Shackled: To A Front-Row Seat Of My Own Horror Film, Dellil L. Mohammed

Theses and Dissertations

This document serves as internal view point, stemming from my experiences as a black muslim, first generation Ethiopian American, overall identity, and it’s disorienting implication on my interpretation of my view-self and the world. This is also informed by my struggling with the realities of type-1 diabetes and the sporadic and often inadequate support of the American health system. All of these intersecting experiences have led to me making work as an agent for advocacy, empathy and social justice. This work is also informed and dressed with the elements of horror, sci-fi, & fantasy. See and hear the voice in …

Plan Quality And Isotoxic Dose Escalation Investigation Using A 0.35t Mr-Linac System In Ablative 5-Fraction Stereotactic Magnetic Resonance-Guided Radiation Therapy (Mrgrt) For Primary Pancreatic Cancer, Robert Eric Hawranko

Theses and Dissertations

This study investigates plan quality generated by an MR-Linac (MRL) treatment planning system (TPS) for 5-fraction stereotactic body radiation therapy (SBRT) of primary pancreatic cancer (PCa). In addition, an isotoxic dose escalation was investigated with the MRL TPS based on the stereotactic MR-guided adaptive radiation therapy (SMART) trial constraints. A clinical workflow was developed for adaptive and non-adaptive treatments with the MRL, on which a time-driven activity-based costing (TDABC) analysis was performed to quantify clinical efficacy. Fifteen Pca patients previously treated with a conventional Linac were retrospectively re-planned for this study. Three plans were generated for each patient: using the …

Human Papillomavirus 16 E2 Regulates Host Cell Pathways Important For Cancer Progression And Treatment Sensitivity Which May Contribute To Cancer Outcomes, Christian Fontan

Theses and Dissertations

Human papillomaviruses (HPVs) are causative agents in around 5% of all cancers, including cervical and oropharyngeal. A feature of HPV cancers is their better clinical outcome compared with non-HPV anatomical counterparts. In turn, the presence of E2 predicts a better clinical outcome in HPV-positive cancers; the reason(s) for the better outcome of E2-positive patients is not fully understood.

Previously, we demonstrated that HPV16 E2 regulates host gene transcription that is relevant to the HPV16 lifecycle in N/Tert-1 cells. One of the genes repressed by E2 and the entire HPV16 genome in N/Tert-1 cells is TWIST1. In these studies, we demonstrate …

Therapeutic Injectable Iron-Chelating Hydrogels, Debbie Campbell-Rance

Theses and Dissertations

ABSTRACT

Therapeutic Injectable Iron-Chelating Hydrogels for Improved Central Nervous System Regeneration

By

Debbie S. Campbell-Rance

A dissertation submitted in partial fulfillment of the requirements of the degree of Doctor of Philosophy at Virginia Commonwealth University 2021.

Director: Xuejun Wen, M.D., Ph.D., AIMBE Fellow, Alice T. and William H. Goodwin Jr. Endowed Chair Professor in Regenerative Medicine, Institute for Engineering and Medicine, Department of Chemical and Life Science Engineering

Severe traumatic brain and spinal cord injuries are major global public health and socioeconomic problems in terms of mortality and morbidity. Currently there are two main lines of treatment under development for …

Multi-Modality Automatic Lung Tumor Segmentation Method Using Deep Learning And Radiomics, Siqiu Wang

Theses and Dissertations

Delineation of the tumor volume is the initial and fundamental step in the radiotherapy planning process. The current clinical practice of manual delineation is time-consuming and suffers from observer variability. This work seeks to develop an effective automatic framework to produce clinically usable lung tumor segmentations. First, to facilitate the development and validation of our methodology, an expansive database of planning CTs, diagnostic PETs, and manual tumor segmentations was curated, and an image registration and preprocessing pipeline was established. Then a deep learning neural network was constructed and optimized to utilize dual-modality PET and CT images for lung tumor segmentation. …

Modeling Of Patient-Specific Periaortic Mechanics And Pulmonary Artery Hemodynamics Based On Phase-Contrast Magnetic Resonance Imaging Sequences., Johane H. Bracamonte

Theses and Dissertations

Inverse modeling in cardiovascular medicine is a collection of methodologies that can provide non-invasive patient-specific estimations of clinical risk factors using medical imaging as inputs. Its incorporation into clinical practice has the potential to improve diagnosis and treatment planning with low associated risks and costs.

Herein, three different phase contrast magnetic resonance imaging (MRI) modalities were implemented as input data, displacement encoding with stimulated echoes (DENSE MRI) applied, and time-resolved velocity encoding phase-contrast MRI, in 1D and 3D, applied to pulmonary artery (PA) hemodynamics.

A model to account for the effect of periaortic interactions due to static and dynamic structures …

Using Molecularly Imprinted Polymers For The Selective Extraction Of Analytes, Haley A. Mulder

Theses and Dissertations

Sample preparation is a critical steps in bioanalysis. Traditional methods such as solid-phase extraction and liquid-liquid extraction are laborious and ultimately incapable of properly separating target analytes from matrix and interferents. The co-extraction of these components interferes with the analytical instrument’s ability to properly detect and quantitate analytes. Molecularly imprinted polymers (MIPs) are synthetic polymers that have been “imprinted” with a template analyte in a co-polymer system. MIPs are capable of selectively extracting analytes from complex biological matrices and can be employed in off-line, benchtop extractions or for on/in-line instrument extractions. MIPs offer faster and more selective sample preparation, leading …

Modulating Ketamine’S Locomotor Activating And Reinforcing Effects Through Drug Combinations, Tegshjargal Baasansukh

Theses and Dissertations

Major Depressive Disorder (MDD) affects approximately 280 million people worldwide. The standard of care for pharmacological treatment of MDD has been monoaminergic antidepressants (MAA). However, MAAs have serious clinical limitations including a relatively slow onset of action and up to 40% of patients failing to respond and being diagnosed as “treatment resistant”. Ketamine, an N-methyl-D-aspartate antagonist, was originally approved for use as an injectable anesthetic. In addition, ketamine has been shown to rapidly improve depressive symptoms in patients with treatment resistant depression. In 2019, (S)-ketamine was approved as a nasal spray (Spravato®) for patients with MDD and treatment-resistant depression in …

A Case Study Exploring How The Zero Barriers In Stem Education Professional Development Program Affects Attitudes And Confidence Toward Teaching Stem Content To Students With Disabilities, Alison Dossick

Theses and Dissertations

This study was designed to assess how the Zero Barriers in STEM Education professional development (PD) course affected teacher attitudes and confidence in teaching science, technology, engineering, and mathematics (STEM) content to students with disabilities. A convergent mixed-methods case study analysis was used. The research questions were devised by examining answers on a pre-survey and post-survey. Documentation included a full analysis of two pre- and post-surveys, teacher implementation logs, team action plans, program evaluations, and semi-structured interviews. Barriers included time to plan and implement the outlined strategies and administrative and colleague support. This research uncovered some of the difficulties of …

Connected: Exploring Automation To Activate Aging In Place Success, Hallie W. Gillespie

Theses and Dissertations

MOTIVATION: There’s no place like home. Technological advances are now allowing us to live and work from anywhere. Spatial divides are disappearing through remote connections, creating a dispersion of the nuclear family, traditionally the prevailing caregivers for seniors. Older adults are projected to outnumber children under eighteen by 2034, a first in U.S. history (Census Bureau, 2019). This is not specific to America; “globally the population is aging. Since 1980, the number of people aged over 60 has more than doubled in size and is projected to do so again by 2050 to 2.1 billion” (United Nations, 2017).

ISSUE: There …

Academic Health Science Centers And Health Disparities: A Qualitative Review Of The Intervening Role Of The Electronic Health Record And Social Determinants Of Health, Wies Rafi

Theses and Dissertations

Literature on the magnitude of negative health outcomes from health disparities is voluminous. Defined as the health effects of racism, environmental injustice, forms of discrimination, biases in science, and sociological or socioeconomic predictors across populations, health disparities are part of an ongoing and complicated national problem that health equity programs are specifically designed to address. Academic Health Science Centers (AHC) institutions are a complex and unique educational-healthcare ecosystem that often serves as a safety net for patients in vulnerable and lower-income communities. These institutions are often viewed as one of the most uniquely positioned entities in the U.S. with an …

Supported Employment Services And Employment Outcomes For Low-Income Youth With Intellectual And Developmental Disabilities: A Case Control Study, Hannah Seward Phd

Theses and Dissertations

Transition-age youth, ages 14-24 years old, with intellectual and developmental disabilities (IDD) face unique barriers to entering the labor force when exiting high school. These barriers can be even more severe if the youth is from a low-income background. Supported employment (SE) services may help this population overcome these barriers and be employed in competitive integrated employment (CIE) settings. SE provides an employment specialist to guide them through obtaining and retaining a job (McDonough & Whittenburg, 2020; Wehman et al., 2007). However, limited research has been done on the SE experiences and outcomes of transition-age youth with IDD (Wehman et …

Examining The Behavioral And Phyisiolgical Effects Of D-Methamphetamine Administered Via E-Cigarette Aerosolization, Srikethan Mahavadi

Theses and Dissertations

Abstract

EXAMINING THE BEHAVIORAL AND PHYISIOLGICAL EFFECTS OF D-METHAMPHETAMINE ADMINISTERED VIA E-CIGARETTE AEROSOLIZATION

By Srikethan Mahavadi, B.S.

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University

Virginia Commonwealth University, 2021

Principal Investigator: Dr. Keith Shelton, PhD., Department of Pharmacology & Toxicology

E-cigarettes have become increasing popular worldwide. They are primarily used as a means to deliver nicotine to users, but these devices may also be used to administer a wide range of other substances including psychomotor stimulants such as d-methamphetamine. Methamphetamine has been widely abused throughout the United States …

Alcohol And Other Addictive Behaviors Among Bariatric Surgery Patients, Rachel M. Arnold

Theses and Dissertations

Research has repeatedly highlighted a high rate of comorbidity of addictive behaviors in both clinical and non-clinical samples. While polydrug use has received significant attention in recent years, less is known about rates of comorbidity with behavioral addictions such as eating, work, exercise, or sex. Individuals with a history of bariatric surgery may provide a unique opportunity to examine the potential co-occurrence of addictive behaviors. High rates of food addiction symptoms and changes in alcohol use patterns post-surgically have highlighted a potential gap in our understanding of bariatric patients and their needs post-surgically. Using a composite measure of addictive behaviors, …

Characterizing The Patterns, Predictors, And Processes Involved In Recovery From Substance Use Disorders, Rebecca L. Smith

Theses and Dissertations

Alcohol and drug use disorders are associated with significant cost to individuals, families, and society.Approximately 40-75% of affected individuals remit from alcohol use disorders (AUD). Although the development of AUD is well studied, recovery from AUD and factors that contribute to recovery are not as well characterized. With the definition of recovery evolving towards a process rather than an outcome, there is a need to better understand psychosocial functioning and quality of life among individuals at different points in their recovery journeys. Concurrently, additional research is needed to understand the interplay between sources of recovery capital, individual differences in risk …

Incorporating Ontological Information In Biomedical Entity Linking Of Phrases In Clinical Text, Evan French

Theses and Dissertations

Biomedical Entity Linking (BEL) is the task of mapping spans of text within biomedical documents to normalized, unique identifiers within an ontology. Translational application of BEL on clinical notes has enormous potential for augmenting discretely captured data in electronic health records, but the existing paradigm for evaluating BEL systems developed in academia is not well aligned with real-world use cases. In this work, we demonstrate a proof of concept for incorporating ontological similarity into the training and evaluation of BEL systems to begin to rectify this misalignment. This thesis has two primary components: 1) a comprehensive literature review and 2) …

Modification Of Culture Medium And Identification Of Microbial Contaminants For Improved In Vitro Propagation Of Freshwater Mussels, Raquel M. Wetzell

Theses and Dissertations

In vitro propagation efforts play an essential role in conserving and restoring threatened freshwater mussel populations by circumventing the need for a fish host. Across a broad range of taxa, transformation is induced with an artificial M199 medium and rabbit serum. However, such formulation may not be sufficient in culturing critical species with more specific physiological requirements. In this study, multiple serum mixtures were tested to improve in vitro transformation of two freshwater mussel species: yellow lampmussel (Lampsilis cariosa) and tidewater mucket (Atlantaconcha ochracea). These species were selected because they parasitize similar fish host species but …

A Thematic Analysis Of African American Fathers' Emotion-Related Beliefs And Behaviors, Deon Brown

Theses and Dissertations

This study explored African American fathers’ beliefs about and experiences with their own and their children’s negative emotions (i.e., parental meta-emotion philosophy and parental emotion socialization). Participants included 58 African American fathers in the Midwestern region of the United States between the ages of 29 and 40 (Mage = 30.94). 57 were biological fathers and one was a stepfather to toddlers between 24 and 31 months of age. Participants were invited to complete lab tasks, including the meta-emotion interview (MEI). The MEI is semi-structured interview of parents’ and their children’s negative emotion (i.e., sadness and anger). I selected a subset …

Using Individual Determinants To Predict Behavioral Health Service Use In Integrated Pediatric Primary Care, Alfonso L. Floyd Jr.

Theses and Dissertations

Mental health problems (e.g., attention, externalizing, internalizing) are commonly observed in youth and are often associated with significant impairment and an increased need for mental health services. Conceptual frameworks, such as Andersen’s Behavioral Model of Health Service Utilization, have proposed that several individual determinants (e.g., predisposing, enabling, and need factors) may influence service use for mental health problems among youth. Despite the glaring need for mental health treatment among youth with mental health problems, studies indicate that many affected youths do not receive mental health care. Integrated pediatric primary care (IPPC) settings provide an ideal setting for youth and families …

Investigating The Role Of Nlrp3 Inflammasome In Chemotherapy-Induced Peripheral Neuropathy, Urszula O. Warncke

Theses and Dissertations

Paclitaxel and oxaliplatin are commonly used antineoplastic drugs that cause chemotherapy-induce peripheral neuropathy (CIPN) in up to 90% of patients. The sensory symptoms of CIPN include numbness, loss of proprioception, tingling, spontaneous burning, shooting or electric shock-like pain, mechanical and thermal allodynia, and cold hypersensitivity among others. Affected patients struggle with daily activities, have a low quality of life, and might stop cancer treatment. Unfortunately, there are no effective prophylactic or therapeutic treatments for these side effects. Many studies point to the involvement of inflammation as a major contributor of CIPN pathology. We investigated the effects of genetic (NLRP3 …

Crosstalk Between Hippo And Rb Tumour Suppressor Pathways In Ovarian Cancer, Fatmata Sesay

Theses and Dissertations

The cell cycle is a highly regulated process that ensures the timely and accurate division of cells. Events of the normal cell cycle fall under two categories - positive and negative regulatory mechanisms. The first category, positive regulatory machinery, includes active protein complexes of cyclins in association with their partnering cyclin-dependent kinases (cyclin/CDK), which mediate series of phosphorylation events that relay a cell cycle progression from one stage to the next. The second category, the negative regulatory mechanisms, include the checkpoint controls consisting of the retinoblastoma (RB) family of proteins, some of which can form a transcriptional repressor complex DREAM. …

Do Coverage Expansion And Patient-Centeredness Care Delivery Improve Patient Health Outcomes And Care Quality?, Shiva Salehian

Theses and Dissertations

Although correlated, improvement of patient health outcomes and quality of care is a result of health care delivery, performance, and healthcare policies that intend to impact health outcomes (Porter, 2010; AHRQ, 2015). This dissertation focuses on a special model of care delivery (Patient-Centered Medical Homes (PCMH)) and two programs (Addiction and Recovery Treatment Services (ARTS) and Medicaid expansion) to examine the correlation and impact of these programs on cardiovascular-related preventive care, healthcare expenditures, and health behavior hospitalizations as patient outcomes.

Artificial Intelligence-Powered Chronic Wound Management System: Towards Human Digital Twins, Salih Sarp

Theses and Dissertations

Artificial Intelligence (AI) has witnessed increased application and widespread adoption over the past decade. AI applications to medical images have the potential to assist caregivers in deciding on a proper chronic wound treatment plan by helping them to understand wound and tissue classification and border segmentation, as well as visual image synthesis.

This dissertation explores chronic wound management using AI methods, such as Generative Adversarial Networks (GAN) and Explainable AI (XAI) techniques. The wound images are collected, grouped, and processed. One primary objective of this research is to develop a series of AI models, not only to present the potential …

Bioinformatic Pipeline For Determining Terminal Repeats In The Human Cytomegalovirus Genome Assembled With Pacbio Long Read Sequences, Ahmed Al Qaffas

Theses and Dissertations

Human Cytomegalovirus (HCMV) is a member of the betaherpesvirinae subfamily of the Herpesvirus family. HCMV infection is common among adults worldwide, with an estimated seroprevalence of 66 to 95%, depending on the geographic region (Zuhair et al., 2019). Although most of the virus genomic content has been studied extensively, the terminal repeating region sequences remain understudied. Two main challenges hindered the study of the region: a) limitations of sequencing technologies; and b) misassembly of the repeats due to its complex nature. Here I show a novel bioinformatics pipeline that takes advantage of PacBio's long reads to resolve the challenges mentioned …

Effect Of Viscoelasticity On Cellular Morphology And Activity, Thomas J. Petet Jr

Theses and Dissertations

It has been well established that there is a link between substrate stiffness and cellular activities such as proliferation, migration, and differentiation. Less characterized is the link between the time-dependent viscosity of a substrate with those cellular activities. To explore this, PDMS substrates were created with predictably tunable stiffness and viscosity parameters. A simulated model was also developed in parallel to explore the potential effects of viscosity in a computationally predictive way. It was found that the inclusion of viscosity caused a major paradigm shift to a non-zero substrate equilibrium that was sensitive to increases in the substrate stiffness. Finally, …

Structure-Based Drug Discovery And Development Of Protein Structure Prediction Tools Using An Empirical Force Field, Noah B. Herrington

Theses and Dissertations

Traditional drug discovery has rapidly accelerated thanks to development of computational molecular modeling. The crucial component that these computational studies hinge upon is having a well-defined, and energetically favorable structure. Structures of proteins and ligands that meet these criteria are important for accurately simulating models used to study drug binding. To demonstrate the role of accurate structure simulation in the study of these events, this thesis presents, first, a story examining the problem of accurate structure modeling of ionizable residues within protein structures, specifically aspartic acid, glutamic acid, and histidine. I present our method, which uses the HINT force field …

Investigating The Potential Causal Relationship Between Free Will Belief And Well-Being, Courtney J. Alderson

Theses and Dissertations

This multi-study dissertation had four primary aims. My first was to add to the evidence base indicating a positive association between free will belief (FWB) and subjective well-being (SWB). My second aim was to develop a measure to assess the FWB theme referred to as the principle of alternate possibilities (PAP). To achieve the first two aims, I conducted two cross-sectional studies to further establish the FWB-SWB association and start the development and assessment of a new PAP FWB measure. In the first study (N=995), I hypothesized that an EFA of the new PAP items would produce at least a …

Secondary English Teachers’ Experiences Of Agency: Connections To Shifting Educational Contexts During Covid-19, Kristina Lee

Theses and Dissertations

The COVID-19 pandemic caused schools around the world to enter uncharted territory. Due to the unprecedented nature of the educational crisis, it was important to examine how teacher agency may have been affected. Teacher agency can have important implications for school climate, policy, and the experience of stakeholders. The main focus of this study was to cultivate an understanding of secondary English teachers’ perceptions of agency as they navigated teaching throughout the COVID-19 pandemic. An ecological framework was used to examine teachers’ experiences of agency in the context of COVID-19. The study utilized a basic qualitative design with in-depth interviews …

Assessing Medical Discrimination, Mistrust, And Healthcare Engagement As Predictors Of Covid-19 Vaccination Among Transgender And Gender Diverse Individuals, Shelby A. Smout

Theses and Dissertations

As of March 11^th 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic. Early studies conducted among LGBT+ communities indicated that individuals of color and transgender individuals were more likely to express hesitation towards a possible COVID-19 vaccine. Such hesitation can be explained by historical medical mistreatment of people of color and LGBT+ communities which contributes to higher medical mistrust within these populations. The present study assessed vaccination behaviors among a sample of transgender and gender diverse individuals (N=385) and results indicated an association amongst experiences of discrimination in healthcare, medical mistrust, COVID-19 mistrust, barriers to vaccination, …

“There Was Some Sort Of Missing Middle”: Lived Experiences Of Jewish Youth With Intellectual And Developmental Disabilities, Aliza Lambert

Theses and Dissertations

Though religion and spirituality contribute to overall well-being (Koenig, 2012; Koenig & Cohen, 2002), social support (Biggs & Carter, 2016; Koenig & Cohen, 2002; Taub & Werner, 2016), quality of life (QOL; Myers & Sweeney, 2000), coping strategies (Krok, 2008), and lower rates of depression and anxiety (Brown et al., 2013; Young et al., 2000), religion and spirituality are seldom included in curriculum in counselor education and supervision doctoral programs (Adams et al., 2015; Henriksen et al., 2015). In the present study, the researcher uses a multiple-case study design to describe the lived experiences of Jewish youth with intellectual and …