Digital Commons Network^™

Integrating Genetics And Neuroimaging To Study Subtypes Of Binge Drinkers, Megan E. Cooke

Theses and Dissertations

Risky alcohol use is a major health concern among college students, with 40.1% reporting binge drinking (5 or more drinks in one occasion) and 14.4% reporting heavy drinking (binge drinking on 5 or more occasions) in the past month. Risky alcohol use is thought to be the result of a complex interplay between genes, biological processes, and other phenotypic characteristics. Understanding this complex relationship is further complicated by known phenotypic heterogeneity in the development of alcohol use. Developmental studies have suggested two pathways to risky alcohol use, characterized by externalizing and internalizing characteristics, respectively. However, the underlying biological processes that …

The Effects Of The Hiv-1 Tat Protein And Morphine On The Structure And Function Of The Hippocampal Ca1 Subfield, William D. Marks

Theses and Dissertations

HIV is capable of causing a set of neurological diseases collectively termed the HIV Associated Neurocognitive Disorders (HAND). Worsening pathology is observed in HIV+ individuals who use opioid drugs. Memory problems are often observed in HAND, implicating HIV pathology in the hippocampus, and are also known to be exacerbated by morphine use. HIV-1 Tat was demonstrated to reduce spatial memory performance in multiple tasks, and individual subsets of CA1 interneurons were found to be selectively vulnerable to the effects of Tat, notably nNOS+/NPY- interneurons of the pyramidal layer and stratum radiatum, PV+ neurons of the pyramidal layer, and SST+ neurons …

Impact Of Chemotherapy On Nicotine Dependence, Yasmin Alkhlaif

Theses and Dissertations

Although cigarette smoke has been implicated in a causal relationship with various types of cancers, around 62% of all cancer patients are current smokers, recent quitters, or former smokers. While most patients who are smokers are motivated to quit after cancer diagnosis, 25 -30% of these patients continue to smoke. Furthermore, most quitters relapse after 2-3 years of post-chemotherapy. This represents a major health concern since several clinical studies revealed that perpetuation of smoking in cancer populations attenuates patient's well-being and quality of life. Smoking may impair healing, attenuate the efficacy of chemotherapy, increase the disease complications and diminish survival …

The Pharmacology Of An Agonist Medication To Treat Stimulant Use Disorder, Amy Johnson

Theses and Dissertations

Cocaine use disorder is a serious public health issue for which no approved pharmacotherapies exist. The development of a pharmacotherapy for cocaine use disorder is a priority for the National Institute on Drug Abuse. Amphetamine maintenance has been shown to be effective to reduce cocaine use in double-blind placebo controlled clinical trials, but has not been approved due to concerns over safety and abuse liability. Development of new pharmacotherapies is facilitated by preclinical testing for effectiveness and identification of new targets for medication development. The first part of this dissertation develops a novel non-human primate cocaine self-administration choice procedure that …

Structure-Activity Relationship Studies Of Bupropion And Related 3-Substituted Methcathinone Analogues At Monoamine Transporters, Abdelrahman R. Shalabi

Theses and Dissertations

The khat plant, catha edulis, has been abused for some time in the Middle East and the African horn for its short-term stimulant effects. However, it was not until 1975 when cathinone, β-ketoamphetamine, was identified as the major stimulant component of khat. Structural analogues of cathinone, synthetic cathinones, are new psychoactive substances available on the clandestine market of numerous countries including the USA. Abuse of these new illicit stimulants is a worldwide growing health concern which necessitates the investigation of the pharmacological properties of these new drugs of abuse. The abuse liabilities of these compounds seem to be related …

Investigating The Relationship Between Emotional Intelligence And Cultural Intelligence To Attitudes Towards Team-Based Learning In Undergraduate Pre-Health Profession Students, Kevin A. Harris

Theses and Dissertations

Improving patient outcomes has long been the rationale supporting calls to reform health care delivery systems and health profession education programs (Greiner, 2002; Institutes of Medicine, 2001, 2004; O’Neil & Pew Health Professions Commission, 1998). In 2003, the Institute of Medicine shared its vision statement for health professions education, asserting that “[a]ll health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches and informatics” (Knebel & Greiner, 2003, p. 3).

Despite the importance placed on teamwork in health sciences education, little attention has been devoted to understanding underlying factors …

A Pilot Study To Measure Dynamic Elasticity Of The Bladder During Urodynamics, Andrew F. Colhoun, Adam P. Klausner, Anna S. Nagle, Ashley W. Carroll, Robert W. Barbee, Paul H. Ratz, John E. Speich

Surgery Publications

AIMS: Previous studies using isolated strips of human detrusor muscle identified adjustable preload tension, a novel mechanism that acutely regulates detrusor wall tension. The purpose of this investigation was to develop a method to identify a correlate measure of adjustable preload tension during urodynamics.

METHODS: Patients reporting urgency most or all of the time based on ICIq-OAB survey scores were prospectively enrolled in an extended repeat fill-and-empty urodynamics study designed to identify a correlate of adjustable preload tension which we now call dynamic elasticity. Cystometric capacity was determined during initial fill. Repeat fills to defined percentages of capacity with passive …

Characterization Of Lower Urinary Tract Symptoms In Patients With Idiopathic Normal Pressure Hydrocephalus, Sarah C. Krzastek, William M. Bruch, Samuel P. Robinson, Harold F. Young, Adam P. Klausner

Surgery Publications

AIMS: The purpose of this study was to evaluate lower urinary tract symptoms (LUTS) in idiopathic normal pressure hydrocephalus (iNPH).

METHODS: Patients with new-onset iNPH were prospectively evaluated for LUTS via detailed history and physical, and administration of questionnaires from the International Consultation on Incontinence to assess incontinence (ICIq-UI), overactive bladder (ICIq-OAB), and quality of life (ICIq-LUTqol), as well as the American Urological Association Symptom Score bother scale. All patients with moderate-to-severe LUTS were offered urodynamic testing. Sub-analysis was performed based on gender, medical comorbidities, and age.

RESULTS: Fifty-five consecutive patients with iNPH completed the initial evaluation and surveys. Total …

Modulating The Innate Immune Response To Electrospun Scaffolds And Polymer Degradative Byproducts, Daniel Abebayehu

Theses and Dissertations

Implanted biomaterials often induce inflammation that frequently leads to the foreign body response, fibrosis, and the failure of the implant. Thus, it is important to evaluate how cells interact with materials to promote a more regenerative response. It is critical to determine how to modulate the response of tissue resident innate immune cells, as they are among the first cells to interact with implanted materials. Among tissue resident innate immune cells are mast cells, which are inflammatory sentinels that degranulate and orchestrate the fate of other cell populations, such as monocytes/macrophages and lymphocytes. Mast cells have also been reported to …

Evaluation Of Volumetric Change Of Periapical Lesions After Apicoectomy As A Measure Of Postsurgical Healing Utilizing Cone Beam Computed Tomography, Eshwar Arasu

Theses and Dissertations

The aim of this study was to evaluate whether volumetric changes in persistent periapical lesions can be detected in follow-ups six months to five years after apicoectomy using cone-beam computed tomography. Patients with a previous treatment history of apicoectomy and for whom a pre-surgical CBCT scan was taken between November 2010 and December 2015 were invited to participate in the study. A post-surgical CBCT image of the treated tooth was obtained at the recall visit. Volumetric and linear measurements of periapical lesions on initial and postoperative CBCT images were performed using DiThreshGUI software and two calibrated examiners—a board-certified endodontist and …

Impact Of School-Based Sex Education On College Students’ Rape Myth Acceptance: An Exploratory Analysis, Erika Carpenter

Theses and Dissertations

Research indicates nearly one-fourth of college women fall victim to sexual assault (Cantor et. al., 2015). Two predictors of high proclivity to rape are endorsement of rape myths and adherence to traditional gender norms (King & Roberts, 2011). Additionally, research shows school-based sex education in the United States presents gender and sexual norms in troubling ways that disproportionately harm women (Kendall, 2013). However, research on sexual assault and rape myths have not examined the impact school-based sex education has on rape supportive attitudes. This study aimed to bridge that gap by using original survey data from undergraduate students at a …

Orthodontists' And Parents' Perspective Of Occlusion In Varying Anterior-Posterior Positions: A Comparative Study, David H. Lindsey

Theses and Dissertations

Objective: The purpose was to compare orthodontists’ and parents’ perception of orthodontic treatment outcomes in the anterior-posterior (AP) dimension. Assessment of treatment time and compliance were also investigated.

Material and Methods: Parallel surveys for orthodontists (n=1000) and parents (n=750) displayed occlusions from 3 mm Class III (Cl III:3) to 3 mm Class II. Participants rated occlusal relationships on a 100 mm VAS from least to most acceptable (0-100).

Results: 233 orthodontists (23%) and 243 parents (32%) responded. Orthodontists (mean=93.9, 25.9) and parents (mean=80.7, 40.9) rated Class I (Cl I) occlusion most and Cl III:3 least acceptable. No significant difference was …

Abuse-Related Behavioral Effects Of Oxycodone In The Mouse And Their Modulation By Hiv-1 Tat Expression, Rachel M. Enga

Theses and Dissertations

Abuse of prescription opioids has become epidemic and oxycodone is among the most frequently abused of these drugs. Opioid misuse is a risk factor for HIV infection and its chronic use by HIV-infected individuals can be accompanied by worsened progression to AIDS, cellular damage, and behavioral deficits collectively termed “neuroAIDS”. This toxicity is likely attributable, in part, to the interaction of opioids with the neurotoxic HIV-1 Tat protein. The ultimate objective of this dissertation was to characterize the interaction of HIV-1 Tat expression with the abuse-related effects of oxycodone. Physical dependence, drug self-administration, and sensitization are three classes of phenomena …

Thyroid Hormone As A Method Of Reducing Damage To Donor Hearts After Circulatory Arrest, William P. Adams

Theses and Dissertations

There is a chronic lack of donor hearts to meet the need for heart transplant both in the US and worldwide. Further, the use of available hearts is limited by the short period between collection and implantation during which the heart can be safely preserved ex vivo. Using mid-thermic Langendorff machine perfusion, we have been able to preserve the metabolic function of a healthy heart for up to 8 hours, twice the limit for current static cold storage. We have also been able to preserve the metabolic function of a damaged DCD Heart collected 30 minutes after cardiac arrest …

Design For Disassembly - A Circular Approach, Wajiha Pervez

Theses and Dissertations

As the world becomes increasingly aware of the need to better care for the environment, innovative business models are helping to counter the damage of the fast fashion system - a phenomenon in the fashion industry whereby production processes are expedited in order to get new trends to the market as quickly and cheaply as possible.

Designing products with a focus on their renewability can shift the product-consumer relationship. The closed loop concept of a “circular economy” is emerging as a viable and promising solution to the current linear business model.

This study explores the possibilities of a more mindful …

A Comparison Of Moderate Oral Sedation Drug Regimens For Pediatric Dental Treatment: A Pilot Study, Ojas A. Parikh

Theses and Dissertations

Purpose: Compare moderate oral sedation of pediatric patients using Hydroxyzine and Meperidine with either Diazepam or Midazolam in management of pediatric dental patients.

Methods: Randomized, double-blind, crossover pilot study of patients 3 to 7 years of age requiring two sedation visits. Frankl and Houpt behavior scores recorded at injection time, initiation of treatment and 100% oxygen at end of treatment. Postoperative phone call surveys conducted within eight hours and within 24 hours of discharge. Wilcoxon Signed-Rank tests, Fisher’s Exact Chi-squared test and 0.10 significance level.

Results: 25 subjects completed 35 sedations. Eight participants completed both treatments and demonstrated significantly higher …

Uncovering The Progress Of Planning For Vulnerability To Sea-Level Rise & Coastal Storms: A Plan Evaluation Of Norfolk, Va & New York City, Eric K. Borchers

Theses and Dissertations

In response to recent storms like Superstorm Sandy and sea-level rise influenced by climate change, cities, particularly those located at the coast, have taken initiative to combat these growing threats with adaptive urban planning. Although civilians residing in susceptible neighborhoods are often the most vulnerable socioeconomically, there has been minimal evidence that planning has accounted for the characteristics of vulnerability. This thesis evaluates the recent planning efforts and vulnerability of Norfolk, VA and New York City to gauge the progress being made toward reducing citizen vulnerability and raising adaptability and preparedness. The most recent peer-reviewed research is consulted to forge …

Evaluation Of The Regional Drug Deposition Of Nasal Delivery Devices Using In Vitro Realistic Nasal Models, Mandana Azimi

Theses and Dissertations

The overall objectives of this research project were i) to develop and evaluate methods of characterizing nasal spray products using realistic nasal airway models as more clinically relevant in vitro tools and ii) to develop and evaluate a novel high-efficiency antibiotic nanoparticle dry powder formulation and delivery device. Two physically realistic nasal airway models were used to assess the effects of patient-use experimental conditions, nasal airway geometry and formulation / device properties on the delivery efficiency of nasal spray products. There was a large variability in drug delivery to the middle passages ranging from 17 – 57 % and 47 …

Misencounters, Francisco J. Besa

Theses and Dissertations

We are immersed in an era of supermodernity, an age defined by excesses: of information—the acceleration of historical time—spatial overabundance—the nullification of distance by electronic media and transportation—and an excess of self-reflexive individuality. In this context, the idea of place is giving way to non-places: designed spaces in which social relations are tangential and the boundary between the individual and the group is increasingly mediated. Media plays an important role in the creation of non-places, by favoring a removed form of communication made pervasive and extensive through mobile devices. The blurring of the line between media and actuality …

Orientia Tsutsugamushi Secretes Two Ankyrin Repeat-Containing Effectors Via A Type 1 Secretion System To Inhibit Host Nf-Κb Function, Sean M. Evans

Theses and Dissertations

Scrub typhus is a potentially fatal infection that threatens one billion persons in the Asia-Pacific region and is caused by the obligate intracellular bacterium, Orientia tsutsugamushi. How this organism facilitates its intracellular survival and pathogenesis is poorly understood. Intracellular bacterial pathogens utilize the Type 1 (T1SS) or Type 4 secretion system (T4SS) to translocate ankyrin repeat-containing proteins (Anks) into the host cell to modulate host cell processes. The O. tsutsugamushi genome encodes one of the largest known bacterial Ank libraries as well as Type 1 and Type 4 secretion systems (T1SS and T4SS), which are expressed during infection. In …

Role Of Epigenetic Modification And Immunomodulation In A Murine Prostate Cancer Model, Jay E. Sulek, Samuel P. Robinson, Albert A. Petrossian, Shaoqing Zhou, Ekaterine Goliadze, Masoud H. Manjili, Amir Toor, Georgi Guruli

Surgery Publications

INTRODUCTION. Decreased expression of highly immunogenic cancer-testis antigens (CTA) might help tumor to achieve low immunogenicity, escape immune surveillance and grow unimpeded. Our aim was to evaluate CTA expression in tumor and normal tissues and to investigate possible means of improving the immune response in a murine prostate cancer (CaP) model by using the combination of epigenetic modifier 5-azacitidine (5-AzaC) and immunomodulator lenalidomide. No study to date has examined the effect of this combination on the prostate cancer or its impact on antigen-presenting cells (APC).

MATERIALS AND METHODS. Gene microarrays were performed to compare expression of several CTA in murine …

Operative And Nonoperative Management Of Blunt Liver Injuries, Jill Peysha, Paula Ferrada

Surgery Publications

Purpose of Review

The purpose of this review is to discuss the indications for operative and nonoperative management in patients with blunt liver injuries.

Recent Findings

Over the past several years, research has begun to show that nonoperative management in blunt liver injuries is feasible and has favorable outcomes over immediate operations in patients who are hemodynamically stable. This includes high-grade injuries who were previously taken to the operating room, in the absence of peritoneal signs or instability, for washout and packing. This trend in management is likely multifactorial and includes improved quality of critical care medicine, advances in imaging …

History Of The Innovation Of Damage Control For Management Of Trauma Patients: 1902-2016, Derek J. Roberts, Chad G. Ball, David V. Feliciano, Ernest E. Moore, Rao R. Ivatury, Charles E. Lucas, Timothy C. Fabian, David A. Zygun, Andrew W. Kirkpatrick, Henry T. Stelfox

Surgery Publications

Objective: To review the history of the innovation of damage control (DC) for management of trauma patients.

Background: DC is an important development in trauma care that provides a valuable case study in surgical innovation.

Methods: We searched bibliographic databases (1950-2015), conference abstracts (2009-2013), Web sites, textbooks, and bibliographies for articles relating to trauma DC. The innovation of DC was then classified according to the Innovation, Development, Exploration, Assessment, and Long-term study model of surgical innovation.

Results: The "innovation'' of DC originated from the use of therapeutic liver packing, a practice that had previously been abandoned after World War II …

A Meta-Analysis Of Resuscitative Endovascular Balloon Occlusion Of The Aorta (Reboa) Or Open Aortic Cross-Clamping By Resuscitative Thoracotomy In Non-Compressible Torso Hemorrhage Patients, Ramiro Manzano Nunez, Maria Paula Naranjo, Esteban Foianini, Paula Ferrada, Erika Rincon, Herney Andrés García-Perdomo, Paola Burbano, Juan Pablo Herrera, Alberto F. García, Carlos A. Ordoñez

Surgery Publications

Background

The objective of this systematic review and meta-analysis was to determine the effect of REBOA, compared to resuscitative thoracotomy, on mortality and among non-compressible torso hemorrhage trauma patients.

Methods

Relevant articles were identified by a literature search in MEDLINE and EMBASE. We included studies involving trauma patients suffering non-compressible torso hemorrhage. Studies were eligible if they evaluated REBOA and compared it to resuscitative thoracotomy. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for final analysis. We conducted meta-analysis using random effect models.

Results

We included three studies in our systematic review. These studies included …

Tim's First Tour, John Price

Mighty Pen Project Anthology & Archive

A veteran father reminisces about the son he lost to the war in Afghanistan.

Articles, stories, and other compositions in this archive were written by participants in the Mighty Pen Project. The program, developed by author David L. Robbins, and in partnership with Virginia Commonwealth University and the Virginia War Memorial in Richmond, Virginia, offers veterans and their family members a customized twelve-week writing class, free of charge. The program encourages, supports, and assists participants in sharing their stories and experiences of military experience so both writer and audience may benefit.

Against Critical Race Theory, Paul C. Mocombe

Ethnic Studies Review

Critical Race Theory (CRT) seeks to apply the negative dialectics of critical theory to the intersection of race, law, and power in the pursuit of racial and ethnic equality in Western society. That is to say, critical race theorists seek to convict Western society for not identifying with their values due to the prevalence of racial and ethnic oppression and subordination in the society. I argue here that this pursuit of racial emancipation and anti-subordination through the negative dialectics of critical theory by critical race theorists offers a false sense of racial difference which is convicting the values of the …

Black Lives Matter: Decrypting Encrypted Racism, Basil Ugorji

Ethnic Studies Review

The agitation of the Black Lives Matter movement has dominated the public discourse in the United States. Mobilized against the killing of unarmed black people, the movement and their sympathizers have made a series of demands for justice and dignity for the black people. However, many critics have raised concern over the legitimacy of the phrase, black lives matter since all lives irrespective of race, should matter. This article does not intend to pursue the ongoing debate over the semantic use of black lives or all lives. Instead, the paper seeks to study, through the lenses of the African American …

The Birth Of A Cinematic Storyline Normalizing Violence Against Black Lives, James Curiel

Ethnic Studies Review

The first Hollywood blockbuster, The Birth of a Nation, did more than establish cinematic conventions of camera techniques and movie distribution, for it also established a conventional storyline whereby white, patriarchal power is re-established through violence led by a white savior. This storyline can be traced throughout the history of major blockbusters such as Gone with the Wind of 1939, the cavalry trilogy by John Ford in the 1940s, The Omega Man from 1971, and The Outlaw Josie Wales from 1976. A quandary thus arises as to why The Birth of a Nation is held in such infamy and disdain …

Nitrosative Stress Sensing In Porphyromonas Gingivalis: Structure And Function Of The Heme Binding Transcriptional Regulator Hcpr, Benjamin R. Belvin

Theses and Dissertations

Porphyromonas gingivalis, a Gram negative anaerobe implicated in the progression of periodontal disease, is capable of surviving and causing infection despite high levels of reactive nitrogen species found in the oral cavity due to its efficient nitrosative stress response. HcpR is an important sensor-regulator that plays a vital step in the initiation of the nitrosative stress response in many Gram negative anaerobic bacteria. We employ a combination of X-ray crystallography, SAXS, resonance Raman spectroscopy, UV-Vis spectroscopy, and molecular biology techniques to better understand this key regulator. Knockout of the hcpR gene in W83 P. gingivalis results in the inability of …

Salvianolic Acid B For Pulmonary Delivery Towards Reversal Of Emphysema, Sneha Dhapare

Theses and Dissertations

A new pathobiologic hypothesis has recently emerged that the alveolar structural destruction and loss in emphysema are caused by the deficiency of vascular endothelial growth factor (VEGF). Therefore, this project hypothesized that such pathobiologic VEGF deficiency of emphysematous lungs can be recovered with a natural caffeic acid tetramer, salvianolic acid B (SalB), through activation of signal transducer and activator of transcription 3 (STAT3), so that emphysema can be reversed as a result of inhibition of induced cell death, stimulation of cell proliferation and migration, and promotion of stem cell recruitment to the lungs.

SalB was first shown to be potently …