Digital Commons Network^™

Implementation Of An Evidenced Based Enteral Nutrition Protocol For Mechanically Ventilated Patients: A Quality Improvement Initiative, Hannah R. Nuzum

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Implementation of an Evidenced Based Enteral Nutrition Protocol for Mechanically Ventilated Patients: A Quality Improvement Initiative.

Hannah Nuzum

Background: Mechanically ventilated patients require supplemental nutrition as an important factor for their overall recovery. Malnutrition in hospitalized patients is reported as high as 35% (Ikram et al., 2022).

Purpose: Lack of an enteral nutrition (EN) protocol has contributed to variability in initiation of EN for post-intubated mechanically ventilated patients.

Intervention: The project interventions are threefold: the development of an EN protocol, EN initiated within 24 to 28 hours for post-intubation patients, and staff understands that EN should be initiated within …

Beyond The Byproduct: Exploring Approaches For The Sustainable Valorization Of Underutilized Food Streams, Ian Phillip Israelsen

Graduate Theses, Dissertations, and Problem Reports (ETD)

Commercial food processing creates side-streams that are often underutilized yet hold significant potential for valorization into value-added products for consumer use. This study investigated and compared potential protein recovery and lipid removal potential from buckwheat (BW; Fagopyrum esculentum Moench), brewer’s spent grain (BSG), and coffee silverskin (CSS) using a one-step solvent defatting and a pH-shift protein extraction method. The extraction efficiency yields of extracted protein from CSS were significantly lower than all other samples (p < 0.05). The defatted BW had the highest extracted protein content of all samples (p < 0.05). The sizes of the proteins in the starting materials were observed using LDS-PAGE. These sizes were consistent with published values and were mostly unchanged by defatting or the pH-shift process. The presence of 13S globulins and 2S albumins was confirmed under reducing conditions. Protein extracted from all native samples had lower total free essential amino acids than the starting materials. Native CSS and extracted protein followed this trend, but in defatted CSS and respective extracted protein samples, the extracted proteins had higher free essential amino acid content than the starting materials, sometimes of twofold or greater (p < 0.05). After defatting, the percentage of lipids recovered compared to the original lipid content of the samples was measured. The crude fat content of native and hexane-defatted BW flour was higher than BW flour defatted with ethanol (p < 0.05). The lipid extraction efficiency of all samples ranged from 4.6 ± 1.26%–43.20 ± 14.21%. The mass of the native and defatted starting materials were recorded at each step of processing, with reasonable losses assessed. The major non-polar lipid classes in each starting material were separated using thin-layer chromatography. All samples also displayed the presence of polar lipids. When comparing starting materials, BW and BSG was the most effective for protein extraction, and BSG has the most promise for lipid removal and potential for upcycling. All the examined starting materials show promise for use in food supplementation, especially as native flours. These products are plentiful and considered underutilized or side-stream products.

Resilience In Adolescents With Type 1 Diabetes: The Relation Between Grit, Benefit-Finding, Diabetes Distress, Hba1c And Health-Related Quality Of Life, Hannah Hardiman

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Type 1 diabetes (T1D) is a common pediatric chronic illness that requires complicated management by both the child and their caregiver. Research and clinical guidelines have highlighted adherence (as measured by HbA1c) and health-related quality of life (HRQOL) as important outcomes particularly in adolescents with T1D. Notably, diabetes distress has been identified as a risk factor contributing to poor adherence and HRQOL outcomes in this population. Given these considerations, understanding what resilience factors contribute to optimal outcomes is vitally important to inform future interventions. Grit and benefit-finding are two novel resilience factors that have yet to be fully evaluated …

Efficacy Of Salmonella Surrogate Enterococcus Faecium In Poultry And Mash Broiler Feed, Corey Waitman Coe

Graduate Theses, Dissertations, and Problem Reports (ETD)

This dissertation investigates the efficacy of Enterococcus faecium as a surrogate for Salmonella in validating thermal inactivation processes during poultry feed manufacturing and meat processing. The research encompassed three studies evaluating microbial kinetics in mash broiler feed, reconstructed ground chicken, and predictive modeling approaches to improve food safety interventions. In the first study, the thermal resistance of nalidixic acid-resistant Salmonella Typhimurium and E. faecium was compared in mash broiler feed heated at 75–95°C. Results demonstrated that E. faecium exhibited significantly greater heat resistance than Salmonella, with longer shoulder times, greater tailing effects, and higher D-values, supporting its use as …

Neuroendocrine Regulation Of The Luteinizing Hormone Surge And Puberty Onset In Sheep, Max J. Griesgraber

Graduate Theses, Dissertations, and Problem Reports (ETD)

Gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), and follicle stimulating hormone (FSH) are essential for the reproduction of all mammalian species, including both sheep and humans. GnRH is secreted by hypothalamic neurons into the hypophyseal portal vasculature in a pulsatile manner, which then acts within the anterior pituitary to elicit the release of LH and FSH into wider systemic circulation. In females LH and FSH act on the ovaries to promote estradiol (E2) production, follicular development, and under certain conditions in regard to LH, ovulation. Furthermore, while E2 inhibits GnRH and subsequent LH secretion under most conditions, at high concentrations E2 …

Molecular Characterization Of Fungus-Arthropod Associations, Angie M. Martin

Graduate Theses, Dissertations, and Problem Reports (ETD)

Arthropods, or phylum Arthropoda, are the largest group of animals, accounting for over three quarters of all animal records on NCBI Taxonomy. And yet, only 40% of all deposited sequences on NCBI Nucleotide come from arthropods. Clearly, arthropods are an understudied group of animals: they are small, often drab, and lead lives very alien to our own. Arthropods have chitinous exoskeletons, segmented bodies, and jointed appendages, and include crabs, barnacles, insects, spiders, and millipedes. Since the era of DNA based studies took off in the 1980s, DNA and other small molecules have been integral to our understanding of the Earth …

Evaluating Osmia Cornifrons As An Effective Pollinator For Agricultural Crops: An Analysis Of Hair Morphology And Sex-Ratio Distorting Bacterium, Wolbachia, Nellie Heitzman

Graduate Theses, Dissertations, and Problem Reports (ETD)

Effective pollination relies not only on the presence of pollinators but also on their morphological adaptations and reproductive biology. In this study, I investigated both the external hair morphology and the intracellular bacterial infection status of Osmia cornifrons, a solitary bee species increasingly used in orchard pollination due to its efficiency and early seasonal activity. Using Scanning Electron Microscopy (SEM), I characterized the distribution and structure of two major hair types present on the bee's body: branched and unbranched. Branched hairs were found widely distributed across the head, thorax, dorsal abdomen, and legs, and appeared to function primarily in incidental …

Monitoring West Virginia Wastewater For Norovirus: A Test Case For Tracking Foodborne Illness Outbreaks In Rural Communities Using Wastewater, Haley M. Phillippi

Graduate Theses, Dissertations, and Problem Reports (ETD)

Foodborne illnesses are a global public health challenge. Foodborne illnesses, like norovirus, often have a large disease and societal burden. Norovirus is a single-stranded, positive-sense RNA virus, with 10 identified genogroups (GI-GX). Genogroups GI and GII are responsible for nearly all human cases of acute gastroenteritis worldwide. In the United States, HuNoV is not notifiable case-by-case. Instead, outbreaks are reported to national surveillance systems when two or more cases are epidemiologically linked. Most norovirus outbreaks occur during Winter to early Spring, however, certain individuals may still shed and transmit the virus without being detected or reported. Wastewater monitoring is a …

An Analysis Of Usopc National Governing Body Policies Related To Body Pressures, Body Image Concerns, And Eating Pathology, Sarah Margaret Sadler

Graduate Theses, Dissertations, and Problem Reports (ETD)

Athletes are often exposed to body pressures in sport environments (Voelker & Reel, 2020), which can contribute to body image concerns and eating pathology (Petrie & Greenleaf, 2007, 2012) with lasting consequences for performance and well-being. Although research has highlighted the harmful impacts of these concerns, and has called for a broader investigation into the sources of athletes’ experiences of these concerns (Voelker et al., 2022), little is known about the role of sport organizations in influencing athletes’ body pressures, body image concerns, and eating pathology. Using a descriptive qualitative research design within a post-positivist paradigmatic approach, the current study …

Non-Lethal Sampling Methods For Fish Health Assessments Using Smallmouth Bass Micropterus Dolomieu, Lindsey Nicole Hartzell

Graduate Theses, Dissertations, and Problem Reports (ETD)

In the early 2000s, fish kills of different species, including smallmouth bass Micropterus dolomieu, were reported in areas of the Potomac River drainage, including the Shenandoah River in Virginia. Since the first reports of fish kills and lesions affecting smallmouth bass, they have continued to show signs of adverse health effects. Additionally, in some areas of the Potomac River drainage, population declines have occurred, and lethal sampling is discouraged. To develop a holistic, integrative approach to assess fish health, Smallmouth Bass were collected and sampled using non-lethal techniques at three sites within the Shenandoah River drainage, VA and one …

Longitudinal And Ensemble Modeling Of Beef Cattle Feed And Water Intakes, Nathan El Blake

Graduate Theses, Dissertations, and Problem Reports (ETD)

Beef cattle production remains a cornerstone of global food systems, providing highly bioavailable protein and essential micronutrients that are difficult to secure from plant-based foods alone. Yet this production is also resource-intensive, requiring substantial land, feed, and water inputs while contributing significantly to greenhouse gas emissions. Efficiency of dry matter intake (DMI) and water intake (WI) is central to both productivity and sustainability, but accurate measurement of these traits—particularly in grazing systems—remains a major limitation. National WI standards continue to rely on pen-level data collected in the 1950s, while most existing DMI prediction equations perform poorly when applied beyond the …

Microbial And Plant Biodiversity In Appalachian Agroecosystems And Their Implications For Soil Health, Kinsey Reed Close

Graduate Theses, Dissertations, and Problem Reports (ETD)

The sustainability of agricultural landscapes depends on understanding the complex interactions between plants, soil, and microbes. In Appalachia, a region shaped by complex terrain and long histories of human and ecological interaction, small family farms produce hay, livestock, and row crops. These agroecosystems, though often treated as “artificial” by many ecologists, have the potential to support both food production and biodiversity conservation if managed with an understanding of ecological complexity. This dissertation examines how plant and microbial diversity interact with soil and management to influence nutrient cycling, soil health, and long-term resilience in Appalachian agricultural systems. A literature review revealed …

Synergetic Effect Of Cellulose And Chitosan Polymers In Cancer Treatment, Grace Peterson

Graduate Theses, Dissertations, and Problem Reports (ETD)

This research explores the development of a biocompatible, natural drug delivery system designed for targeted cancer therapy. Lung cancer cells are used in these particular tests, but further research indicates treatment could be used for various cancer types. Traditional cancer treatments like chemotherapy are often limited by poor selectivity for tumor cells, causing significant damage to healthy tissues. The study proposes a dual-layered delivery system, utilizing Carboxymethyl Cellulose (CMC) as the core material and a charge-reversible chitosan shell to encapsulate and target cancer drugs. CMC, with its water solubility and ability to form stable gels, serves as a stable drug …

Exploring The Ruminal Microbiome And Its Impacts On Feed Efficiency In Beef Cattle, Taylor Simone Sidney

Graduate Theses, Dissertations, and Problem Reports (ETD)

The ability for beef cattle to utilize feed efficiently is a critical determinant for both economic and environmental sustainability in livestock production. However, despite extensive research, the complex microbial ecosystem within the rumen and its relationship to feed efficiency remain incompletely understood. This dissertation explores the physiological and microbial foundations of feed efficiency by characterizing how rumen microbial communities and their functions differ among beef cattle with divergent residual feed intake (RFI) phenotypes and how the RFI status of beef cattle influenced their response to dietary interventions such as supplementation with a Bacillus-based feed additive. In the first study, …

Access And Entitlement: Investigating The Contours Of Public Health In Late Colonial Bengal And Post Colonial West Bengal (1920-1960), Ametasree Bhattacharya

Graduate Theses, Dissertations, and Problem Reports (ETD)

This dissertation employs the comparative framework of “Access and Entitlement,” which serves as a metric to measure the goods and services the state could responsively provide to the public. It utilizes this framework to analyze the realm of public health in Bengal/West Bengal before and after decolonization. The main body is divided into two parts: the first three chapters focus on malaria, and the last three on nutrition. The first chapter explores debates over malaria control between 1919 and 1935. The second examines anti-malarial efforts from 1935 to 1947, emphasizing the influence of communal politics and the Second World War …

Formulation, Sensory Evaluation, And Physicochemical Assessment Of And Consumer Behavior Toward Novel Energy Bars, Ian Phillip Israelsen

Graduate Theses, Dissertations, and Problem Reports (ETD)

The objectives of this study were to 1) formulate a novel energy bar containing significant macronutrients and calories per serving with favorable ratings from consumers; 2) analyze responses to a consumer preference survey and sensory evaluation of novel energy bars compared to a commercially available energy bar. For the first study, fourteen iterations of an energy bar were synthesized with differing protein sources (whey, soy, pea, hemp), and characteristic variations (nougat, chocolate truffle, peanut butter, double-date caramel). A shortbread base, date caramel, and chocolate coating were included in every bar. Sensory evaluations determined that the most liked variation overall was …

Cellular Level Changes Induced In Cancer Cells Due To Microgravity, Sai Deepika Reddy Yaram

Graduate Theses, Dissertations, and Problem Reports (ETD)

The increase in human activity in space has revealed several kinds of physiological challenges brought on by the absence of Earth's gravitational pull. NASA observed that during spaceflight, astronauts experience a 1-1.5% monthly loss in the mineral density of weight-bearing bones, with rehabilitation efforts on Earth often proving ineffective. This issue extends to muscles, the neuro vestibular system, the cardiovascular system, and vision. Cancer has emerged as a significant cause of mortality among astronauts, with studies up to 2017 showing that 41.3% of natural cause deaths among U.S. astronauts were due to cancer, primarily due to space radiation exposure. Cancer …

Associations Among Psychosocial Factors, Health-Related Quality Of Life, And Adherence In Pediatric Inflammatory Bowel Disease, Cecelia I. Nelson

Graduate Theses, Dissertations, and Problem Reports (ETD)

Inflammatory Bowel Disease (IBD) is a prevalent disorder among youth in the United States. IBD is one of the leading causes of chronic pain in adolescence and symptoms can lead to reduced quality of life, social embarrassment, and lower self-esteem. Adherence to medical regimens for IBD is incredibly important to prevent morbidity, mortality, and impaired health-related quality of life (HRQOL). However, adolescents struggle generally with adherence and the regimen for IBD can be complicated and include aversive side effects. Psychological factors, such as depressive symptoms, are key factors associated with non-adherence. Nevertheless, gut-specific anxiety (GSA) is a psychological factor that …

Impacts Of Community Food Outreach Programs On Low-Income Families: St. Ursula’S Food Outreach Program In Pursglove Monongalia, West Virginia, United States As A Case Study, Oluwafunke Abeleje

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Impacts Of Community Food Outreach Programs on Low-Income Families: St. Ursula’s Food Outreach Program in Pursglove Monongalia, West Virginia as A Case Study

Abeleje Oluwafunke Rebecca

According to previous research studies as stated by Fatka (2023), in 2014, 14% of households in the United States had levels of food insecurity. Also, as noted by Pitts, 2020, food insecurity rates rose across the board in the United States during the early COVID-19 epidemic and tripled among families with children. Compared to other industrialized countries, the United States had very high rates of food insecurity before the outbreak (Poblacion et al., …

Adverse Childhood Experiences Predict Mortality Risk: The Role Of Social Support & Social Strain, Meredith A. Willard

Graduate Theses, Dissertations, and Problem Reports (ETD)

Childhood adversity has long-lasting negative effects across the lifespan including increased mortality risk. The love and support individuals receive from others, also known as social support, has shown to be a protective factor against ACEs. However, little research has investigated the amplifying effects of social conflict and strain that often accompanies social relationships. Utilizing data from the Midlife Development in the U.S. (MIDUS) study, I tested whether higher levels of social support would buffer the negative effects of adverse childhood experiences on mortality risk, and whether higher levels of social strain would amplify these associations. The sample included 6,150 participants …

Effect Of Haemonchus Contortus Excretory/Secretory Protein On Differences In Host Neutrophil Migration, Hannah Grace Teddleton

Graduate Theses, Dissertations, and Problem Reports (ETD)

An excretory/secretory (E/S) product, common to many helminths, is neutrophil inhibitory factor (NIF) which negatively affects neutrophil migration and activity. Due to differences in neutrophil accumulation between parasite resistant St. Croix STC and parasite susceptible Suffolk (SUF) sheep, we hypothesized that Hc-NIF may inhibit migration of SUF and not STC neutrophils. Previous studies have demonstrated that Hc produces NIF but is not commercially available. To test our hypothesis, neutrophils were cultured from STC and SUF sheep in the presence of Ancylostoma caninum-derived NIF (Ac-NIF) and measure chemotaxis to Interleukin-8 (IL-8), HcLA or H. contortus third-stage excretory/secretory (E/S) products. Neutrophils were …

Comparison Between Coronally Advanced Flap With Sub-Epithelial Connective Tissue Graft And Tunnel Technique With Sub-Epithelial Connective Tissue Graft In Achieving Mean Root Coverage At Multiple Recession Defects: A Retrospective Study, Christian Daniel Davila

Graduate Theses, Dissertations, and Problem Reports (ETD)

Aim: The primary objective is to retrospectively compare the mean root coverage (MRC) achieved using a coronally advanced flap and sub-epithelial connective tissue graft (CAF + CTG) with that achieved using the tunnelling technique and sub-epithelial connective tissue graft (TUN + CTG) for the treatment of multiple recession defects. The secondary objectives are to compare the proportion of complete root coverage (CRC) achieved with CAF + CTG compared to TUN + CTG, compare the proportion of CRC achieved in these two techniques with respect to level of training (American board-certified periodontist or Graduate periodontics residents) and to evaluate the …

Puberty-Associated Changes In Kiss1r, Mc3r, And Mc4r In The Ewe, Ashleigh Caitlyn Thomson

Graduate Theses, Dissertations, and Problem Reports (ETD)

The neural mechanisms that control the onset of puberty are not completely understood. In livestock, the onset of puberty relies on an increase in gonadotropin releasing hormone (GnRH) and luteinizing hormone (LH). Kisspeptin, neurokinin B, and dynorphin neurons (KNDy) and their receptors, Kiss1r, NK3R, and KOR, respectively, are important regulators of puberty. Previous data from our laboratory has shown that KNDy neurons may be responding to other inputs, including the melanocortin system, that will affect the timing of puberty. Given this, we examined kisspeptin receptor (Kiss1r) mRNA expression in GnRH neurons as well as examining melanocortin 3 and 4 receptor …

Investigating Changing Macronutrient Dynamics At A Plant, Microbe And Plant-Microbe Interactions Scale, Emel Kangi

Graduate Theses, Dissertations, and Problem Reports (ETD)

Nutrient limitation drives forest ecosystem processes by altering net primary production, belowground (C) investments, and microbial activity. As such, the availability of essential macronutrients, such as nitrogen (N) and phosphorus (P), can severely impact plant growth, microbial decomposition, and the strength of plant-microbial interactions. However, our understanding of plant and microbe responses to changing nutrient availability, and the extent to which nutrient availability affects plant-microbe interactions, remains somewhat limited. Therefore, in this dissertation, I aimed to investigate nutrient limitation on a plant, microbe, and plant-microbe interaction level. First, to connect the phenotypic responses of nutrient-limited plants to key molecular mechanisms, …

Improving Patient Self-Advocacy And Communication With Providers Through Diabetes Self-Management Education: Analyses From A Randomized Controlled Trial, Brenna Owens Kirk

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: West Virginia (WV), a rural state in Appalachia, has the highest type 2 diabetes mellitus (T2DM) prevalence in the United States. Open communication in the patient-provider relationship is an integral part of comprehensive chronic disease management. This is especially true for patients living with T2DM, a disease that requires many complex, daily self-management activities and is associated with increased emotional distress. However, patients living with T2DM are often reluctant to openly share their concerns regarding self-care with their provider. This study aimed to test the effectiveness of the Diabetes and Hypertension Self-Management Program (DHSMP), a 12-week group lifestyle …

Risk Of Parasiticides To Dung-Associated Beetles In West Virginia, Haylie J. Brown

Graduate Theses, Dissertations, and Problem Reports (ETD)

Ecosystem services provided by dung-associated beetles, such as reducing pasture fouling, parasite suppression, supporting nutrient recycling, and increasing water infiltration, contribute to animal and pasture health. However, parasiticides used to manage cattle parasites, particularly flies and helminths, in West Virginia, can adversely affect these non-target beetles. We assessed the exposure and impact of some parasiticides used in WV including Clarifly^® (active ingredient [a.i.] diflubenzuron), Cydectin^® (a.i. moxidectin), LongRange^® (a.i. eprinomectin), and Safe-guard^® (a.i. fenbendazole). In Chapter 1, we review the use of parasiticides in the US and their non-target effects on beneficial dung-associated beetles. In Chapter …

The Effects Of Feed Manufacture On Exogenous Enzymes, Starch Gelatinization, And Antinutritional Factors Associated With Soybeans, Kristina M. Bowen

Graduate Theses, Dissertations, and Problem Reports (ETD)

This doctorate dissertation consists of four individual studies with the overarching theme of the effect of feed manufacture on exogenous enzymes and antinutrients found in soybeans.

Study 1. Including exogenous enzymes in poultry diets can liberate nutrients that are typically inaccessible to monogastric animals. Phytase feeding research has traditionally been conducted by rearing broilers in raised wire cages, whereas commercially grown broilers are reared on built-up litter. Therefore, cage-based studies may not accurately represent commercial bird performance response to phytase. Birds with access to litter consume it, possibly increasing phosphorus intake leading to suggestions that lower phytase concentrations are required. …

The Effects Of Diet-Induced Obesity On Cerebral Microvascular Bioenergetics, Alec Anthony Hanshew

Graduate Theses, Dissertations, and Problem Reports (ETD)

Obesity is a worldwide epidemic but is especially a concern in the United States with over 40% of the population being obese. Obesity is known to cause increased metabolic demand, systemic inflammation, peripheral vascular dysfunction, and increased levels of oxidative stress and reactive oxygen species (ROS). However, the role of obesity on cerebrovascular bioenergetic function has not been fully elucidated. This study aimed to determine the impact of diet-induced obesity on cerebrovascular bioenergetics. 72, 6-month-old C57Bl/6 male and female mice were randomized into control and HFD groups. Control mice were subjected to the feeding of standard chow (18% fat, 24% …

Performance And Physiological Impacts Of Branched-Chain Amino Acid And Tryptophan Ratio Variations In Turkey Starter Diets Utilizing Concentrated Corn Proteins, Emily Blair Estanich

Graduate Theses, Dissertations, and Problem Reports (ETD)

In Chapter 2, a study was designed to evaluate the effects of varying dietary branched-chain amino acids (BCAA) ratio in corn and soybean meal-based turkey starter diets. The BCAA leucine, isoleucine, and valine are considered indispensable amino acids needed for energy and stimulation of muscle protein synthesis via the mammalian target of rapamycin (mTOR) pathway. Imbalanced BCAA ratios can lead to antagonism and degradation of limiting BCAA, particularly in diets with excess leucine. Concentrated corn proteins contain high levels of leucine and can alter BCAA requirements; however, crystalline BCAA may be added to correct these ratios. This study aimed to …

Pathways To Health: Linking Accessible Green Space To Improved Health And Well‐Being In Rural Appalachia., Udday Shankur Datta

Graduate Theses, Dissertations, and Problem Reports (ETD)

Green spaces are essential for our physical health. The quality of its green space often determines the health of a community. The presence of green space in our lives is associated with reduced stress levels, better sleep, and increased feelings of safety. Lack of access to green space can lead to many health issues, such as high blood pressure, diabetes, and cardiovascular diseases, and has been linked to obesity and physical inactivity.

The Appalachian Regional Commission (ARC) defines Appalachia as a region covering 420 counties across 13 states in the eastern United States. A large part of this region is …