Cannabis Use Among Cancer Survivors And The Impact On Cancer-Related Pain, Tiffanie A. Vargas

Theses and Dissertations

With a growing population of older adult cancer survivors—many of whom experience cancer-related pain—interest in medical cannabis as a pain management strategy has increased. This secondary analysis used data from the 2022 U.S. Behavioral Risk Factor Surveillance System (BRFSS) to examine cannabis use behaviors among cancer survivors and assess associations with cancer-related pain. The study had three aims: (1) to describe 30-day cannabis use (prevalence, intensity, and administration routes) by chronic health condition and cancer diagnosis, focusing on non-melanoma skin cancer, melanoma, and other cancers; (2) to compare demographics, health characteristics, and tobacco use by cannabis use status among cancer …

Investigating Mitochondrial Stress Response Mechanisms In Aging, Aileigh E. Daniel

Theses and Dissertations

Mitochondrial dysfunction is widely recognized as a key contributor to aging and age-related diseases. The concept of mitohormesis suggests that low levels of ROS can activate stress-responsive transcription factors, promoting adaptive mechanisms that enhance longevity. We hypothesized that changes in protein abundance under conditions of mild mitochondrial stress reflect an adaptive response, and that commonly altered proteins across diverse genetic backgrounds of mitochondrial stress can help identify key regulators of stress resilience and aging. Our study identified conserved mitochondrial stress response pathways and highlighted candidate regulators for further investigation. These regulators appear to impair mitochondrial energy production by downregulating ATP …

Substrate Preference And Foraging Behavior Of Two Declining Warblers In Appalachian Shrublands, Samantha Fishman

Theses and Dissertations

Abstract Shrubland and early successional habitats (ESH) support a diversity of wildlife, including many declining songbirds. However, nonnative shrubs increasingly dominate these habitats, potentially altering habitat quality by influencing prey availability. Habitat quality can be assessed by observing foraging behaviors of songbirds and identifying preferred and avoided substrates as well as testing the predictions of optimal foraging theory; specifically that birds will maximize their energy gain relative to the costs. We examined foraging behaviors of Golden-winged Warblers (Vermivora chrysoptera; GWWA) and Chestnut-sided Warblers (Setophaga pensylvanica; CSWA) in ESH on private lands in Virginia with varying amounts …

Strength Imbalances And Shoulder Pain In Manual Wheelchair Users Stratified By Age Of Spinal Cord Injury/Disorder (Sci/D) Onset, Ashlyn M. Jones

Theses and Dissertations

Introduction The majority of manual wheelchair users (MWUs) with spinal cord injury or disorder (SCI/D) develop shoulder pain. In adults with SCI/D, there is evidence that upper limb strength imbalances are associated with shoulder pain. However, strength imbalances may indicate protective compensatory strategies, and other factors may be important contributors to pain. Currently, personalized prevention and management of pain is limited, little is known about joint strength imbalances and pain in children who use manual wheelchairs, and the effect of the age of SCI/D onset is poorly understood. The purpose of this study was to assess the effect of age …

Unleashing Serine Palmitoyltransferase In Test Tubes And Mice, Matthew W. Peart

Theses and Dissertations

Canonically known both for structural contributions to lipid bilayers and roles in cell signaling, the sphingolipids comprise a dynamic, multifaceted class of molecules which are studied to understand homeostatic cell biology as well as pathophysiology. Sphingolipids contribute to tissue-specific structures such as myelin, a multilayer membrane that allows for rapid conduction of action potentials along neuronal axons. All sphingolipids are downstream products of the rate-limiting and initiating enzyme in the de novo sphingolipid synthesis pathway, Serine palmitoyltransferase (SPT). Demonstrative of its status as the enzyme that catalyzes a crucial step in a biochemical pathway, SPT activity is strictly regulated. This …

Reply Stop To Stop, Molly A. M. Garrett

Theses and Dissertations

Over the course of 8 years working in progressive political strategy, 2015–2023, I became increasingly critical of the systems, formulas and tools we were using to communicate with voters. Reply STOP to Stop is documentation of my time at graduate school, of wrestling with ideas of political design, language, communication and distribution. I analyzed my past work — all the texts, emails, social media posts, print ads, web banners, videos and other miscellaneous scripted content — and wondered if we would all be better off without it. Would elections be fairer, would there be less fake news, more community building? …

Hafnium Oxide-Based Nanoheterostructures For Catalytic Radiosensitization And Enhanced X-Ray Radiotherapy, Marlen Dariela Calix Quezada

Theses and Dissertations

Orthovoltage X-ray beams are attractive for surface and intra-operative radiotherapy. Yet, their clinical utility is constrained by rapid attenuation and the limited dose that can be delivered without harming healthy tissue. High-Z hafnium oxide (HfO₂) nanoparticles can boost local energy deposition through the photoelectric effect, while catalytic surface defects accelerate water radiolysis. Harnessing both mechanisms in a single nano-heterostructure could enable potent radiosensitization at diagnostic-range energies.

This thesis develops and evaluates HfO₂-based nanoheterostructures, both bare and Au-decorated, as catalytic radiosensitizers.

Two types of HfO₂ were evaluated, one was synthesized following a specific route and the …

Wander, Wonder: Beyond The Window, Se Young Lee

Theses and Dissertations

This thesis explores how small, site-specific interventions can reframe everyday spaces through acts of observation, walking, and placement. In response to the increasing detachment from physical environments caused by digitized, image-saturated culture, this research asks how gentle gestures might restore presence and embodied perception in overlooked urban sites.

Drawing on the notion of the flâneur and grounded in theories by Peter Zumthor, Rebecca Solnit, and others, walking is employed as a form of spatial inquiry—a way of thinking through movement, of seeing through slowness. Along a recurring route between home and studio, three underappreciated sites were identified and engaged through …

Enhancing Clinical Trial Matching In Molecular Diagnostics: Using Natural Language Processing And Clustering Approaches In Hematological Malignancies, Gillian Fanning

Theses and Dissertations

Clinical trial matching is a critical component of personalized medicine, particularly in the management of hematologic malignancies. At Virginia Commonwealth University (VCU) Health, the Molecular Diagnostics (MDX) Lab produces somatic variant reports and recommends clinical trials based on the presence of clinically significant mutations. However, the current manual trial recommendation process is time-intensive and lacks scalability.

This study introduces a computational framework to streamline and standardize clinical trial matching using natural language processing (NLP) and unsupervised clustering. Trial brief descriptions were analyzed to extract frequent terms, and trials were grouped based on term similarity using joint dimensionality reduction and clustering. …

Developing Bioinformatics Expertise Through The Annotation Of The Gut Microbiome Of Odontotaenius Disjunctus, Keidra E. Carter

Theses and Dissertations

Next-generation sequencing (NGS) technologies have revolutionized biological research by generating unprecedented volumes of genomic data, necessitating advanced bioinformatics tools and specialized expertise to fully interpret complex microbial communities. This study outlines an integrated workflow to characterize the gut microbiome of the wood-feeding beetle Odontotaenius disjunctus. Prokka is employed for functional annotation to identify protein-coding genes and other genomic features, while Kaiju is used for taxonomic classification. DIAMOND is then applied to locate and validate the taxonomic assignments generated by Kaiju by aligning sequences within the contigs to a comprehensive protein database, proGenomes. Functional analysis revealed that the contigs encode proteins …

Understanding The Experiences Of People Of Color Who Engage In Psychedelic Use, Amber B. Livingston

Theses and Dissertations

There is a growing body of research that supports the potential of psychedelic substances being used to support individuals with alleviating mental health symptoms such as depression, anxiety, and existential distress. Though it has been labeled that Western society is within a psychedelic renaissance, it should also be noted that many indigenous cultures have utilized plant-based medicines as a form of healing and connection. Despite the ever increasing amount of studies being conducted, a consistent deficit is the lack of representation of non-White individuals in research samples. Utilizing the theoretical framework of set and setting, the present study aims to …

Radical Hope Amid Generational Oppression And Puerto Rican Well-Being, Natalia Gomez Giuliani

Theses and Dissertations

Oppressive systems (e.g., colonialism, racism, capitalism) create a disparate distribution of power that, through various mechanisms, negatively impacts the health and well-being of members of the oppressed group. Boricuas have experienced over 500 years of oppression, with the island currently maintaining a colonial relationship with the United States. As these adverse effects of oppression are identified, the need for protective factors (e.g., hope) has emerged. This study explored how islander Boricuas practice radical hope, understand their history of oppression and resistance, and how they perceived it to impact their overall well-being. Utilizing a phenomenological qualitative approach, I conducted 15 semi-structured …

Health Equity In Times Of Crisis: The Impact Of Economic And Public Health Shocks On Access To Care Among Women In Zimbabwe And The United States, Vimbainashe Dihwa

Theses and Dissertations

Abstract

This dissertation examines health equity during times of national public health and economic crises by examining access to care among women of reproductive age. Papers 1 and 2 estimate the effects of the 2020 Covid-19 pandemic in the United States (US). Paper 3 examines the potential effects of the 2008 hyperinflation and subsequent economic crisis in Zimbabwe.

Paper 1 assessed the role of health professional shortage areas (HPSAs) in the Covid-19 pandemic-related temporal trends in mental health access among women in the 18 to 44 years age group with self-reported anxiety and/or depression. The findings suggest decreased unmet prescription …

Integration Of Phenotyping Into A Preliminary Investigation Of Stand-Alone Web-Based Cognitive Behavioral Therapy Among A Non-Treatment Seeking Sample, Anna B. Parlier-Ahmad

Theses and Dissertations

Alcohol use disorder (AUD) is the most common substance use disorder. However, most people with AUD do not receive treatment. Among those who do, it is only moderately effective largely due to the heterogeneity of people with AUD. Many of these individuals, particularly those with mild AUD, can reduce or cease alcohol use without specialized treatment. However, efforts to refer those with more severe AUD to community residential or outpatient programs have been largely unsuccessful, especially among women who often face practical barriers like lack of transportation and childcare. Technology offers innovative opportunities to make treatment more readily accessible to …

Narratives Of Illness Identity Development In Adolescents With Cancer, Rachel Holder

Theses and Dissertations

Introduction: Adolescence is a pivotal developmental stage characterized by the development of independence, autonomy, and identity. A diagnosis of cancer can be disruptive to this process (Grinyer, 2009; Hazen et al., 2008; Neylon et al., 2023). How one incorporates cancer into their identity, or illness identity, has been associated with clinical outcomes, including adherence, life satisfaction, psychosocial functioning, and health-related quality of life and could be a target for supportive interventions aimed at adolescents with cancer (Commissariat et al., 2020; Luyckx et al., 2008, 2018; Meyer & Lamash, 2020; Oris et al., 2016; Raymaekers et al., 2020). Prior literature has …

Trauma-Informed Beliefs And Our Child Welfare System, Gabriela Ana Aisenberg

Theses and Dissertations

The integration of trauma-informed care (TIC) into behavioral health and child welfare systems has garnered increasing attention, reflecting a growing acknowledgment of the pervasive and multifaceted impacts of trauma on individuals, families, and service delivery structures (Barnett et al., 2019; Bartlett et al., 2018; Bassuk et al., 2017; Substance Abuse and Mental Health Services Administration [SAMHSA], 2014). Legislation such as the Family First Prevention Services Act (FFPSA) has led to increased adoption of trauma-informed practices through increased funding for training and services (Bowen & Murshid, 2016; Brown et al., 2023). Research shows that providers’ understanding and implementation of TIC is …

Optimal Data Splitting Methods, Sujay Mudalgi

Theses and Dissertations

In predictive modeling, effective data splitting is crucial for creating statistically representative training and validation sets. The state-of-the-art data splitting methods are based on minimizing the energy distance between the split subsets. However, there are a number of limitations in the existing methods, which this dissertation aims to address. First, the existing methods were computationally inefficient. Thus, Chapter 2 proposes a method to scale up these approaches for big data. Here, we introduce scalable Twinning (s-Twinning), which significantly improves the execution speed of data splitting without sacrificing accuracy. Second, the existing methods did not consider the predictive relationship in the …

Machine Learning Models Leveraging Patient-Similarity And Clinical Temporality For Disease Prognoses, Ahmad F. Al Musawi

Theses and Dissertations

Electronic Health Records (EHRs) constitute a comprehensive and high-dimensional repository of clinical data, encompassing a wide array of patient-level information such as diagnoses, procedures, medications, laboratory results, and unstructured clinical narratives. These data hold immense potential for advancing predictive modeling in healthcare, including tasks such as disease progression modeling, hospital readmission prediction, and length of stay (LoS) estimation. However, the intrinsic complexity of EHR data—manifested in its heterogeneity, sparsity, and temporal dynamics—poses significant analytical challenges that limit the generalizability and interpretability of conventional machine learning models. Recent methodological advancements in deep learning and graph-based learning, particularly Graph Neural Networks (GNNs), …

Treatment Resistant Obesity Among Midlife Women Receiving Care From A Specialized Weight Management Clinic, Emily C. Stevens

Theses and Dissertations

Background: Obesity is a complex chronic disease that conveys significant health risk. Women with obesity are at greater risk for associated conditions including heart disease, hypertension, ischemic stroke, and sex-specific cancers compared to their male counterparts. Midlife may present unique challenges for women as it is during this life phase that they experience an increase in their overall obesity prevalence and severity. Some midlife women experience treatment resistant obesity (TRO), a phenomenon not previously explored in the research literature, conceptualized as failure to achieve clinically meaningful weight loss of ≥ 5% after having received medically specialized obesity care for one …

Characterization Of Nanoplastic-Induced Exacerbation Of Asthmatic Pathophysiology In A Murine In Vivo Model, Keith Li

Theses and Dissertations

As global plastic production increases, so does the environmental and biological presence of nanoplastics (NPs), raising growing concerns about their potential impact on human health. These particles have been detected in various organs, including the lungs, yet their role in respiratory inflammation remains largely unexplored. Emerging evidence suggests that NP exposure may influence immune responses in the lungs, particularly in individuals with preexisting conditions such as asthma. However, the specific ways in which these particles interact with allergen driven inflammation are still unclear.

In this study, a murine model of allergic airway inflammation was used to investigate how surface modified …

Intervertebral Lateral Bending Moment Differences In The Lumbar Spine Of Baseball Pitchers Across Throwing Velocities, Justin Humenay

Theses and Dissertations

Introduction Baseball pitching imposes substantial mechanical demands on the lumbar spine, a crucial link in the kinetic chain responsible for transferring energy from the lower body to the upper extremity. While increased pitch velocity is associated with greater trunk forces the specific intervertebral loading patterns during high-velocity pitching remain unclear. This study investigates differences in lateral bending moments across lumbar spinal segments between collegiate pitchers throwing at high versus low velocities.

Methods Twenty right-handed collegiate pitchers were divided into two groups: high-velocity (n = 10, 90.3 ± 1.6 mph) and low-velocity (n = 10, 81.6 ± 1.1 mph). Motion capture …

Rare Variant Analysis Of Electronic Health Record-Defined Major Depressive Disorder In The All Of Us Research Program, Stephen Emil Vieno

Theses and Dissertations

The underlying pathogenesis of MDD remains poorly understood, with multiple competing hypotheses regarding its exact etiology. As a heterogeneous disorder with relatively low heritability, large-scale genome-wide association studies of MDD have relied on increasingly large sample sizes to identify common genetic variants associated with the disorder. However, the rare variant genetic architecture of MDD is still largely unknown. The aim of the present analysis was to use the AoU—a United States-based biobank that integrates healthcare records from over 50 healthcare systems and possesses whole genome sequencing data for participants—to perform a gene set–based analysis of MDD. This analysis presented several …

Modeling Vaccination Strategies And Intervention Impacts On Infectious Disease Dynamics, Elizabeth B. Amona

Theses and Dissertations

This dissertation explores how mathematical and statistical modeling can inform vaccination strategies and evaluate the impact of interventions during infectious disease outbreaks. Motivated by the challenges observed during the COVID-19 pandemic, the research integrates compartmental modeling, Bayesian inference, and agent-based simulation to assess policy effectiveness and disease control across varying contexts. The first study develops a SEIRDV model that incorporates government interventions and vaccination rollout to examine COVID-19 dynamics in Qatar. A Bayesian approach is used to estimate parameters and compute time-varying transmission rates. The model captures shifts in transmission following policy changes and quantifies the reduction in deaths attributable …

Exploring Collaboration In Interdisciplinary Ei/Ecse Programs: A Qualitative Study On Service Provider Preparation, Meagan Dayton

Theses and Dissertations

Interdisciplinary preparation is critical for early childhood special education professionals, yet few programs are designed to support such collaboration across disciplines. This study aimed to explore how interdisciplinary EI/ECSE preparation programs support collaboration. The study was guided by the following research questions: (1) How are program components designed to support the development of collaboration skills? (2) What is the student experience of collaboration in the program? (3) What connections exist between program components, student experiences, and the development of collaboration skills? Using a qualitative multiple-case study approach grounded in ecological systems theory, data were collected from program documents and interviews …

Automated Treatment Planning Framework For Cervical Cancer In Brachytherapy, Suman Gautam

Theses and Dissertations

Brachytherapy (BT) is a critical treatment modality for cervical cancer that delivers ionizing radiation directly to the tumor using intracavitary (IC) and/or interstitial (IS) applicators. In high dose-rate (HDR) BT, a remote afterloader guides the radioactive source to specific dwell positions for defined durations, known as dwell times, allowing for a conformal dose to the tumor while minimizing exposure to surrounding organs at risk (OAR). However, due to the inherent nature of ionizing radiation, some dose to OARs is unavoidable, creating a fundamentally conflicting objective in treatment planning: maximizing tumor coverage while minimizing OAR dose. This characterizes the problem as …

An Adaptive Method For Covariate Balancing In Block Randomized Clinical Trials, Ren Rasnick

Theses and Dissertations

Clinical trials are randomized in part to limit allocation bias, but also to ensure comparability between treatment arms for a baseline variable of concern. Comparable with regard to a baseline variable of concern is necessary for the validity of statistical methods. However, comparability is not guaranteed for trials of any size and is even more likely in trials with < 200 total participants. We propose a new method for adapting the allocation of participants in a sequentially allocated two-armed study with a small sample size to better ensure comparability.

The proposed method calculates the expected final imbalance (lack of comparability) based on the current participant values. Unlike several other methods, our method ensures the final desired sample size for each treatment arm, utilizes the expected final imbalance, increases comparability between …

Associations Between Community Violence Exposure And Internalizing Outcomes: The Moderating Role Of Racial Identity, Kimberly S. Lazarus

Theses and Dissertations

Community violence continues to be an ongoing public health crisis, driven by structural inequities and systemic disinvestment. Due to historical discriminatory policies and ongoing systemic barriers, Black adolescents are disproportionately affected, placing them at heightened risk for adverse mental health outcomes, particularly post-traumatic stress symptoms (PTSS) and depressive symptoms. While existing literature highlights racial identity as a promotive factor linked to a lower likelihood of negative health outcomes, less is known about its protective role in buffering the mental health effects of adversity. There is an increasing call for public health researchers to consider racial-ethnic factors as potential moderators in …

Characteristics Of Permanent Teeth Undergoing Surgical Endodontic Evaluation: A Retrospective Study, Yasamin Mojarad

Theses and Dissertations

Objective: This study examines the pre-surgical clinical and radiographic characteristics that may influence the choice of apicoectomy over nonsurgical retreatment in a more detailed approach, focusing on the clinical factors that come into the evaluation phase. We hypothesize that there are certain patterns observed through a pre-operative CBCT that may impact the decision for surgical intervention. The study aims to assess patterns in the decision-making in surgical treatment planning.

Methods: Retrospective review analyzing 142 cases treated or planned for apicoectomy by VCU endodontic residents. Data collected from CBCT and PA radiographs included: restorations, quality of prior root canal treatment, presence …

Hyperreality Ain’T Really Real: Postmodernity, Social Media, & Blackness, Micah White

Theses and Dissertations

This qualitative study examines the interplay between postmodernity, social media, and African American identity formation through focus group analysis and Grounded Theory methodology. The research investigates how social media’s postmodern features—fragmentation, hyperreality, commodification, and context collapse—shape identity development among African Americans, who historically navigate cultural disruption and systemic racism. Data from semi-structured interviews with two generational focus groups revealed that participants engaged in sophisticated identity curation to balance authenticity and protection in racially charged digital spaces. Key findings highlight the tension between empowerment and marginalization, as social media served as both a platform for racial affirmation and a source of …

A Multimethod Approach To Examining Racial Coping Socialization Among Black Adolescents, Rachel J. Davis

Theses and Dissertations

Experiences of racial discrimination are pervasive in the lives of Black youth and result in race-related stress. Racial coping has been found to mitigate the negative physical and mental health effects of racial discrimination; thus, it is imperative that we understand the process that Black youth undertake to navigate racialized experiences by utilizing a person-centered approach. Additionally, parents socialize their Black youth to navigate racialized experiences, indeed, previous research has investigated racial and emotion socialization as separate phenomena, however, this does not reflect the integrated nature by which racial and emotion socialization processes are interconnected during parents’ and youths’ discussions …