Capstones, and Portfolios

The stories and lived experiences of Early Career Special Education Teachers must be shared. This study provides more information on the beginning lived experiences of Special Education Teachers during COVID-19. The researcher conducted a qualitative narrative design to further investigate burnout and self-efficacy among Early Career Special Education Teachers. The researcher conducted an open-ended question interview that allowed participants to relive their experience teaching during COVID-19. The conclusion of this study is that Special Education Teachers love their job but seek more financial security, administrative support and guidance, recognition.

Black Bear Population Health Monitoring In The Southeast, Kathleen Elizabeth Riese

Masters Theses

Recent growth of the American black bear (Ursus americanus) population in the southeast raises concerns about the potential spread of density-dependent diseases among bears, particularly sarcoptic mange. However, research on the health of bears in this area is limited. We analyzed samples from 169 bears in the region. We performed Knotts tests, skin scrapes, fecal floats; Canine adenovirus (CAV), canine parvovirus (CPV), canine distemper virus (CDV), and Toxoplasma gondii serology, Trypanosoma, Rickettsia rickettsii, and apicomplexan PCR, and identified ecto- and endoparasites found grossly or histologically. We found that 69% (63 of 91) had microfilaria; genetic analysis identified …

Encouraging Human Papillomavirus Vaccine Uptake: A Healthcare Improvement Project, Lauren E. Woll

Dissertations

Abstract

Problem: Human papillomaviruses are the causative agents of >95% of cervical cancers, most oropharyngeal and anogenital cancers, yet the vaccination status of the population remains critically low despite Gardasil9 offering robust protection against HPV-related disease.

Methods: This quality improvement project utilized a descriptive, observational design to assess the effect of the HPV Encouragement Bundle, a two-step intervention to improve HPV vaccine uptake. Quantitative data was collected via retrospective chart review to assess the effect of the intervention on first-dose administration of Gardasil9 (series initiation), as well as overall Gardasil9 vaccine uptake.

Results: Following implementation, Gardasil9 first dose uptake increased …

Low-Incidence Special Education Teachers Lived Experience Teaching During Covid-19, Christina Samone Hatcher

Graduate Student Dissertations, Theses, Capstones, and Portfolios

This study's purpose is to identify how the shift has impacted low-incidence special education teachers to remote learning during the COVID-19 pandemic. There is minimal research regarding the lived experiences of how low-incidence special education teachers teach remotely during the COVID-19 pandemic. This study will consist of evaluating how prepared low-incidence special education teachers felt they were for the demands of remote learning, how they mitigated the demands, what resources and support were received that were helpful, as well as what resources and support low-incidence special education teachers feel they still need to continue to teach remotely, and how their …

Mining Sars-Cov-2 Phylogenetic Trees To Estimate Circulating Infections And Patterns Of Migration, Erin V. Brintnell

Electronic Thesis and Dissertation Repository

The SARS-CoV-2 pandemic led to the formation of very large databases of genomic viral data. These databases contain information on transmission dynamics, emergence and evolution of SARS-CoV-2. However, extracting this information from sequences is difficult, as most methods of analyzing viral genomes were developed for smaller data sets. Therefore, my objective was to develop new fast estimators of the number of infections (I) and the rate of migration based on simple features of SARS-CoV-2 phylogenies.

I simulated pathogen evolution using a susceptible-exposed-infectious-recovered (SEIR) model of pathogen spread, reconstructing evolution using CoVizu. For simulations of I, I varied the total number …

Impact Of Covid-19 On Latinx And Black Communities, Carolina Zuluaga

Dissertations

This critical literature review project explored the impact of COVID-19 on Latinx and Black communities. According to the Centers for Disease Control and Prevention, as of September 28, 2022, around 16% of COVID-19 cases in the United States were among Latinx people, and 14% of cases were among Black people (Centers for Disease Control and Prevention, 2022). Since COVID-19 began, clinicians have become more conscious of the effects of health disparities within racial and ethnic minorities, which has warranted increased advocacy by educating health and mental health providers and creating and providing resources to these communities and clinicians. The review …

Development Of An Immunoblot Assay To Detect Antibodies To Sars-Cov-2 Spike And Nucleocapsid Antigens In Serum Of Covid-19 Patients, Christian Hollis

Honors Theses

The coronavirus disease (COVID-19) has created one of the most world-halting events in recent world history. Its effects have reached every corner of the globe and manifested problems within each country’s healthcare and social systems. During the pandemic, many researchers have searched to develop a more robust understanding of the novel virus’s genetic and structural material. In year three since the emergence of COVID-19, these researchers hope to implement new advancements in testing and detection for the presence of the virus.

This thesis intends to produce evidence for the reliability of COVID-19 antibody tests using immunoblot assay detection. These tests …

Evolution And Epidemiology Of Channel Catfish Virus (Ccv), Arun Venugopalan

Theses and Dissertations

Channel catfish virus disease (CCVD) is the principal viral disease in the United States catfish industry. The CCVD is caused by channel catfish virus (CCV), with mortality reaching up to 100% in fingerlings. CCV is assigned taxonomically to the family Alloherpesviridae, genus Ictalurivirus, species Ictalurid herpesvirus 1 (IcHV-1). To date, virulence, immunogenicity, and genome plasticity of the CCV field isolates have not been investigated. Three genotypes of CCV (IcHV-1A, IcHV-1B, and BCAHV) were identified using restriction fragment length polymorphism (RFLP) analysis. Virulence assessment of three representative isolates of RFLP groups suggests that IcHV-1B (pooled survival [mean ± SE]: 58.3% ± …

Center Based Cardiac Rehabilitation Outcomes Associated With Covid-19 Pandemic: A Retrospective Comparative Cohort Study, Haley Williams, Kayla Woodworth

Doctor of Nursing Practice Projects: College of Nursing

Background: Traditional cardiac rehabilitation (CR) is a multidisciplinary, multifaceted program for cardiac patients. Throughout the Covid-19 pandemic, health care, including center-based CR (CBCR) programs, were closed to in-person sessions. Even with the return to CBCR participation, patient outcomes may have been affected by this disruption in care. The goal of this study was to determine if CR participation outcomes differed before and after CBCR program closure due to Covid-19.

Methods: A retrospective comparative cohort design was used to examine CR participant outcome data before and after the Covid-19 pandemic. Convenience sampling of CR participants at a large, urban …

An Investigation On The Effect Of Conserved Hinge Histidine On Influenza Hemagglutinin(Ha2) Protein Conformation Using Md Simulations, Nada Tolba

Chemistry & Biochemistry Undergraduate Honors Theses

Hemagglutinin is a protein on the surface of Human Influenza Viruses.¹ It is composed of two glycopolypeptide domains, the HA1 and HA2 domains. Previous studies have found that across different strains of Influenza viruses, HIS435 residues remain conserved.⁴ In studies where mutations occurred in hinge-site histadine residues, the Influenza virus was inactive.⁴ These investigations indicated a significant role of HIS435 (hinge-site histadines) in virulence. Four systems were created using Molecular dynamics (MD) simulations. Each system was composed of an Isolated HA2 trimer solvated in a 150 mM NaCl rectangular water box at 310 K under isobaric and …

Exploring The Plausibility Of Human Ecosystem Disruption Being The Cause For Increased Viral Prevalence, Andrew Ventura

University Honors Theses

Viral diseases and their prevalence--including both the number of cases and the appearance of new viruses--has increased in the last century, and these diseases have become an increasing threat to human health and well-being. The influenza and COVID-19 pandemics served both as introductions and reminders respectively to the power these viruses have to destroy and disrupt human life. As such, it intimates a necessity to investigate possible causes for the increase in these deadly diseases. Among these plausible causes is the dilution effect hypothesis, which states that decreasing the biodiversity of an ecosystem increases a pathogen's ability to infect, both …

Assessing The Impact Of Ebola Virus Inoculum Size On Likelihood Of Infection, Joseph Lukowski

Capstone Experience

Background: Indirect transmission of Ebola virus disease (EVD) is not uncommon but is poorly understood. Improving the understanding of the potential risk of EVD transmission from fomites should result in new or updated prevention or control measures for suspected or confirmed EVD cases or outbreaks.

Objective: This study aims to compile and understand pertinent data from peer-reviewed literature, establish the dose-response relationship between inoculum doses introduced to mucous membranes, and finally estimate the risk of EVD transmission from fomites.

Methods: A literature search was conducted through PubMed to obtain relevant data. This study employed this data to perform Poisson regression …

An Ecological Perspective Of American Rodent-Borne Orthohantavirus Surveillance, Nathaniel Mull

Graduate Theses and Dissertations

Orthohantaviruses are a global group of viruses found primarily in rodents, though several viruses have also been found in shrews and moles. Many rodent-borne orthohantaviruses are capable of causing one of several diseases in humans, and the mortality associated with these diseases ranges from < 0.1% - 50% depending on the specific etiological virus. In North and South America, orthohantavirus research was ignited by an outbreak of severe disease in the Four Corners region of the United States in 1993. However, despite the discovery of over 20 orthohantaviruses in the Americas, our understanding of orthohantavirus ecology and virus-host dynamics in this region is still limited, and orthohantavirus surveillance is generally restricted in scope to select regions and small portions of host distributional ranges. In Chapter I, I present a literature review on the current understanding of American rodent-borne orthohantavirus ecology. This review focused on under-studied orthohantaviruses, addressing gaps in knowledge by extrapolating information from well-studied orthohantaviruses, general rodent ecology, and occassionally from Eurasian orthohantavirus-host ecology. There were several key conclusions generated from this review that warrant further research: 1) the large number of putative orthohantaviruses and gaps in orthohantavirus evolution necessitate further surveillance and characterization, 2) orthohantavirus traits differ and are more generalizable based on host taxonomy rather than geography, and 3) orthohantavirus host species are disproportionately found in grasslands and disturbed habitats. In Chapter II, I present a prioritized list of rodent species to target for orthohantavirus surveillance based on predictive modeling using machine learning. Probable orthohantavirus hosts were predicted based on traits of known orthohantavirus hosts using two different types of evidence: RT-PCR and virus isolation. Predicted host distributions were also mapped to identify geographic hotspots to spatially guide future surveillance efforts. In Chapter III, I present a framework for understanding and predicting orthohantavirus traits based on reservoir host phylogeny, as opposed to the traditional geographic dichotomy used to group orthohantaviruses. This framework establishes three distinct orthohantavirus groups: murid-borne orthohantaviruses, arvicoline-borne orthohantaviruses, and non-arvicoline cricetid-borne orthohantaviruses, which differ in several key traits, including the human disease they cause, transmission routes, and virus-host fidelity. In Chapter IV, I compare rodent communities and orthohantavirus prevalence among grassland management regimes. Sites that were periodically burned had high rodent diversity and a high proportion of grassland species. However, rodent seroprevalence for orthohantavirus was also highest in burned sites, representing a trade-off in habitat management outcomes. The high seroprevalence in burned sites is likely due to the robust populations supported by the high quality habitat resulting from prescribed burning. In Chapters V and VI, I describe Ozark virus and Sager Creek virus, two novel orthohantaviruses discovered from specimens collected during Chapter IV. Both chapters report full genome sequences of the respective viruses and compare both nucleotide and protein phylogenies with related orthohantaviruses. Additionally in Chapter VI, I support the genetic analyses with molecular and ecological characterizations, including seasonal fluctuations in host abundance, correlates of prevalence, evidence of virus shedding, and information on host cell susceptibility to Sager Creek virus.

Hepatitis Screening, Kathryn Bland

Masters Theses/Capstone Projects

Project on hepatitis screening.

Various Synthetic Pathways Towards Efavirenz And Its Analogs; The Replacement Of The Side Chain, Elizabeth S. Bautista

Selected Honors Theses

Cyclopropyl acetylene (CA) is a key intermediate in the synthesis of the human immunodeficiency virus (HIV) reverse transcriptase inhibitor, Efavirenz (EFV), an antiviral drug used to treat HIV. CA is an expensive raw material, difficult to obtain, and employed in the preparation of medications to combat acquired immunodeficiency syndrome (AIDS). It was found that the structure could be synthesized by the utilization of PCl5; however, this resulted in unwanted ring opening products. To address this issue, a one pot synthesis was developed using Ph3PCl2 as a mild chlorinating agent. In addition, a new analog has been proposed substituting the cyclopropyl …

Generation Of Chimeric Rhinoviruses Presenting Sars-Cov-2 Broadly Neutralizing Epitopes And Their Antigenicity Characterization, Danish Ansari

Biotechnology Theses

The global COVID pandemic is not yet fully under control as there were over 21 million new cases of SARS-CoV-2 infections and over 50,000 deaths globally as of January of 2022. A heavily mutated variant of concern, Omicron is responsible for most of these cases which demands an urgency for a new vaccine. NIH reports over 180 vaccine candidates that use various strategies currently in development. However, a recurring concern with these vaccines is that the continuous viral mutations decrease the efficacy of vaccines. Therefore, we proposed to construct a human rhinovirus (HRV) based chimeric virus containing highly conserved, broadly …

Implementing A Covid 19 Policy For Telehealth, Ashley M. Morello

Doctor of Nursing Practice Projects

The proposed DNP Project explored the implementation of a COVID-19 telehealth policy to clarify evidence-based practice, promote use of safe medications, and reduce hospitalizations. Providers were recruited from a telehealth organization, educated on current guidelines, and given a pocket card for reference and re-enforcement of training. Data was collected to examine guideline utilization, confidence in treating COVID-19, and efficacy of pocket card. COVID-19 patients also received follow up calls to determine if hospitalization was required post treatment. Chart audits were then completed to review compliance with guidelines. The results indicated both objective and clinical improvement in provider confidence treating COVID-19. …

Characterization Of The Function And Regulation Of The Hmpv Phosphoprotein, Rachel Thompson

Theses and Dissertations--Molecular and Cellular Biochemistry

Human metapneumovirus (HMPV) is a non-segmented, negative strand RNA virus (NNSV) that frequently causes respiratory tract infections in infants, the elderly, and the immunocompromised. Despite the initial identification of HMPV in 2001, there are currently no FDA approved antivirals or vaccines available. Therefore, understanding the mechanism of HMPV replication is critical for the identification of novel therapeutic targets. A key feature in the replication cycle of HMPV and other NNSVs is the formation of membrane-less, liquid-like replication and transcription centers in the cytosol termed inclusion bodies (IBs). Recent work on NNSV IBs suggests they display characteristics of biomolecular condensates formed …

The Impact Covid-19 On The Healthcare Industry’S Systems And Policies: A Case Study, Jameyshia Franklin

West Chester University Doctoral Projects

People worldwide experienced some impacts from the 2019 Coronavirus at various degree. The healthcare industry worldwide was significantly affected by the high volume of patients being infected with the Coronavirus. The COVID-19 virus brought on several challenges for the healthcare industry and the federal government in the United States. Hospitals operated under severe circumstances to treat sick COVID-19 patients and keep their employees safe from contracting the disease. Government mandated social distancing, mask wearing, and cancelation and closing of services to assist with stopping the spread of the virus. This study aimed to identify how the pandemic affected the healthcare …

Interactions Between Hiv And Opioids On Antiretroviral Accumulation, The Blood Brain Barrier, And The Inflammatory Response In The Brain., Kara Rademeyer

Theses and Dissertations

The complex mechanisms related to HIV infection, neurodegeneration, and chronic neuroinflammation collectively describe neuroHIV (Hauser et al. 2007; Chang et al. 2014; Smith et al. 2014). Specifically, opioid abuse, poor penetration of antiretroviral (ARV) drugs, chronic inflammation and neuronal injury/degeneration are all implicated in neuroHIV (Fantuzzi et al. 2003; Letendre et al. 2004; Verani et al. 2005; Duncan and Sattentau 2011; Hong and Banks 2015; Simoes and Justino 2015; Olivier et al. 2018; Murphy et al. 2019; Osborne et al. 2020). For the first time, we demonstrate that morphine, fentanyl, and methadone in vivo alter the brain accumulation of ARVs, …

Perspectives On The Use Of Molecular Hiv Data For Public Health, Margaret Watson

Electronic Theses and Dissertations

Background. Effective HIV treatment and pre-exposure prophylaxis can drastically reduce the risk of acquiring HIV and prevent most future transmission, but these advances are not accessible to many who could most benefit from them. Advances in use of molecular sequence data to inform prevention efforts, paired with supportive interventions, have the potential to identify clusters of rapid HIV transmission and focus prevention resources toward areas of highest need. Although molecular cluster detection has been successfully used in other areas of public health, advocates for people with HIV have raised concerns about the application of this approach because of HIV …

Stressors And Hormone Levels: Predictors Of Covid-19 Health Outcomes In Latine Adults, Wendy Rodriguez

CMC Senior Theses

The Coronavirus 2019 Disease (COVID-19) has been shown by multiple studies to have disproportionate impacts on some individuals, especially minority populations. These may be attributed to differences in biological (sex), gender, social or cultural factors. In this study, we aim to identify and investigate the gender and social predictors that may be involved in the pathogenesis of the virus and its health outcomes. To achieve this, a literature review expands on relevant topics that better contextualize COVID-19’s complex nature. The potential role of hormones, estrogen, and testosterone is considered across different sexes and genders as protective agents against COVID-19. This …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

Electronic Theses and Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Role Of Endoplasmic Reticulum Stress Response In Parainfluenza Virus Acute To Persistent Infections, Lauren L. Abbitt

Honors Undergraduate Theses

Persistent viral infections are a major health concern, with persistently infected (PI) cells being a source of continued shedding of virus and generation of viral mutants. Here, we hypothesized that cells persistently infected with the enveloped virus parainfluenza virus 5 (PIV5) would show altered expression of endoplasmic reticulum (ER) stress proteins and increased resistance to death caused by drug-induced ER stress. To test this, lysates of mock-infected, PIV5 acute-infected, and PIV5 PI human lung A549 cells were collected and levels of ER stress proteins were compared. Western blotting revealed that immunoglobulin heavy chain binding protein (BiP/GRP78) was present in higher …

Split Catalytic Probes For The Detection Of Monkeypox Virus, Jaehyun Ahn

Honors Undergraduate Theses

The COVID-19 outbreak highlighted the important role that diagnostic tests play in the healthcare system. To reduce the impact of infectious disease outbreaks, the development of rapid and cost-effective point-of-care-tests (POCTs) is crucial. With the dissemination of the Monkeypox (Mpox) virus, it became a necessity to produce POCTS that are inexpensive and easy to use. This work explored the construction of two colorimetric assays that aim to detect Mpox genetic signatures. One is based on the split-peroxidase-like deoxyribozyme probes (sPDz), while the other utilizes a cascade system of split RNA-cleaving deoxyribozyme (sDz) and peroxidase-like deoxyribozyme (PDz). Both rely on catalytic …