Digital Commons Network^™

Perception Of Patient Cooperation Among Dentist, Guardian, And Child, Cole A. Staines Dds

Theses and Dissertations

Purpose: Evaluate behavior assessment and agreement among dentist, guardian, and child. Evaluate child behavior by appointment type.

Methods: Patients recruited from the pediatric dental department at Virginia Commonwealth University for this convenience sample. Inclusion criteria: patients presenting for clinical exams and/or restorative treatment without the use of advanced behavior guidance between August 29, 2018, and March 7, 2019; ages 4-12-years-old; and scheduled with a single clinician. Appointments were stratified by difficulty. Behavior was assessed by dentist and caregiver using the Frankl Scale. Patient self-assessed cooperation using an age-appropriate modified Frankl Scale, developed for this study. Agreement assessed among the 3 …

The Efficacy Of A Fluoride-Containing Orthodontic Primer In Preventing Demineralization, Alyssa G. Ricci

Theses and Dissertations

Purpose: To evaluate the efficacy of a fluoride-containing orthodontic primer in preventing demineralization adjacent to brackets and compare the quality of enamel on tooth surfaces that received interproximal reduction (IPR).

Methods: Patients at the VCU Orthodontic clinic who consented to orthodontic treatment involving extraction of at least 2 premolars were recruited to this pilot clinical study. Brackets were bonded to premolars using one of two primers, fluoride-containing experimental or control. IPR was also performed, and the experimental primer was applied to randomly selected teeth. Extracted teeth were analyzed visually for the presence of white spot lesions (WSLs). Micro-CT analyses were …

A Genetically Informed Study Of Acute Threat Endophenotypes For Callous-Unemotional Traits, Ashlee A. Moore

Theses and Dissertations

Introduction. Callous-unemotional (CU) traits predict socially debilitating outcomes including Antisocial Personality Disorder and violent crime in adulthood. Despite significant research, the etiology of CU traits is not well understood. This dissertation incorporates genetic, physiological, neuroanatomical, and self-report measures to investigate the etiology of CU traits. Specifically, this project focuses on measures previously found to associate with impaired fear-processing observed in individuals high on CU. Brain morphometry for paralimbic regions of interest (ROIs) and electromyographic facial eyeblink reflex to startle and fear-potentiated startle probes were investigated as potential endophenotypes for CU traits. Methods. Two genetically informative (ages 9-20) twin samples ( …

The Dna Methyltransferase Inhibitor, Guadecitabine, Targets Tumor-Induced Myelopoiesis And Recovers T Cell Activity To Slow Tumor Growth, Andrea J. Elkovich

Theses and Dissertations

Myeloid Derived Suppressor Cells (MDSC) represent a significant hurdle to cancer immunotherapy because they dampen anti-tumor cytotoxic T cell responses. Previous studies have reported on the myelo-depletive effects of certain chemotherapies. Using guadecitabine, a next-generation DNA methyltransferase inhibitor (DNMTi), we observed significantly reduced tumor burden in the 4T1 murine mammary carcinoma model. Guadecitabine treatment prevents excessive tumor-induced myeloid proliferation and systemic accumulation, and skews remaining MDSCs toward a beneficial antigen-presenting phenotype. Together, this alters the splenic environment to improve T cell activation and interferon-gamma (IFNg) production. Additionally, guadecitabine enhances the therapeutic effect of adoptively transferred antigen-experienced lymphocytes to diminish tumor …

Evaluating Predixcan’S Ability To Predict Differential Expression Between Alcoholics And Non-Alcoholics, John E. Drake Jr

Theses and Dissertations

PrediXcan is a recent software for the imputation of gene expression from genotype data alone. Using an overlapping set of transcriptome datasets from postmortem brain tissues of donors with alcohol use disorder and neurotypical controls, which were generated by two different platforms (e.g., Arraystar and Affymetrix), and an additional unrelated transcriptome dataset from lung tissue, we sought to evaluate PrediXcan’s ability to impute gene expression and identify differentially expressed genes. From the Arraystar platform, 1.3% of matched genes between the measured and imputed expression had a Pearson correlation ≥ 0.5. Our attempt to replicate this finding using the expression data …

Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker

Theses and Dissertations

Provider incentives are a commonly used policy tool to mold provider behaviors.¹ However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program.

Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic …

Negotiating Masculinity In Tabletop Roleplaying Game Spaces, Rigby L. Bendele

Theses and Dissertations

As video games and other gaming has become a popular media form, with 60% of Americans playing games daily (Entertainment Software Association [ESA], 2018), gaming communities have increased in size and participation. While scholarly research has consistently found that women are marginalized in these communities, little research has looked at how men see these communities. Research on homosociality shows that men use communities and relationships with other men to access masculinity (Bird, 1996; Dellinger, 2004; Houston, 2012). Building on game studies and masculinity studies, this research looks at the way men in tabletop roleplaying game communities understand their involvement and …

The Role Of Sphingosine Kinase 2 In Alcoholic Liver Disease, Eric K. Kwong

Theses and Dissertations

Alcoholic liver disease (ALD) is one of the most common liver diseases worldwide characterized by the accumulation of lipids within the liver, inflammation and the possibility of progressing to cirrhosis and liver failure. More importantly, there are currently no effective treatments for ALD and liver transplantation remains the only therapeutic option for end-stage liver disease. Previous studies have shown that ALD is a result of a combination of endoplasmic reticulum (ER) stress, lipid metabolism dysregulation and inflammation. It has been previously reported that alcohol disrupts gut microbiota homeostasis and causes increased endotoxins that contribute to the pathology of ALD. However, …

A Cross-Cultural Examination Of The Relations Among Parkinson’S Disease Impairments, Caregiver Burden And Mental Health, And Family Dynamics In Mexico And The United States, Erin Smith

Theses and Dissertations

Parkinson’s Disease (PD) is a common progressive neurodegenerative disorder that leads to both physical and cognitive impairment over time. Eventually, these impairments may include the loss of autonomy, and the individual may require the assistance of an informal caregiver. Informal caregivers are critical in the care of individuals with PD and spend substantial time providing care, which may be associated with negative caregiver outcomes such as burden, mental health issues, as well as poor family dynamics. Although research in the United States and Europe has generally supported these relations, there is very limited research on PD caregiving in Latin America. …

Role Of Sarm1 In Chronic Immune-Mediated Central Nervous System Inflammation, Kenneth E. Viar Ii

Theses and Dissertations

SARM1 is an injury-induced nicotinamide adenine dinucleotide nucleosidase (NADase) that was previously shown to promote axonal degeneration in response to traumatic, toxic, and excitotoxic stressors. This raises the question of whether a SARM1-dependent program of axonal degeneration is central to a common pathway contributing to disease burden in neurological disorders. The degree to and mechanism by which SARM1 inactivation decreases the pathophysiology of such disorders is of interest to establish the rationale to pursue SARM1 as a therapeutic target. In this study, we compare the course and pathology of experimental autoimmune encephalomyelitis (EAE) in Sarm1-knockout (KO) mice and wild-type …

Connecting The Dots: Investigating The Effects Of Trans-Synaptic Tau Transmission In The Hippocampus, Michael Bamisile

Theses and Dissertations

Tauopathy, which results from the oligomerization of misfolded tau protein in neurons, is a feature present in a number of neurodegenerative diseases and a hallmark of Alzheimer’s Disease (AD). Tau is an important phosphoprotein that regulates the assembly of microtubules, but tauopathy can occur when tau becomes hyperphosphorylated. Phosphorylation prevents tau from binding to tubulin, which results in cytosolic accumulation of tau and eventual oligomerization. This abnormal accumulation of tau leads to the spreading of hyperphosphorylated tau to downstream synaptically connected neurons through an unknown mechanism. In AD, the hippocampus is one of the first brain structures to be affected …

The Effect Of Repeated Opioid Dosing On The Gut Microbiome, Anne K. Rowe

Theses and Dissertations

Opioids are prescribed to millions of people each year, especially to help patients cope with chronic pain, something from which more than a fifth of U.S. adults suffer (CDC). Unfortunately, opioid use and abuse has become a national emergency as the number of opioid prescriptions, opioid misuse, and opioid-related drug overdoses and death have drastically increased in the last twenty years (HHS). Because of the emergent state surrounding opioid use and misuse, the effects of opioids on all aspects of the human body has been an increasingly large focus of research scientists. This study focuses on the possible effect of …

Facilitative And Competitive Tradeoffs Between Morella Cerifera Seedlings And Coastal Grasses, Michael N. Sinclair

Theses and Dissertations

Morella cerifera is a rapidly expanding native shrub on the Virginia barrier islands which displaces other native coastal species and may interrupt normal sediment dynamics. Barrier islands are considered stressful environments with low nutrients, high solar load, and frequent drought and salt exposure; facilitation often dominates in stressful environments according to the Stress Gradient Hypothesis. The objective of this project was to understand the importance of species interactions with grasses on the growth and physiology of M. cerifera at the seedling life stage through both field and lab experiments. Grasses provided ~1.3°C insulation to shrubs during winter freeze events and …

The Role Of Syndecan-1 And Extracellular Vesicles In Breast Cancer Brain Metastasis, Megan R. Sayyad

Theses and Dissertations

Breast cancer metastasizes to the brain in 15-30% of all breast cancer cases, and metastasis is the predominant cause of breast cancer-related deaths. Patients with HER2-enriched and triple-negative breast cancers (TNBCs) are more likely to develop brain metastases. While targeted therapies exist for HER2-enriched breast cancers, there are no effective treatments for TNBCs. Thus, a greater understanding of how these cancers spread to the brain is critical. In order to spread to the brain, disseminated breast cancer cells must overcome 2 major steps—crossing the blood-brain barrier (BBB) and survival and successful colonization of the distinctive and mostly cellular brain environment. …

Spag17 Deficiency Impairs Neuronal Cell Differentiation In Developing Brain, Olivia J. Choi

Theses and Dissertations

The development of the nervous system is a multi-level, time-sensitive process that relies heavily on cell differentiation. However, the molecular mechanisms that control brain development remain poorly understood. We generated a knockout (KO) mouse for the cilia associated gene Spag17. These animals develop hydrocephalus and enlarged ventricles consistent with the role of Spag17 in the motility of ependymal cilia. However, other phenotypes that cannot be explained by this role were also present. Recently, a mutation in Spag17 has been associated with brain malformations and severe intellectual disability in humans. Therefore, we hypothesized that Spag17 plays a crucial role in …

Competing Strength-Based Models Of Trauma And Suicidality In A High-Risk Primary Care Sample, Samantha Mladen

Theses and Dissertations

There is limited research on the relationship between trauma exposure, depression, and suicidality, particularly in high-risk primary care samples. The present study aims to: 1) characterize the prevalence of suicidality, depression, and trauma exposure in this sample; 2)develop and test models of the relationships between suicidality, depression, and trauma exposure in this sample; 3) augment the selected model with key protective factors, including social support and religiosity; and 4) further elaborate the nature of religiosity as a potential protective factor using the subscales of the Attitudes toward God scale, Anger toward God and Comfort with God.

Patients (n …

Determination Of Optimal Parameter Estimates For Medical Interventions In Human Metabolism And Inflammation, Marcella Torres

Theses and Dissertations

In this work we have developed three ordinary differential equation models of biological systems: body mass change in response to exercise, immune system response to a general inflammatory stimulus, and the immune system response in atherosclerosis. The purpose of developing such computational tools is to test hypotheses about the underlying biological processes that drive system outcomes as well as possible real medical interventions. Therefore, we focus our analysis on understanding key interactions between model parameters and outcomes to deepen our understanding of these complex processes as a means to developing effective treatments in obesity, sarcopenia, and inflammatory diseases.

We develop …

A Sacred Gift: Rebalancing Our Relationship With Water, Noora Naser Melhim

Theses and Dissertations

In the Middle East, and specifically Qatar, water has significant cultural history and preciousness as a commodity. Today, the rapid economic development has resulted in a disconnection from the past leading to subconscious overconsumption of water.

This thesis investigates water from the context of cultural relevance, by examining systems of distribution before and after the discovery of oil. It reinterprets the materiality of the traditional ceramic vessels used to contain and preserve water with the intention of using the natural properties of clay, such as cooling and filtering, to produce new artifacts. The intent of this research is to critically …

Arab Americanesque, Hannah W. Shaban

Theses and Dissertations

Culture, as defined by Edward Said, is a concept of identity selectively curated through imperialism. Through my ceramic practice, I explore what constitutes my cultural identity as a first generation Arab American. My work, primarily influenced by family narrative was initially expressed through investigations in the figure and viewer relationships with my sculpted figures. As my research progressed into Western Imperialism, I began noticing extensive evidence of colonialism’s lasting effects, especially within Western consumer markets. Interest in the writings of Said, works by French Orientalist painters, family memory, and a general displeasure with the plethora of Middle Eastern design used …

Designing Biomimetic Implant Surfaces To Promote Osseointegration Under Osteoporotic Conditions By Revitalizing Mechanisms Coupling Bone Resorption To Formation, Ethan M. Lotz

Theses and Dissertations

In cases of compromised bone remodeling like osteoporosis, insufficient osseointegration occurs and results in implant failure. Implant retention relies on proper secondary fixation, which is developed during bone remodeling. This process is disrupted in metastatic bone diseases like osteoporosis. Osteoporosis is characterized low bone mass and bone strength resulting from either accelerated osteoclast-mediated bone resorption or impaired osteoblast-mediated bone formation. These two processes are not independent phenomena. In fact, osteoporosis can be viewed as a breakdown of the cellular communication connecting bone resorption to bone formation. Because bone remodeling occurs at temporally generated specific anatomical sites and at different times, …

An Evaluation Of Induced Shear Stress On Endothelial Cellular Adhesion Molecules, Edward B. Crabb

Theses and Dissertations

The pathophysiology of atherosclerotic cardiovascular disease (CVD) is highlighted by vascular dysfunction and low-grade vascular inflammation. Furthermore, the site-specific distribution of atherosclerosis throughout the arterial vasculature is primarily determined by local hemodynamic force. Therefore, this dissertation outlines three experiments designed to investigate the role of acute mental and physical (i.e., aerobic exercise), and vascular wall shear stress (SS) on the inflammatory aspects of atherosclerosis. Chapter 2 examines the effect of acute laboratory-induced mental stress on intracellular pro-inflammatory signaling pathways in peripheral blood mononuclear cells. Chapter 3 investigates the impact of acute laboratory-induced mental stress and maximal aerobic exercise on the …

Singing The Landscape: A Meditation On Song, Sound And Community At The Fall Line Of The James River, Sara Bouchard

Theses and Dissertations

I work in the medium of song. A multidisciplinary artist and composer, I make work that is immersive, time-based and often participatory. I interact with landscape and the complexities of American history, bringing into focus local ecologies through the lens of song.

This document accompanies my thesis performance The Sound of a Stone, an immersive exploration of song, language, ecology and locational listening performed in a 4-channel surround format. In the semi-improvised composition, I sample live vocals, mandolin and found natural objects in a combination of roots music traditions and experimental techniques. Utilizing the software Ableton Live to process …

Molecular Pharmacology Of Non-Phyto-Cannabinoid Approaches For Treatment Of Neuropathic Pain, Nadejda A. Blajkevich

Theses and Dissertations

Approximately twenty million people in United States have some form of peripheral neuropathy. It has been shown that the CB₂ cannabinoid receptor is upregulated when there is peripheral nerve injury and activating the CB₂ receptor produces anti-inflammatory effects that translate to a reduction in signs of “neuropathic pain” in animal models. Elevating endogenous cannabinoids by inhibiting degradative enzymes has also been used to reduce neuropathic pain signs in laboratory animal models of pain. We hypothesize that the molecular pharmacology of these two approaches can be leveraged to optimize CB₁/CB₂ activation to improve non-phyto-cannabinoid treatments for …

Therapeutic Targeting Of Relaxin Signaling In Ischemic Heart Disease, Siva Teja Vk Devarakonda

Theses and Dissertations

Ischemic heart disease is characterized by reduced perfusion of oxygenated blood to the myocardium, potentially resulting in infarction upon occlusion of coronary arteries. While prompt reperfusion and advances in in-hospital care have led to a decline in short term mortality, sustained damage to the ventricle, along with reperfusion injury, can lead to progressive deterioration in cardiac function. Limiting the extent of this initial ischemia-reperfusion injury and combating the course of adverse remodeling remains the scope of several preclinical studies geared towards improving cardiac health after MI. To this, relaxin-2 – the peptide hormone that regulates maternal hemodynamic function during pregnancy …

Discriminating Between Technical And Global Competence In Cbt Programs For Youth Anxiety, Jennifer Cecilione

Theses and Dissertations

Therapist competence refers to the skillfulness and responsiveness demonstrated when delivering an intervention and is an important factor to consider in the training and evaluation of therapists. However, competence research is sparse, especially in the youth psychosocial treatment field. A primary discrepancy is whether technical (related to interventions associated with a specific treatment program) and global (general clinical expertise) competence can be measured as distinct dimensions of competence. The goal of the current study was to determine whether instruments of technical (Cognitive-Behavioral Treatment for Anxiety in Youth Competence Scale; CBAY-C; McLeod et al., 2018) and global (Global Therapist Competence Scale …

The Effect Of Quercetin In Periodontal Inflammation, Sara Holden

Theses and Dissertations

Purpose: To determine the effect of Quercetin, a plant based over the counter flavonoid, on periodontal inflammation in a murine model of periodontitis.

Methods: Periodontitis was induced in age and gender matched mice (C57BL/6) using ligatures on the left side of the maxilla and right side was left un-ligated as baseline control. The animals received daily Quercetin gavage or Phosphate Buffered Saline (PBS) starting 5 days prior to ligation which continued throughout the experimental protocol. Micro-computed tomography (micro CT) imaging was used to determine alveolar bone loss. Real Time quantitative (qRT) PCR was used to determine level of gingival tissue …

Abolish Ice . . . And Then What?, Peter L. Markowitz

Articles

In recent years, activists and then politicians began calling for the abolition of the United States’s interior immigration-enforcement agency: U.S. Immigration and Customs Enforcement (ICE). Many people have misinterpreted the call to “Abolish ICE” as merely a spontaneous rhetorical device used to express outrage at the current Administration’s brutal immigration policies. In fact, abolishing ICE is the natural extension of years of thoughtful organizing by a loose coalition of grassroots immigrant-rights groups. These organizations are serious, not only about their literal goal to eliminate the agency, but also about not replacing it with another dedicated agency of immigration police. Accordingly, …

Commercial Speech Protection As Consumer Protection, Felix T. Wu

Articles

The Supreme Court has long said that “the extension of First Amendment protection to commercial speech is justified principally by the value to consumers of the information such speech provides.” In other words, consumers—the recipients or listeners of commercial speech—are the ones the doctrine is meant to protect. In previous work, I explored the implications of taking this view seriously in three contexts: compelled speech, speech among commercial entities, and unwanted marketing. In each of those contexts, adopting a listener-oriented approach leads to the conclusion that many forms of commercial speech regulation should receive far less First Amendment scrutiny than …

The “New” District Court Activism In Criminal Justice Reform, Jessica A. Roth

Articles

Historically, the debate over the judicial role has centered on the constitutional and administrative law decisions of the United States Supreme Court, with an occasional glance at the Federal Courts of Appeals. It has, moreover, been concerned solely with the “in-court” behavior of Article III appellate judges as they carry out their power and duty “to say what the law is” in the context of resolving “cases and controversies.” This Article seeks to deepen the discussion of the appropriate role of Article III judges by broadening it to trial, as well as appellate, judges; and by distinguishing between an Article …

Jurisliterature And Transgression, Peter Goodrich

Articles

The jurisliterary profession is the curious enterprise of writing, as a jurist, about law. Many seek to escape into literature, philosophy, critique, psychoanalysis, the couch, but then, in the main, they have abandoned law. Those that persist, who remain jurists, have the propensity to transgress the boundaries of the juridical, the strictures of abstraction and disembodiment, so as to generate accounts of legal sensibility, so as to manifest the polyglottal and visceral potential of transforming the juridical bubble into that most ethical of realms, the poetics of desire. Jurisliterary transgression, at its strongest, returns the materiality of imagination to the …