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Implementing Noninvasive Capnography Monitoring To Enhance Early Recognition Of Postoperative Respiratory Decline In High-Risk Patients: A Quality Improvement Project, Trevor A. Messenger

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Implementing Noninvasive Capnography Monitoring to Enhance Early Recognition of Postoperative Respiratory Decline in High-Risk Patients: A Quality Improvement Initiative

Trevor Messenger

Background: Those suffering from chronic respiratory disease, obstructive sleep apnea (OSA), obesity, and other serious comorbidities are at an increased risk of respiratory decline after receiving general anesthesia. Respiratory decline leads to adverse outcomes, including increased hospital length of stay, intensive care unit (ICU) admissions, morbidity, and mortality.

Purpose: To improve the safety of postoperative patients at risk for OSA, and to reduce adverse events and airway interventions by enhancing the monitoring capabilities of bedside clinicians with waveform …

All-Terrain Vehicle Injuries Among Youth: A Multidimensional Analysis Of Injury Patterns In West Virginia And Safety Laws Across High-Fatality States, Sabrina Chyann Beal

Graduate Theses, Dissertations, and Problem Reports (ETD)

All-terrain vehicles (ATVs) pose significant injury risks, particularly among youth. These powerful machines are widely used across recreational and rural settings. West Virginia consistently ranks among the top five states for ATV-related deaths and injuries. Safety equipment and requirements are often not followed nor enforced, causing children and adolescents to be the most vulnerable group because they tend to not wear safety equipment such as helmets, ride on roadways, carry passengers, and operate oversized ATVS. This study examined ATV injury patterns from the WVU Medicine Trauma Registry and ATV laws across the five states with the highest reported fatalities. This …

Code Blue Narrator Documentation: An Evidence Based Quality Improvement Initiative, Stefanie A. Benvenuto

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The code documenter plays a crucial role in ensuring accurate, real-time documentation during Code Blue events, which is critical for patient care and compliance with established guidelines and protocols. However, nurses have reported discomfort with the Code Narrator tool in EPIC, which has hindered effective documentation during these high-pressure situations.

Purpose: The lack of comfort in using the Code Narrator tool has led to inconsistent and inaccurate documentation during Code Blue events, potentially impacting the effectiveness of the response and patient outcomes, such as the achievement of return of spontaneous circulation (ROSC).

Intervention: An educational competency …

Approaches To The Synthesis Of Highly Substituted Arenes, Kh Tanvir Ahmed

Graduate Theses, Dissertations, and Problem Reports (ETD)

While benzene rings and their derivatives are among the most frequently encountered ring systems in natural products, pharmaceuticals, agrochemicals, dyes, and functional materials, polysubstituted arenes are relatively scarce. The analysis of FDA-approved small molecules provides valuable insights into the characteristics of successful drugs while also highlighting gaps in the availability of synthetic methods capable of efficiently accessing diverse substitution patterns on aromatic rings. Highly substituted arenes are typically synthesized through sequential modification of a pre-existing benzene core; however, this stepwise approach becomes increasingly challenging with each additional substitution. An alternative strategy involves the direct construction of benzene rings via annulation …

Reprogramming Of Immunometabolic Functions In Brain Microvascular Endothelial Cells During Neuroinflammation: Insights From Ischemic Stroke And Sepsis, Shokofeh Rahimpourkaldeh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Ischemic stroke and sepsis-associated encephalopathy (SAE) are two distinct conditions that share common pathophysiological mechanisms affecting brain microvascular endothelial cells (BMECs). Ischemic stroke results from an acute reduction in cerebral blood flow due to thrombosis or embolism, leading to energy failure, oxidative stress, and blood-brain barrier (BBB) dysfunction. SAE, a neurological complication of sepsis, arises from systemic inflammation, endothelial activation, and BBB disruption, leading to cognitive impairment and neuroinflammation. Despite their different etiologies, both conditions involve BMEC dysfunction as a central mediator of neurovascular injury. This dissertation aims to investigate the immunometabolic dysfunction of BMECs in ischemic stroke and sepsis, …

Transforming The Athlete Through Occupational Therapy-Facilitated Mentorship Programming, Cecelia D. Simons

Graduate Theses, Dissertations, and Problem Reports (ETD)

There is a high prevalence of role strain experienced among collegiate athletes with increased attention and awareness surrounding its impact on the transition out of sport and into the next phase of their lives. Many colleges and universities throughout the United States have developed career readiness programs focused on mental health, career transitions, and resilience training preparation for life after sport. However, these programs are often delivered in a group format, making it difficult to provide individualized support to student-athletes. This project elaborated on the role occupational therapy serves in both program development and the transition out of sport. This …

Prioritizing Amd Impaired Watersheds For Watershed-Scale Restoration Using Multi-Criteria Decision Analysis, James Nicholas Marino

Graduate Theses, Dissertations, and Problem Reports (ETD)

Acid Mine Drainage (AMD) remains a significant environmental challenge in coal-mining and hard rock regions like West Virginia, degrading water quality and ecosystem health. Traditional site-specific remediation efforts often prove inefficient in addressing AMD at large scale. This study explores watershed-scale restoration as a more effective solution, leveraging centralized treatment facilities and multi-source pollution management. This study will follow Multi-criteria Decision Analysis (MCDA), specifically the Analytical Hierarchy Process (AHP), to develop a structured rubric for grading watersheds. The process involves identifying critical criteria, organizing them into a hierarchy, and generating weights for clusters of criteria through collaboration with decision makers. …

Creative Energies: Unearthing The Role Of Romantic Ecocriticism, Nicole Marie Chambers-Stahl

Graduate Theses, Dissertations, and Problem Reports (ETD)

The literary field of ecocriticism has transcended the boundaries of Academia: excited to connect to their physical environments, many of these scholars are focusing on genres like place-based writing, rhetoric of energy policy, and representations of the Earth in film and media. Interdisciplinary by nature, ecocriticism has demonstrated clear potential in its ability to intersect with concentrations like the history of science, animal studies, and environmental justice.

However, as the language around global crises is heating up —“Today it is scientists, not prophets,” writes Tobias Menely in “‘The Present Obfuscation,’” “who speak the language of apocalypse” (478)—ecocritical scholarship is at …

Using Visual Prompts To Analyze Ejection Fraction In Echocardiograms, Kevin Reisch

Graduate Theses, Dissertations, and Problem Reports (ETD)

Left ventricular ejection fraction (LVEF) is a critical biomarker for heart failure, but manual estimation from echocardiograms is time-consuming. Artificial intelligence can be used to accelerate this process, allowing clinicians to focus on other critical tasks. Current methods typically train models from scratch on echocardiogram datasets; however, this approach is limited by the scarcity of large medical imaging datasets, which are expensive and difficult to acquire. We present a transfer learning approach that leverages pretrained models from massive datasets, enabling continuous improvement as foundation models advance. Our method employs visual prompting to generate trainable masks for echocardiogram videos, transforming the …

Selective Recovery Of Critical Minerals (Ni, Zn, Co, And Mn) From Acid Mine Drainage Utilizing Ion Exchange And Selective Precipitation Processes, Esteban Albeiro Cardenas Restrepo

Graduate Theses, Dissertations, and Problem Reports (ETD)

Critical minerals (CMs) are essential for U.S. national security and technological development. The U.S. heavily depends on imports of these minerals from other countries, making supply chain disruptions a likely scenario. In consequence, finding alternative sources to conventional mining for these elements has become a topic of interest in recent years. Acid Mine Drainage (AMD), once solely viewed as an environmental problem, has emerged as a potential alternative source for CMs. AMD is a naturally occurring process where surface and underground water interact with sulfur-bearing minerals in the presence of oxygen and microorganisms. This interaction causes the water to become …

Comparative Analysis Of Safety, Accuracy, Comprehensiveness, And Organization In Endodontic Patient Education Material: American Association Of Endodontics (Aae) Vs. Ai-Generated Content., Fabiola M. Salgado Reyes

Graduate Theses, Dissertations, and Problem Reports (ETD)

Comparative Analysis of Safety, Accuracy, Comprehensiveness, and Organization in Endodontic Patient Education Material: American Association of Endodontics (AAE) vs. AI-Generated Content. Fabiola Salgado Reyes, DMD Introduction: With patients increasingly using AI chatbots like ChatGPT4o and Copilot, it is essential to assess whether these tools can effectively support patient understanding of complex endodontic procedures. AI-generated responses may occasionally provide inaccurate, unsafe, disorganized, or content that is not comprehended. The purpose of this study is to examine if dental experts and patients can determine if patient education materials (PEMS) were 1) generated by AI; 2) medically safe; 3) accurate; 4) can be …

Improving Neuromuscular Blockade Surveillance In Anesthesia Care With Quantitative Train Of Four Monitoring, Carley S. Blair

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem Statement: Despite the availability of quantitative train of four (TOF) monitoring, anesthesia providers more frequently rely on tactile (qualitative) TOF monitoring, which is associated with underestimation of recovery from muscle relaxation. Inadequate recovery from muscle relaxants results in residual weakness and its associated complications in the postoperative period, including compromised respiratory function (Thilen et al., 2023).

Background: Neuromuscular blockade (NMB) drugs are required to facilitate endotracheal intubation and allow for surgical manipulation. When these drugs are used, train of four (TOF) stimulations are used to monitor and assess the depth and recovery from NMB. TwitchView monitors (quantitative monitoring) is …

The People Of The North: Influencer Histories And Miniaturization In Eleventh-Century Italy, Evan Anthony Simonetti

Graduate Theses, Dissertations, and Problem Reports (ETD)

The Norman invasion of Italy in the eleventh century was a process that required political support and legitimacy for its leaders, the Hauteville dynasty. The members of this dynasty either commissioned or financed three individuals as they wrote three respective histories of the Norman conquest in order to accomplish this legitimation. In these sources, each author took inspiration from the classic works of history and poetry of the Greek and Roman world and applied symbolism and direction from their understanding of medieval Christian theology. In addition, these works catalogued examples of events, people, places, animals, and behavior as exotic objects …

Parental Behavioral Control Across Domains In Indian And Indian American Families, Avneet Batra

Graduate Theses, Dissertations, and Problem Reports (ETD)

Prior research literature has often found parental behavioral control to have mixed associations with varied adolescent outcomes (Bean et al., 2006; Finkenauer et al., 2005). However, a relatively lesser explored topic of research focusses on the domain specificity of this kind of control and its association with internalizing and externalizing behaviors in sample of Indian and Indian American parents (Arim et al., 2010). The current study adds to the limited literature by emphasizing the five domains of control (e.g., moral, conventional, prudential, personal and overlapping) based on the social cognitive domain theory and explores their association with adolescent adjustment outcomes …

State Determinants Of Medicaid Fraud Convictions: Insights From Panel Regression Analysis, Kevin Patrick Krantz

Graduate Theses, Dissertations, and Problem Reports (ETD)

Medicaid is the largest public health insurance program in the United States, providing critical coverage to over 78 million low-income individuals, children, and people with disabilities. While Medicaid fraud has received extensive public and political attention, empirical research examining enforcement outcomes across states remains limited. This study analyzes state-level Medicaid fraud metrics from 2010 to 2022 to evaluate how structural and policy changes, particularly rising managed care enrollment and the implementation of the 2010 Affordable Care Act and the 2016 Managed Care Final Rule, have shaped enforcement outcomes. Using random-effects generalized least squares (GLS) and fixed-effects panel regression on a …

Behavioral Effects Of Prenatal Ecig Aerosol Exposure On Sprague-Dawley Rats, Erin Elizabeth Wylie

Graduate Theses, Dissertations, and Problem Reports (ETD)

Maternal electronic cigarette (ECIG) use during pregnancy raises concerns about potential risks to offspring, yet its behavioral effects remain unclear. The present studies were designed to investigate how prenatal exposure to ECIG aerosols, with and without nicotine, influences the behavior of Sprague-Dawley rat offspring. Dams were exposed to aerosols containing base liquid alone, aerosols containing base liquid with 18 mg/ml nicotine, or filtered air (control) throughout gestation. Following postnatal day 65, male offspring from 17 litters completed lever-press acquisition (Experiment 1), sustained-attending (Experiment 2), and nicotine self-administration (Experiment 3) tasks. One-way analyses of variance (ANOVAs) were used to compare task …

Three Essays On The Socioeconomics Of Drinking Water Pfas Contamination, Nabin Babu Khanal

Graduate Theses, Dissertations, and Problem Reports (ETD)

Per- and polyfluoroalkyl substances (PFAS) are a group of over 15,000 synthetic compounds widely used for their resistance to heat, stains, grease, and water. While central to many modern conveniences, ingestion of PFAS is increasingly linked to adverse human health outcomes and are now detected globally in drinking water systems. This dissertation investigates three interrelated aspects of PFAS contamination in U.S. drinking water: (1) socioeconomic determinants and spatial patterns of contamination; (2) the economic impacts of contamination on residential property values; and (3) the effect of inconsistent PFAS regulations on public trust in environmental governance.

Using data from the U.S. …

Motivation And Well-Being: A Study Of Wvu Extension Volunteers, Amber Renae Goff

Graduate Theses, Dissertations, and Problem Reports (ETD)

Volunteers are the heart of the land-grant outreach model. They bring education and resources to communities across West Virginia. Volunteers have been relied upon in many aspects of Extension programming and current budget conditions have reduced the level of staffing within WVU Extension. There may be an increased demand for volunteers to help with programming. The purpose of this study was to investigate the relationship between motivation and the perceived level of well-being within the WVU Extension volunteer programs. The study yielded 464 responses from a descriptive survey. Based on the results, WVU Extension volunteers are motivated based on their …

Economic Behavior And Policy Distortions: Evidence From Firms And Households, Seth Joseph Carter

Graduate Theses, Dissertations, and Problem Reports (ETD)

In Chapter 1, I reopen the question of whether U.S. firms experience effective tax decreases directly resulting from federal lobbying expenditures by introducing more rigorous causal-inference testing. I first model lobbying as a productive input for the legislator, affecting firm tax outcomes by influencing the share of scarce legislative attention afforded to industry tax priorities. Using multi-industry, firm-level data from 2007 to 2022, I exploit percentage changes in non-industry lobbying as a proxy for political competition facing firms through a novel application of Bartik, shift-share instrumental variable estimation and two-stage residual inclusion. Effects of induced firm lobbying shifts on reported …

Developing A Simplified Method Of Measuring Ultrafine Particulate Matter Dose Concentrations For Diesel Emissions, Nafisat Ohunene Isa

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Developing a Simplified Method of Measuring Ultrafine Particulate Matter Dose

Concentrations for Diesel Emissions

Ultra-fine particulate matter (UFP), particularly from diesel emissions, poses significant health and environmental risks due to its small size and potential to penetrate deep into the respiratory system. Accurate measurement of UFP concentrations is essential for assessing exposure and mitigating health impacts. However, current methods for measuring UFP can be complex, time-consuming, and costly. This study aims to develop a simplified method for efficiently measuring UFP concentrations from diesel emissions, which will enable easier and more widespread monitoring of air quality and public health impacts. …

Implementation Of The Novel Nurse Intuition Patient Deterioration Scale To Assess For A Correlation Among Nurse Intuition And Patients Returning To The Intensive Care Unit, Janie L. Walsh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Adult hospitalized medical and surgical patients at an academic medical center are being transferred out of the Intensive Care Unit (ICU) to the step-down floor and having rapid response calls in less than 48 hours after the transfer. Nurse intuition is not a consideration in the decision to transfer a patient. Physiological variables such as Modified Early Warning Scores (MEWS) and vital signs are relied on heavily as indicators for escalation or de-escalation of care. There is evidence supporting the use of acknowledging nurse intuition to better predict a patient’s readiness for transitions of care.

Purpose: To evaluate the …

An Investigation Into Energy Consumption And V2g Potential Of An Electric School Bus Fleet, Rupesh Dahal

Graduate Theses, Dissertations, and Problem Reports (ETD)

The transition towards sustainable public transportation demands detailed evaluation of alternative fuel technologies. This thesis presents a comprehensive energy assessment and comparative analysis of diesel and electric school buses (ESBs) operating within the Monongalia County school district, its Vehicle-to-Grid (V2G) potential, and efficiency analysis of charging system. Utilizing real-world operational data collected from buses running identical routes, the study quantifies and compares their mileage specific energy consumption. The analysis reveals an average fuel economy of approximately 6.17 miles per gallon (MPG) for the conventional diesel school bus, contrasted with an average energy consumption rate of 0.46 miles per kilowatt-hour (miles/kWh) …

3d Printed Microfluidic Platforms For Elisa-Based Diagnostics: Advancing Toward Point Of Care, Brandi Marie Binkley

Graduate Theses, Dissertations, and Problem Reports (ETD)

Protein biomarker detection is a critical analytical method for quantifying proteins in biological samples. It is relevant not only in medical diagnostics and research but also numerous other fields such as environmental monitoring, pharmacology, food safety, and biotechnology. Sensitive detection at picogram-per-milliliter (pg/mL) levels is essential for diagnosing diseases, monitoring progression, and tailoring treatments, especially for low-abundance biomarkers like troponin, interleukin 6, carcinoembryonic antigen (CEA), activin A, and vascular endothelial growth factor (VEGF). Immunoassays, particularly enzyme-linked immunosorbent assays (ELISAs), are the gold standard for protein biomarker detection due to their high specificity and sensitivity. The development of point-of-care (POC) diagnostic …

What Does It All Mean? Differences In Self-Defining Memories Between Community And Adjudicated Youth, Hannah Elias

Graduate Theses, Dissertations, and Problem Reports (ETD)

Identity development is driven in large part by self-defining memories, or memories though which we base our definition of who we are (Habermas & Bluck, 2000). In adolescence, cognitive skills are gained that allow us to make meaning, or learn lessons and gain insight, from self-defining memories (Bluck & Habermas, 2001; McLean & Thorne, 2003). To determine whether there are differences in their ability to make meaning from their self-defining memories, this study compares narratives of self-defining memories between community youth and adjudicated youth. Additionally, the ability to be specific in self-defining memory recollection may differ between these groups, which …

Community-Wide Impacts Assessment Of Silver Carp (Hypophthalmichthys Molitrix) In The Ohio River, Luka Marques

Graduate Theses, Dissertations, and Problem Reports (ETD)

Invasive species can cause measurable impacts on the properties of recipient ecosystems, with effects that often vary spatially and temporally. One of the most complex and pressing invasion cases in the United States involves invasive carp. Invasive carp have quickly expanded throughout the Mississippi River Basin, with ecological impacts that may vary across space and time. Silver Carp has the potential to provoke community-wide impacts on native fish abundances and food webs of native fish communities. My study area ranged from the confluence of the Mississippi River and the Ohio River to R.C. Byrd Lock and Dam. The Ohio River …

A Limb-Speed-Driven Locomotor Control System And Its Ability To Adapt, Emily Marie Herrick

Graduate Theses, Dissertations, and Problem Reports (ETD)

Despite how simple walking may seem, the locomotor control system is structurally and functionally complex. Its hierarchical organization of supraspinal and spinal networks with forward and feedback pathways has many interactions at multiple levels that are dependent on the dynamics of a high-dimensional musculoskeletal system. Having a comprehensive understanding of sensorimotor integration within a healthy locomotor control system is crucial for understanding changes to the system due to age or neurologic disease and developing effective technologies to recover mobility in those populations. In this dissertation, we address persistent gaps in knowledge pertaining to how the nervous system controls locomotion.

In …

Numerical Investigation Of Pressurized Oxy-Combustion, Lei Li

Graduate Theses, Dissertations, and Problem Reports (ETD)

Pressurized oxy-combustion (POC) is emerging as a promising and transformative technology for carbon capture, utilization, and storage, offering advantages of low cost, low emissions, and high efficiency. POC operates by burning pulverized coal at elevated pressures in a recycled flue gas environment, typically rich in O₂ and CO₂. This study presents a comprehensive numerical investigation into the fundamental behaviors of lab-scale POC reactors, using both two-dimensional (2D) Reynolds-Averaged Navier-Stokes (RANS) simulations and three-dimensional (3D) Large-Eddy Simulations (LES) with the commercial computational fluidized dynamics (CFD) software package ANSYS Fluent.

The primary focus of this work is to understand flame stabilization and …

Forensic Characterization And Comparison Of Modern Nail Polish Products By Their Physical Features And Chemical Composition, Madison Meredith Lindung

Graduate Theses, Dissertations, and Problem Reports (ETD)

Nail polish can serve as valuable evidence in forensic investigations as it is often found on the hands and feet of individuals. Nail polish can break off and transfer easily during self-defense actions or forceful contact, such as in cases of kidnapping, sexual assault, or homicide. These residues can provide clues about who was at the scene, as well as where, when, and how the event evolved. However, compared to other types of paints commonly analyzed in forensic laboratories, limited forensic research has been conducted on the chemical composition and discrimination capabilities of popular nail products. The lack of information …

An Evidence-Based Practice Initiative To Improve Blood Pressure Control, Teresa D. Hines

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: High blood pressure (HBP) is a significant public health concern. It affects millions of adults in the United States (US) and half of the adult population in the Appalachia regions. High blood pressure is a known risk factor for cardiovascular disease (CVD), which is the leading cause of morbidity and mortality Appalachia. Complications associated with high blood pressure result in substantial economic burdens for patients and their families, healthcare systems, and national economies. High blood pressure is a significant health issue in West Virginia (WV), with an estimated 602,000 people suffering from HBP.

Purpose: The purpose of this …

Three Essays On Environmental Regulation And Economic Revitalization In Energy Rich Regions, Young Gwan Lee

Graduate Theses, Dissertations, and Problem Reports (ETD)

This dissertation consists of three essays that investigate the environmental and regulatory dimensions of unconventional oil and gas (UOG) development and place-based policy in the United States. The research examines how energy production activities interact with water resource management, regulatory compliance behavior, and regional economic resilience. By integrating empirical modeling, quasi-experimental methods, and policy evaluation, the dissertation provides new insights into how environmental risks and economic tradeoffs are shaped by regulatory constraints, strategic behavior of regulated entities, and government interventions in extractive regions. Managing produced water from unconventional oil and gas (UOG) production is a growing environmental challenge, particularly as …