The Effect Of Intermittent Theta Burst Stimulation On Biceps Corticomotor Excitability In Non-Impaired Individuals And Individuals With Tetraplegia, Blaize Majdic

Theses and Dissertations

Neuromodulation of the primary motor cortex (M1) in pair with physical therapy may be a promising method for improving motor outcomes after spinal cord injury (SCI). Increased excitability of the corticospinal motor pathways (i.e. corticomotor excitability) has shown to be associated with improved motor learning and skill acquisition. Intermittent theta burst stimulation (iTBS) is a form of non-invasive brain stimulation which can increase corticomotor excitability, as measured by an increase in the amplitude of motor evoked potentials (MEPs). However, the ability for iTBS to increase the corticomotor excitability of proximal muscles such as the biceps, and muscles affected by spinal …

Understanding The Contributions Of Discrepant Parent-Adolescent Views Of Parenting Practices And Peer Deviance To Adolescent Problem Behavior: A Cross-Lagged Polynomial Regression Approach, Mallory Stephenson

Theses and Dissertations

The present study used autoregressive cross-lagged models to examine the processes through which peer deviance and discrepant parent-adolescent views of monitoring-related communication, involvement, and positive parenting influence one another and contribute to physical and relational aggression, substance use, and delinquency. Participants included 535 adolescents (64% male) who were identified as prone to aggression and socially influential by their sixth-grade teachers during the 2001-2002 and 2002-2003 school years; participants self-identified as African American (69%), Hispanic (14%), White (9%), Multiracial (5%), or another race (3%). Contrary to expectations, parent-adolescent reporting discrepancies were not related to peer deviance, physical aggression, substance use, and …

Exploring The Use Of Pulsed Erbium Lasers To Retrieve A Zirconia Crown From A Zirconia Implant Abutment, Ahmed Elkharashi

Theses and Dissertations

Removal of zirconia crowns, commonly used as cement-retained implant fixed restorations, can be challenging. Conventional methods of crown removal are time consuming and often leave irreparable damage to the crown, which can be costly to patients and practitioners. This research explored the use of two different types of pulsed erbium lasers, erbium-doped yttrium aluminum garnet laser (Er:YAG) and erbium, chromium-doped yttrium, scandium, gallium and garnet (Er,Cr:YSGG), as non-invasive tools to retrieve cemented zirconia crowns from zirconia implant abutments. Times needed to remove the crowns were recorded and analyzed using ANOVA (��=0.05). No statistical differences between the debond times of each …

Effects Of Active Reminders And Motivational Techniques On Oral Hygiene And Gingival Health In Orthodontic Patients: A Randomized Clinical Trial, Jennifer Shim

Theses and Dissertations

Purpose: To compare repeated oral hygiene instructions and motivation to text message reminders in improving oral hygiene compliance

Methods: For this prospective, randomized controlled clinical trial, 60 patients were assigned to one of four groups. Group 1 served as a control. Group 2 received weekly text message for oral hygiene. Group 3 received in-person oral hygiene instructions at each visit. Group 4 received both text messages and in person oral hygiene instructions. Oral hygiene was measured with Bleeding Index (BI), Modified Gingival Index (MGI), and Plaque Index (PI). Baseline measurements were obtained at the day of bonding (T0) and then …

Role Of Nurd In Acute Leukemia Cell Survival, Javeria Aijaz

Theses and Dissertations

Depletion of the ATPase component of the Nucleosome Remodeling and Deacetylase (NuRD) complex, CHD4, reduces acute myeloid leukemia (AML) cell survival. This study identified other NuRD components, as potential therapeutic targets for disrupting protein-protein interactions within NuRD. In addition to AML, we established that T-cell Acute Lymphoblastic Leukemia (T-ALL) cell lines responded similarly to CHD4 depletion.

Greater than 90% depletion of either MBD2 or MBD3 (the mutually exclusive two DNA binding NuRD paralogues) – was unremarkable, but complete depletion of MBD3 increased apoptosis and genotoxic sensitivity. Combined depletion of MBD-NuRD proteins augmented apoptosis observed with complete MBD3 depletion - indicating …

Teacher Approaches To Women’S History, Gender, And Feminism In Secondary Social Studies, Kimberly R. Bowman

Theses and Dissertations

While several scholars have worked to reimagine social studies curriculum from a feminist perspective, there are few studies that look at how teachers understand and experience gender equity work (Bohan, 2017; Engebretson, 2018). This study seeks to bridge that gap between theory and practice in order to progress toward a more gender-equitable social studies education. Utilizing a hermeneutic circle design to facilitate dialogue across participants, I conducted one-on-one, semi-structured interviews with seven secondary social studies teacher participants and collected participant-provided curriculum materials. Using techniques from constructivist grounded theory, I analyzed how teachers made sense of their experiences trying to include …

An Intersectional Analysis Of Disproportionality Of Dual Language Learners In Special Education In Virginia: A Mixed Methods Study, Melissa J. Cuba

Theses and Dissertations

The disproportionality of dual language learners (DLLs) in special education has been a persistent and complex issue for decades. These students have multidimensional identities that require a look at how they are positioned in school systems and the broader social landscape. Using a multilevel model of intersectionality and an explanatory mixed methods design, this study examines how social categories, practice, and policies influence the representation of DLLs in special education in Virginia, a state where DLLs represented 13 percent of the total student population in 2018-19. Findings from this study reveal overrepresentation and underrepresentation of 63 DLL subgroups using nuanced …

“Is Therapy For Me?” Perceptions Of Therapy Inclusivity And Willingness To Seek Help Among Black Emerging Adults, Randl B. Dent

Theses and Dissertations

Mental health issues are prevalent among Black emerging adults; however, they tend to underutilize mental healthcare services. The goals of the current study were to examine whether: (1) perceived therapy inclusivity would predict willingness to utilize mental healthcare services and (2) the relationship between perceived therapy inclusivity and willingness would be moderated by two indices of racial identity (i.e., centrality and private regard). Results provide evidence that greater perceptions of therapy inclusivity are associated with greater willingness to seek mental health services even after controlling for factors, such as gender, self-stigma, and previous mental healthcare utilization. Additionally, there was no …

A Randomized Trial Of Cbt4cbt For Women In Residential Treatment For Substance Use Disorders, Sydney S. Kelpin

Theses and Dissertations

Women with substance use disorders (SUD) face unique barriers to substance use treatment, and as a result, are less likely than their male counterparts to seek treatment for the disorder. Cognitive behavioral therapy (CBT) is an evidence-based treatment known to reduce relapse rates by teaching clients to recognize and respond to their cues for substance use. Recent research suggests CBT may be particularly of benefit to women. Despite the effectiveness of CBT, its dissemination in clinical practice is limited due to a range of barriers (e.g., time, cost). Computer-based training for cognitive behavioral therapy (CBT4CBT) offers an opportunity to improve …

Disentangling Student Engagement In Afterschool Programs, Ashlee M. Lester

Theses and Dissertations

This dissertation presents a line of research exploring the characteristics and role of student engagement in afterschool programs, specifically during early adolescence. The dissertation takes a two-study format, building off of my comprehensive exam Measuring engagement in out-of-school time programs. This first chapter is an introduction in which I will detail the underlying problem that is investigated in the following two manuscripts. Following this introduction, the two separate studies are presented.

Phenotype Extraction: Estimation And Biometrical Genetic Analysis Of Individual Dynamics, Kevin L. Mckee

Theses and Dissertations

Within-person data can exhibit a virtually limitless variety of statistical patterns, but it can be difficult to distinguish meaningful features from statistical artifacts. Studies of complex traits have previously used genetic signals like twin-based heritability to distinguish between the two. This dissertation is a collection of studies applying state-space modeling to conceptualize and estimate novel phenotypic constructs for use in psychiatric research and further biometrical genetic analysis. The aims are to: (1) relate control theoretic concepts to health-related phenotypes; (2) design statistical models that formally define those phenotypes; (3) estimate individual phenotypic values from time series data; (4) consider hierarchical …

Comparison Of Endodontic Treatment Planning Decisions Using Cone Beam Computed Tomography Versus Periapical Radiography In Previously Endodontically Treated Molars, Sarah Alkanderi

Theses and Dissertations

Objectives: The aim of this study was to determine if treatment plans differ when evaluating previously endodontically treated molars using periapical images (PA’s) alone versus PA’s and CBCT.

Methods: A retrospective cohort chart review was conducted including 67 previously treated molars that had a CBCT taken. Two calibrated board-certified endodontists evaluated standard PA’s. A data sheet questionnaire regarding radiographic findings and treatment plan decisions was completed. Two weeks later, the same steps were repeated but the examiners evaluated both PA’s and CBCT images and again arrived at a recommended treatment plan.

Results: Agreement between raters was assessed with Cohen’s Kappa …

Senescent Trees Stabilize Aboveground Wood Net Primary Production Immediately After Disturbance, Maxim S. Grigri

Theses and Dissertations

In the United States, forests sequester 17% of national carbon (C) emissions annually (UGCRP, 2018), however shifting forest disturbances threaten the stability of this essential C sink. Unlike the high severity, stand-replacing disturbances that were widespread a century ago, today’s eastern temperate forests experience frequent low-to-moderate severity disturbances from invasive pests and pathogens with mixed effects on net primary production (NPP). Carbon cycling stability after disturbance has been reported, however, the mechanisms underlying immediate NPP stability or decline are not well understood. Through weekly measurements of production in a landscape scale experiment, we show that the sustained growth of senescent …

Magnetic Refrigerator Device Based On La (Fexcoysi1-X-Y)13, Khushar Javed

Theses and Dissertations

Particles of Lanthanum-iron-silicide, La (Fe_xCo_ySi_1-x-y)₁₃exhibit different magnetic properties when stored in air compared to the same stored in water. The sample with a nominal composition of La(Fe0_.842Co_0.073Si_0.084)₁₃was prepared by arc-melting from elements under argon atmosphere. In recent years, there has been research conducted on different processes that could drastically reduce energy costs of cooling and replacing gas compressors with magnetocaloric materials. Magnetization measurements were carried out on this magnetocaloric material to characterize it in order to design magnetic refrigerator device based on it. The …

Characteristics Of Alveolar Bone Marrow Cells From Patients Undergoing Dental Extractions Or Dental Implant Therapy, Meng H. Lee

Theses and Dissertations

Alveolar bone marrow stromal cells (aBMSCs) play important roles in craniofacial wound healing. To establish an easy, efficient and reliable method to harvest aBMSCs, we compared three different methods: extraction socket aspiration, osteotomy aspiration and bone core digestion. Samples of aBMSC were collected from two groups of subjects. Group 1 (dental extraction): after dental extraction, 22.5-gauge needles were used to collect 0.5-1cc marrow aspirate. Group 2 (dental implant): during implant surgeries, bone core and 0.5-1cc marrow aspirate were obtained from the osteotomy. Samples were cultured in petri dishes and attached cells were expanded. The population doubling time (PDT), surface markers, …

Predictors Of Mental Health Need And Treatment In Safety Net Primary Care, Kristen O'Loughlin

Theses and Dissertations

Many mental health (MH) needs go unidentified in primary care, and certain patients appear to be at higher risk of needs going unidentified and subsequently untreated. Little is known about patterns of detection and treatment in clinics with integrated mental health services. The purpose of this study was to characterize the prevalence of MH needs and evaluate patient characteristics as predictors of both the presence of a MH need and type of MH services received. Subjects were patients receiving care at two safety net primary care clinics with integrated mental health services (N=816; 52.7% Latinx, 15.9% African American), …

Associations Between Stress, Racial Discrimination, And Cytokine Levels In Black Americans, Takia Williams

Theses and Dissertations

Inflammation is a common pathophysiological pathway for a number of chronic diseases and is influenced by exposure to stress. Although there are racial disparities in health outcomes, relatively little is known about factors that may influence the inflammatory response in Black American individuals. This study examined whether racial discrimination and other forms of stress are associated with the balance of pro- and anti- inflammatory cytokines in Black American adults. Data from 22 participants were drawn from a larger study of Black American children (ages 5-12) and their primary caregivers drawn from low income neighborhoods in Richmond, Virginia. Caregivers reported demographics, …

Characterizing Glycosaminoglycan And Glycosaminoglycan-Oligo Interactions With Cancer Stem Cells And Their Regulators, Rahaman Navaz Gangji

Theses and Dissertations

Tumor metastasis and recurrence account for more than 90% of cancer-associated deaths and are thought to occur due to a small subpopulation of neoplastic cells known as cancer stem cells (CSCs). Because CSCs are resistant to conventional chemotherapy, there is a critical need to develop CSC-targeting agents. Microenvironmental components, especially glycosaminoglycans (GAGs), play a key role in regulating CSC phenotype. GAGs such as heparan sulfate (HS) interact with hundreds of proteins and influence a variety of biological processes including tumor proliferation, angiogenesis, metastasis and stem cell biology.

Recently, the Desai and Patel laboratories have demonstrated that a hexasaccharide form of …

The Relationships Among External Environments, Organizational Structures, And Performance In Pursuit Of The Clinical And Academic Missions At Academic Health Centers, Eric J. Strucko

Theses and Dissertations

Clinical and academic missions place Academic Health Centers (AHCs) at the center of the American health care system, and the future viability of these institutions requires successful performance in competitive environments. AHCs are organizations involving hospitals, physician group practices, and medical schools, and treat patients with complex conditions, conduct bio-medical and health science research, and educate future physicians and health professionals. AHCs account for 20% or $540 billion of national health care expenditures, conduct over 80% of all heart, liver, and lung transplants, utilize over $27 billion in annual sponsored research funding, and graduate approximately 17,300 medical doctors annually. Financial …

Psychometric Developments Of The Ace-Iq: Understanding The Trauma History Of Latine Immigrants, Jorli K. Swingen Dr.

Theses and Dissertations

Adverse childhood experiences (ACEs) have a profound effect on an individual’s physical and mental health. The World Health Organization has recently updated the ACE questionnaire so it could be used with international populations. The Adverse Childhood Experiences-International Questionnaire (ACE-IQ), has not been translated to Spanish or used with Latine immigrants.

This study translated the ACE-IQ into Spanish, evaluated the psychometric properties of the questionnaire, and collected data on 184 four adult English Language Learners in Chesterfield County, VA.

There is evidence of internal consistency for the ACE-IQ as a whole (α = .908) and within subscales. Three factors were identified …

Modulation Of Ferroportin In Oral Cancer, Ashley N. Hemingway

Theses and Dissertations

Iron plays a critical role in life sustaining functions for the cell. Dysregulation of these processes can be an issue with maintaining homeostatic conditions. Various cancer types have been observed to show malfunction in the maintenance of their iron homeostasis, in particular with the iron export protein—ferroportin. Ferroportin is the sole iron exporter known. Its structure and mechanism have not fully been elucidated yet, but its modulation has been associated with a poorer prognosis in cancers like breast, leukemia, prostrate, ovarian, colorectal, etc. Decreased iron exportation by ferroportin may lead to an increased labile iron pool allowing the cell to …

A Comparison Of Patient Testimonials On Youtube Of The Most Common Orthodontic Treatment Modalities: Braces, In-Office Aligners, And Direct-To-Consumer Aligners, Riley Hunsaker

Theses and Dissertations

Introduction: The objectives of this research was to investigate and compare the educational value of the most popular YouTube orthodontic patient testimonials between braces (B), in- office aligners (IOA), and direct-to-consumer aligners (DTCA), and to classify the emotional response of the viewers through a sentiment analysis of the video comments.

Methods: Three different phrases relevant to B, IOA, and DTCA were searched on YouTube. The 20 most popular patient testimonial videos that met the criteria for each group were selected, for a total of 60 videos. Using the YouTube API for each video, 13 video metrics were extracted, an information …

Design, Synthesis, And Biological Evaluation Of Mu Opioid Receptor Selective Antagonists Bearing Pyrazole And Imidazole Side Chains, Pornprom Klongkumnuankarn

Theses and Dissertations

Opioid Use Disorder (OUD) is one of the major national threats to human health and economic system. Since the opiate substances produce their pharmacological effects mainly at the Mu Opioid Receptor (MOR), the development of potent MOR selective antagonists is imperative. By application of the message-address concept, the novel selective MOR antagonist, NAP was synthesized in our group. The molecular modeling studies of NAP revealed that its MOR selectivity was determined by interactions between the C(6) side chain and the non-conserved residues of the receptor. To enrich our understanding of Structure-Activity Relationship (SAR) of the opioid ligands as well as …

The Effect Of Print Angulation On The Accuracy And Precision Of 3d-Printed Orthodontic Retainers, Allison Williams

Theses and Dissertations

Purpose: The aims of this study were: 1) to compare the accuracy and precision of 3-

dimensional (3D) printed retainers at various angulations, 2) to evaluate the effect of angulation

on printing time and the amount of resin consumed.

Methods: Using a stereolithography (SLA) 3D printer, a total of 60 clear retainers were printed at five angulations (n=12, each): 15, 30, 45, 60, and 90 degrees. Six retainers were printed each cycle at a random order for all print angulations as print 1 and print 2. Digital images of the original and printed retainers were superimposed. Discrepancies on eight landmarks …

The Effects Of Autophagy And Senescence On Sensitivity To Cisplatin In Head And Neck Cancer, Zara H. Siddiqui

Theses and Dissertations

While current treatments in cancer, such as chemotherapy and radiation, can generally be effective in eliminating disease in patients, there also exists the possibility of recurrence of cancer cells over time. In patients diagnosed with locally advanced head and neck carcinoma, about 50-60% develop a loco-regional recurrence within two years, and 20-30% of patients develop metastatic disease at distant sites in the body [5]. On a cellular level, one mechanism for this survival may be that natural mechanisms such as autophagy and senescence play a role in allowing cells to survive after undergoing treatment. One standard of care chemotherapy for …

Achieving Dentin Conservation Using Dynamic Navigation Technology For Locating Calcified Canals, Madison W. Saunders

Theses and Dissertations

Purpose: Pulp canal obliteration (PCO) is a common sequela of dental trauma, caries, restorations and vital pulp therapy procedures. Despite the application of high magnification and CBCT imaging, access cavity preparation for such cases is prone to procedural errors that may lead to substantial loss of dentin structure thereby reducing the long-term prognosis. This study aimed to achieve dentin conservation using a novel computer assisted dynamic navigation system (Navident) in comparison to freehand access preparation for locating calcified canals.

Methods: Forty maxillary and mandibular central incisors (tooth #9 and tooth #25) were 3-D printed to simulate PCO. They were randomly …

A Cost-Effectiveness Analysis Of Early Literacy Growth In Public Pre-Kindergarten Programs, Bruce A. Fillman

Theses and Dissertations

Student early literacy readiness is predictive of later academic success and pre-k programs are a proven intervention to develop early literacy; however, the cost of pre-k programs differs greatly. These differences in cost are related to the opportunities and services included within each program. This study examined four pre-k programs offered within a large school system in Virginia to determine if there were differences in students’ early literacy growth by program attended and evaluated the ratio of cost to achievement of each pre-k program to determine their cost-effectiveness. To do this, two one-way analyses of variances (ANOVAs) were conducted to …

Smallest Worthwhile Effect Values For Pain And Function After A Total Knee Replacement, Nancy Wofford

Theses and Dissertations

ABSTRACT

SMALLEST WORTHWHILE EFFECT VALUES FOR PAIN AND FUNCTION AFTER A TOTAL KNEE REPLACEMENT

Nancy Henderson, PT

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2020

Dr. Dan Riddle, PT, PhD, Physical Therapy

Meaningful change is an important concept in healthcare as it allows providers to better understand the efficacy of an intervention. Three commonly used methods to assess meaningful change include the distribution-based, anchor-based, and benefit-harm trade-off methods. The benefit-harm trade-off method improves upon the limitations of the distribution-based and anchor-based methods. Unlike the …

Effects Of (R,S)-Ketamine And (2r,6r)-Hydroxynorketamine: A Preclinical Study, Remington Rice

Theses and Dissertations

In 2017, 7.1% of US adults were diagnosed with depression, and 50% of patients received medication to treat their depression. Depression can cause severe interruptions in an individual's cognitive functioning and behaviors like sleeping, eating, working, and socializing. Unfortunately, approximately 40% of patients do not respond to treatment with monoaminergic medications (e.g. Prozac) and therapeutic effects may be delayed 2-8 weeks. Due to these therapeutic shortcomings, faster acting and more efficacious treatments are needed. Recent preclinical findings indicate potential for glutamatergic drugs like (R,S)-ketamine and (2R,6R) hydroxynorketamine to produce more rapid and longer-acting therapeutic effects. The antidepressant effectiveness of (R,S)-ketamine …

Molecular And Behavioral Mechanisms Mediated Paclitaxel-Induced Changes In Affect-Like Behavior In Mice, Julia Meade

Theses and Dissertations

Paclitaxel and oxaliplatin are two chemotherapeutics that cause acute neurotoxicity and chemotherapy-induce peripheral neuropathy (CIPN) in 70-90% of cancer patients. Chemotherapy-induced sensory changes are correlated with depression and anxiety. We characterized the effects of these drugs on sensation and various mood-related behaviors in mice, to determine if changes in sensation are associated with depression-like behavior, to explore putative mechanisms of chemotherapy-induced depression-like behavior (Aim 1), and to develop a mouse model of chemotherapy-induced operant responding deficit (Aim 2). In Aim 1, we observed that a cumulative dose of 32 mg/kg paclitaxel induced mechanical hypersensitivity and transiently reduced preference for sucrose …