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Population Pharmacokinetics And Dosing Simulations Of Pentobarbital In The Pediatric Population, Victoria Etges Helfer, Lorena Medina-Aymerich, William J. Muller, Marisa Meyer, Amira Al-Uzri, Russell Mcculloh, Chi D. Hornik, Stephen J. Balevic, Rachel G. Greenberg, Daniel K. Benjamin, Sarah G. Anderson, Daniel Gonzalez

Department of Pediatrics Faculty Papers

Pentobarbital is a barbiturate with sedative and anticonvulsant properties, occasionally used in pediatric patients for preoperative sedation, deep sedation during mechanical ventilation, and seizure control. Despite its long-standing clinical use, age-appropriate dosing remains challenging due to variability across studies and limited pediatric pharmacokinetic (PK) data. This study (NCT01431326) aimed to characterize the population pharmacokinetics of pentobarbital in pediatric patients (birth to 21 years) and evaluate dosing strategies using model-based simulations. A two-compartment population PK model, allometrically scaled to total body weight, adequately described pentobarbital plasma concentrations, with no additional covariates identified as significant. Simulations were conducted across four age groups: …

The Impact Of Glucose Exposure On Organic Cation Transporters (Oct) Function In A Corneal Epithelial Cell Line, David A. Garza

Theses & Dissertations

Organic cation transporters (OCT) facilitate the movement of neurochemicals and medications, contribute to the removal of cellular waste, and facilitate neuronal communication. Three subtypes of these high-capacity, low-affinity transporters (OCT1, OCT2, and OCT3) are differently expressed in peripheral tissues such as the liver, kidneys, as well as the central nervous system. OCTs are also expressed in ocular tissues. Chronic hyperglycemia is a complication commonly associated with diabetes that can lead to ocular diseases such as diabetic keratopathy, which affects the cornea. In this project, we expose immortalized human corneal epithelial cells (HCE-S) to various glucose concentrations to study their impact …

Prefrontal Engagement In Cognitive Flexibility Across Paradigms, Katarina Kalajzic

Honors Scholar Theses

Cognitive flexibility is an executive function that involves dynamically adapting behavior in the face of changing environmental circumstances to achieve a particular goal. Disrupted in numerous psychiatric disorders such as Alzheimer’s disease, schizophrenia, OCD, and depression, the neural correlates of cognitive flexibility are not well understood. However, the prefrontal cortex (PFC) is strongly implicated in executive function and attentional control processes. Thus, we sought to examine the neural circuitry involved in distinct cognitive flexibility tasks – the attentional set-shifting task and the probabilistic 2-armed bandit task. Through optogenetic suppression, we targeted pyramidal neurons of the rodent medial prefrontal cortex, an …

Factors Affecting Pedestrian-Vehicle Conflicts: An Empirical Analysis, Christo D. Jamo

Honors Scholar Theses

The number of pedestrian deaths increased by 78% between 2009 and 2023, while other motor vehicle crash deaths increased by 13% in the same period [1]. To identify potential pedestrian safety measures, this study analyzed the effects of location-based demographics, pedestrian phasing type, and other physical infrastructure and behavior variables on the probability of pedestrian-vehicle conflicts at signalized intersections, which is a surrogate measure of crash risk. Data were collected from 55 intersections in Connecticut, and the pedestrian-vehicle interactions were classified by severity based on the Swedish Traffic Conflict Technique: undisturbed passage, potential conflict, minor conflict, or serious conflict. Because …

Diagnostic Ability Of Rate Of Torque Development For Patellofemoral Pain, Arun Loganathan, Neal R. Glaviano Phd, Sungwan Kim Phd

Honors Scholar Theses

Context: Patellofemoral pain (PFP) is a highly prevalent condition (22.7% in general population) that significantly impacts the quality of life of those who suffer from it. However, there is no gold standard test to diagnose it yet, leading to inconsistencies with treatment as well as delayed intervention. Rate of torque development (RTD) is a neuromuscular measure that has shown strong connections to PFP.

Objective: The purpose of this study is to determine the diagnostic ability of RTD for PFP.

Design: Cross-sectional.

Setting: Laboratory.

Participants: Thirty-five individuals with PFP (24 males and 11 females, 22.7 ± 3.7 years, 1.67 ± 0.1 …

Validation Of A Real-Time Pcr Laboratory Developed Test For The Detection Of Pneumocystis Jirovecii In Bronchoalveolar Lavage Samples, Caitlyn Moon

Honors Scholar Theses

Pneumocystis jirovecii is an opportunistic, host-obligate fungal pathogen responsible for causing P. jirovecii pneumonia (PJP) in humans. PJP is treated with trimethoprim-sulfamethoxazole (TMP-SMX), a strong broad-spectrum antibiotic that carries risk of renal and hepatotoxicity. Therefore, rapid diagnosis or exclusion of PJP is crucial to ensure PJP-positive patients receive effective treatment and PJP-negative patients avoid unnecessary antibiotics. Unlike most microorganisms, P. jirovecii cannot be cultured, presenting complications for the typical methods of diagnosing fungal pathogens. Historically, the gold standard for diagnosis was direct microscopic examination with stains such as methenamine silver and calcofluor white, but this diagnostic technique requires highly skilled …

Play To Win: A Randomized Controlled Trial To Assess The Effects Of Play-Based Training On Upper Extremity Function In Children With Hemiplegia, Vivian London

Honors Scholar Theses

Hemiplegia, or paralysis of one side of the body, is the primary symptom of unilateral cerebral palsy, a subtype of cerebral palsy, the most common movement disorder in children. Standard of care is regular physical and occupational therapy to improve performance in bimanual activities, but conventional therapy can be expensive and draining for caregivers and children, so a need exists for a novel intervention that can take place at home and that is economical for families while being engaging for children. This thesis reports data from a subset of ten children seen as part of a randomized controlled clinical trial …

The Development Of A Crispr-Based Calibrated Functional Assay For Classifying Pathogenicity Of Msh2 And Msh6 Variants In Lynch Syndrome, Olivia N. Amodeo

Honors Scholar Theses

Lynch syndrome is a hereditary disease caused by the inheritance of a mismatch repair gene variant. Individuals with this condition are predisposed to cancer development, most commonly colorectal cancer. Current guidelines for variant classification are based on numerous evidence categories, including functional evidence. However, many novel clinical variants are not well characterized, and evidence is difficult to obtain if functional assays are not calibrated.

To address this, our lab created a calibrated functional assay that calculates an odds of pathogenicity score for MSH2 and MSH6 gene variants that can be used as evidence for classifying variants of uncertain significance. This …

Essays On Ai-Driven Analytics For Enhanced Healthcare Delivery: From Onset To Outcomes In Neurological Diseases Management, Gabriel Owusu

Theses and Dissertations

Chronic neurological diseases, particularly Alzheimer's disease and related dementias (ADRDs), pose mounting global healthcare burdens. Despite advances in AI and health information technologies, early detection, precise diagnosis, and effective caregiver support remain elusive. This dissertation proposes innovative AI-enabled analytical frameworks to address these challenges across the full ADRD continuum.

The first essay designs an explainable AI-enabled clinical decision support system (CDSS) using a graph neural network for early AD identification, evaluated through usability studies demonstrating improved risk awareness and clinical engagement. The second essay introduces MADT-RNN, a multi-level attention-based deep transfer recurrent neural network that fuses convolutional and recurrent architectures …

A Mixed-Methods Investigation Of Physician Compassion In Consultations For Chronic Primary Pain, Sarah Daehler

All Graduate Theses and Dissertations, Fall 2023 to Present

Chronic primary pain refers to physical pain that has no apparent organic cause, cannot be explained by another condition, and has associated psychological distress or functional impairment. Chronic primary pain is common and can significantly interfere with functioning, including occupational or social functioning. Research has shown that physicians struggle to treat this population, with many physicians reporting feeling unequipped and many patients feeling that their physicians are unhelpful and dismissive. Compassion may play a key role in improving these difficult interactions. The present study analyzed a sample of 99 participants with chronic pain and 100 healthy controls to learn more …

Characterizing Metabolic Flux Of Plant Secondary Metabolites From Diverse Animal-Source Foods To Humans, Muhammad Ahsin

All Graduate Theses and Dissertations, Fall 2023 to Present

There is a popular saying: “You are what you eat.” But does this also mean, “You are what your food eats”? This dissertation explores that question by examining how farming practices shape the nutritional quality of meat—and what, if anything, those differences mean for the people who consume it. While modern livestock production and nutrition research often emphasize protein and fat, this work tests the idea that animals function as biological mediators, linking soil and plant conditions to human diets through the chemical composition of meat and milk. To evaluate this hypothesis, we tracked health-relevant plant compounds— phytonutrients—across the soil–plant–animal–human …

Dyadic Agreement In And Task Correlates To A Measurement Of Conversational Success, Samantha Budge

All Graduate Theses and Dissertations, Fall 2023 to Present

Successful conversation matters for social connection, wellbeing, and quality of life, but people do not always agree on whether a conversation was successful, even when they participated in the same interaction. Conversation is also commonly measured through task success, even though it’s unclear how task success correlates to how successful a conversation feels. This study examined how conversational success is experienced by different conversation partners and whether feeling successful in a conversation is related to how well a task is completed.

Participants took part in a structured conversational task and then rated their own conversational experience using a self-report questionnaire …

May 2026 News You Need, David Foe

The Journal of the Michigan Dental Association

This source provides comprehensive updates on organized dentistry, including the appointment of Dr. Nader A. Nadershahi as the new ADA executive director. It reports on the MDA's current membership market share, which remains high at approximately 70% despite national trends. Significant health topics covered include Mental Health Awareness Month resources like the Well-Being Index and a patient fact sheet linking oral health to systemic conditions like heart disease and diabetes.

J Mich Dent Assoc May 2026

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200-plus members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons.

The May 2026 (Volume 108, No. 5) issue of the Journal is published in print format to provide updates and insights for Michigan's oral health community and MDA members. Print editions occur every other month beginning with January.

The May 2026 issue of the MDA Journal introduces Dr. Melanie Mayberry as the new association president, highlighting her …

Ligand-Based Pharmacophore Modeling And Structure-Based Virtual Screening For Identifying Potential Therapeutic Agents Targeting The Sars-Cov-2 Spike Protein-Ace2 Receptor Interaction, Timoteo Delgado-Maldonado, Gilberto Vargas-Salas, Debasish Bandyopadhyay, Adriana Moreno-Rodriguez, Eyra Ortiz-Pérez, Gildardo Rivera-Sanchez

School of Integrative Biological & Chemical Sciences Faculty Publications

Coronavirus disease (COVID-19) remains a global health concern due to its high mortality and morbidity. In this study, we combined ligand-based pharmacophore modeling (LBPM) with structure-based virtual screening (SBVS) to identify novel inhibitors targeting the SARS-CoV-2 spike protein. Ligands from the MolPort database were screened via docking and molecular dynamics simulations at the receptor-binding domain (RBD). Four compounds showed promising docking scores (-8.7 to -6.4 kcal/mol) and dynamic stability (root mean square deviation < 5 Å). In vitro assays confirmed that compounds C3 (IC50 = 0.03 µM) and C4 (IC50 = 10.4 µM) effectively inhibited spike-ACE2 binding with low cytotoxicity (CC50 > 100 µM). These findings show the efficacy of the LBPM technique and highlight 1H-pyrazol-5-ol derivatives as potential building blocks for developing new antiviral agents against SARS-CoV-2.

How Are Women Dealing With Polycystic Ovary Syndrome?, Adrianna A. Brown

Electronic Theses, Projects, and Dissertations

Background and Aims: PCOS is one of the leading multisystem conditions among women of reproductive age. Dietary changes may help improve outcomes associated with PCOS and its comorbidities. While a lower carbohydrate, moderate protein diet is often recommended, those with PCOS often use temporary diets or dietary supplements instead of or in addition to prescription medications due to dissatisfaction with their treatment options. Additionally, studies examining the usefulness of supplements and their effects on PCOS symptoms are lacking. This study explored the prevalence of use of temporary diets, prescription medications, and dietary supplements among women with PCOS.

Methods: An anonymous …

What Is Transitional Care And Its Role In Reducing Readmissions, Decia Rodriguez

Electronic Theses, Projects, and Dissertations

Thirty-day readmissions to hospitals creates significant clinical and financial burdens in healthcare systems and worsens patient outcomes. This project reviews transitional care programs as strategic interventions to minimize preventable readmission with a specific focus on pharmacist-led medication reconciliation. Due to the extensive literature review, this work proves that structured transitional care is effective in closing the gaps between acute hospital care and home-based recovery because it coordinates medication management, patient education, and follow-up care. As it has been shown, pharmacists are in a central position to minimize medication errors and enhance compliance, especially in chronic patients such as those with …

Promoting Influenza Vaccination Among College Students, Wajeeha Khan Valley

Electronic Theses, Projects, and Dissertations

Influenza remains a significant public health concern on college campuses, where high population density, shared living environments, and frequent social interaction increase the risk of viral transmission. Despite the availability of safe and effective influenza vaccines, vaccination rates among college-aged students remain consistently low. Many students underestimate their personal risk for influenza and hold persistent misconceptions regarding vaccine safety, effectiveness, and side effects. The widespread use of social media further influences these attitudes, as misinformation can rapidly spread while credible health messaging often struggles to gain visibility. It is important to eliminate vaccine hesitancy among college students through innovative, behavior-focused …

Mycobacterium Chimaera In A Young Patient Without Underlying Cardiac Surgery History, Kate A. Szczesniak, Rakesh Shah, Malitha Hettiarachchi

Conference Presentation Abstracts

Introduction/Objective Mycobacterium chimaera (M. chimaera), within the Mycobacterium Avium Complex (MAC), is a slow-growing nontuberculous mycobacterium (NTM) species that is most often characterized by nonspecific symptoms of night sweats, fever, and fatigue. Due to the nonspecific symptoms of M. chimaera and the rarity of this infection, delayed or misdiagnosis occurs in these patients. Risk factors of contaminated heater-cooler units used in cardiac surgery have been reported; however, cases without this exposure, such as this case, have been cited less commonly. This case of M. chimaera will present a young patient initially presenting with dyspnea who was found to have a …

Targeting The Dorsolateral Prefrontal Cortex With Transcranial Direct Current Stimulation To Improve Depression And Anxiety In Parkinson's Disease, Brock Renicks

Honors Theses

The aim of this study is to observe the outcomes of transcranial direct current stimulation (tDCS) as a treatment for Parkinson’s Disease (PD). This study will primarily look at changes in depression and anxiety, as these symptoms are often comorbid with Parkinson’s Disease. Transcranial direct current stimulation is a non-invasive, very low-intensity form of electrical stimulation of the brain. It is being increasingly used as a form of treatment for Parkinson’s Disease and depression and anxiety, however the literature is ambiguous, showing mixed results throughout various studies, with no standardization of tDCS administration. To determine the effect of tDCS on …

Community Perceptions Of A Hospital-Based Doula Program In Mobile, Alabama, Sarah Laney

Honors Theses

Background: The maternal mortality ratio in the United States is much higher than the mortality rate for women who live in other countries with similar Human Development Index scores. Black women are more likely to die than their white counterparts. Most of these deaths are preventable. Patients feel like they are being ignored, or that they are not being seen. Doula care is a possible solution to these problems.

Purpose: The purpose of this study was to assess patient understanding and perception of doulas as well as comparing desire for doulas to demographics and past experiences to search for relationships. …

Effects Of A Passive Assistive Hamstring Device On Overground Running Kinematics And Hamstring Activation., Quinn Castner

All Theses

Hamstring strain injuries are among the most common and recurring injuries in sports, occurring most often during the terminal swing phase of gait. Despite progress in rehabilitation, the incidence of injury has only increased, suggesting a need for a novel intervention. We designed a passive, assistive, wearable device with two specific criteria in mind: to offload the hamstrings during running, and do so without hindering normal kinematic patterns. The device consists of an adjustable elastic band anchored proximally at the waist and distally just above the ankle joint center. It stretches and shortens with the hamstrings, providing passive hip extension …

Fluorescence-Based Quantification Of Hepatic Ldl Uptake And Donor Hepatocyte Engraftment Using Atto 700–Labeled Ldl, Victor Agustin Cortes Flores

All Theses

Familial hypercholesterolemia (FH) is an inherited disorder characterized by elevated low-density lipoprotein cholesterol (LDL-C) that increases the risk of premature atherosclerotic cardiovascular disease. In severe FH, including low-density lipoprotein receptor (LDLR), hepatic LDL clearance is profoundly impaired and many lipid lowering treatment strategies have limited effectiveness. Current advances in ex vivo CRISPR–Cas9 hepatocyte gene editing in vivo and ex vivo approaches for treatment of FH are under development.

However, a central barrier to translation is the ability to quantitatively measure the percentage of healthy gen edited hepatocytes in the liver while simultaneously assessing functional hepatic LDL handling. This thesis establishes …

Pattern Dynamics And Stochasticity Of Brain Rhythms And Spike Trains In A Tauopathy Mouse Model Of Alzheimer’S Disease, Clarissa M. Hoffman

Dissertations and Theses (Open Access)

Systems neuroscience posits that every aspect of perceived physical reality, every aspect of animal and human behavior, and every cognitive phenomenon emerges from patterns of neuronal activity. While most researchers embrace this idea, there are major difficulties in describing and analyzing these complex neuronal dynamics—spike flows produced by cells ensembles, synchronized extracellular field oscillations, and other patterns—which limits our understanding of how the activity of individual neurons and the whole-animal cognition and behavior might be connected. In particular, we lack the approaches and even the semantics for connecting the individual cell outputs and the integrated results of their activity. Current …

Technical Development, Optimization, And Clinical Implementation Of Quantitative Magnetic Resonance Imaging Methods For Radiation Oncology, Lucas Mccullum

Dissertations and Theses (Open Access)

Magnetic resonance imaging (MRI) has gradually grown more important in the field of radiation oncology. This paradigm shift has grown from initial experiments with MRI of cancerous lesions in the early 1970s, to the integration of MRI images for radiation therapy treatment planning (i.e., MRI-Simulation) in the early 1980s, to the combined MRI linear accelerator (MR-Linac) becoming commercially available in 2018 which can simultaneously image a tumor and treat it with radiation. However, due to its novelty in radiation oncology, its full potential for the integration of quantitative MRI-based biomarkers has yet to be fully realized.

Therefore, this dissertation will …

Learning About The Direct Experiences Of Very Young Children With Hearing Loss: A Feasibility Study, Jenni M. Funk

Undergraduate Honors Capstone Projects

We aimed to explore the feasibility of employing a developmentally appropriate, modified puppet interview method to elicit thoughts and perspectives directly from very young children (ages 3 to 6 years old) who are deaf or hard-of-hearing. Little is known about the direct experiences of children with hearing loss, making it difficult to improve care. In our field of speech and hearing sciences, there is no current method of gathering direct experiences of young children and placing them at the center of care. We proposed that researchers may be able to learn about the direct experiences of very young children who …

From Synapse To Circuit: Mechanisms Of Behavioral Flexibility And Its Restoration After Prenatal Alcohol Exposure, Jayapriya Chandrasekaran

Biomedical Sciences ETDs

Behavioral flexibility—the ability to adapt behavior when contingencies change—is a fundamental executive function supported by orbitofrontal–striatal circuitry. This dissertation examined molecular, motivational, and circuit mechanisms underlying flexibility and its restoration after prenatal alcohol exposure (PAE). In healthy mice, GluN2B-containing NMDA receptors in the orbitofrontal cortex increased during outcome updating, while AMPA receptor subunits in the dorsal striatum rose during new learning, defining temporally distinct plasticity processes. PAE impaired reversal learning under low-reward conditions, but not when motivation was high, indicating altered thresholds for circuit engagement rather than permanent loss. Finally, optogenetic stimulation of OFC→dorsal striatum projections rescued flexibility in PAE …

Exploring Clinical Reasoning In Occupational Therapy Students Using Think Aloud During Computerized Patient Simulation, Candra Selene Talylor

Graduate Theses and Dissertations (2019 - present)

The objective of this research was to explore the effects of the think aloud (TA) method on the development of clinical reasoning in occupational therapy students completing an online simulation assignment. The study aimed to determine if thinking aloud develops clinical reasoning in occupational therapy students as evidenced by a change in clinical reasoning skill scores and investigates the relationship between students' overall clinical simulation competency scores.

This study used a mixed methods design, combining quantitative and qualitative data to explore and measure the use of the TA strategy on the development of clinical reasoning skills. The sample from this …

Changes In Opioid Prescribing Patterns In Opioid Naive Patients Can Translate To Improved Outcomes In The Opioid Non-Naive Patients With Anterior Cervical Surgery: A Michigan Spine Surgery Improvement Collaborative (Mssic) Study, Anisse Chaker, Geoff Kahn, Michael Melhem, Jian-Hui Hu, Kari Jarabek, Heegook Yeo, Bhargav Ayloo, Trevor Ruesch, Adam Junn, Jad Khalil, Kenneth Easton, Richard Easton, Doris Tang, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, David Nerenz, Victor Chang

Conference Presentation Abstracts

Introduction: Though often necessary for adequate analgesia after spine surgery, continued opioid use can lead to chronic dependency. The Michigan Spine Surgery Improvement Collaborative (MSSIC) has demonstrated in prior work the promise of utilizing a multi-institutional morphine milliequivalent (MME) cutoff for elective anterior cervical surgery in the opioid naıve population. However, the effect of this cutoff in patients who were already on opioids pre-operatively have not previously been studied. The goal of this study was to evaluate whether changes in prescribing patterns in the opioid naıve population would also translate to the non-naıve populations, and whether the non-naıve population would …

The Intersection Of Occupational Therapy And Optometry In The Treatment Of Visual Impairments: Addressing An Unmet Need, Grace Bannon

Capstone Projects

The prevalence of visual impairments in the United States is substantial and anticipated to increase in severity over the coming decades. These impairments have wide-reaching consequences on an individual’s occupational performance in daily living. While both occupational therapists and optometrists focus on the relationship between visual function and engagement in meaningful and purposeful occupations across the lifespan, only a limited number of optometrists offer specialized vision therapy services. This gap emphasizes a growing demand for vision services to manage the needs of individuals with visual deficits. Therefore, this Doctoral Capstone Experience (DCE) sought to bridge this gap by exploring the …