Digital Commons Network^™

Driving-Related Challenges For Autistic Youth, Jeong-Heun Kim

ETDs from 2020-2029

Individuals with autism spectrum disorder (ASD) often face barriers to driving. Despite evidence that they have potential to drive safely, some unique challenges exist, manifested in a substantially lower licensure rate than typically developing (TD) peers and restricted driving patterns among this population. Therefore, the overarching goal of this dissertation project was to investigate driving-related challenges that young autistic people face. Both objective and subjective measures were used to comprehensively explore this research topic. The first two papers focused on investigating perceptual, cognitive, and behavioral factors underlying hazard response using data from a total of 34 licensed drivers (17 with …

Investigating The Role Of Centromere Deletion In Chromosome Segregation, Azait Imtiaz

ETDs from 2020-2029

Centromeres are critical genomic regions responsible for ensuring accurate chromosome segregation during cell division. Disruptions in the structural or functional integrity of centromeric DNA could impair kinetochore assembly, leading to chromosome missegregation and chromosomal instability (CIN), a hallmark of various human diseases, including systemic sclerosis (SSc). This study investigated the contribution of centromeric DNA damage and deletion to CIN and explored potential pathogenic mechanisms relevant to SSc. We utilized hTERT-immortalized fibroblast cell lines (CHON-002 and BJ-5ta) to implement two complementary approaches: (i) treatment with bleomycin, a chemotherapeutic agent known to induce DNA double-strand breaks (DSBs), and (ii) targeted deletion of …

A Pilot Study Of The Acute Effects Of Isometric Exercise And Aerobic Exercise For Improving Blood Pressure And Vascular Hemodynamics In Hypertensive Adults, Ayih Cedric Edoh

ETDs from 2020-2029

Hypertension (HTN) is one of the most prevalent and modifiable risk factors for developing cardiovascular disease (CVD). Aerobic exercise is a well-known method to lower blood pressure (BP), but recently, isometric exercise has been purported to lower BP to a similar or greater extent. There is little known about the effects of isometric exercise on acute BP and 24-hour ambulatory blood pressure (ABP). Therefore, the purpose of this pilot study was to compare the effects of isometric and aerobic exercise on improving vascular hemodynamics and 24-hour ABP in hypertensive adults. METHODS: Seven participants (age 25-65 years) with a diagnosis of …

Altered But Adaptive: Network Integration In Pediatric Acute Lymphoblastic Leukemia Survivors A Diffusion Mri Graph Theory Analysis, Amanda Cook

ETDs from 2020-2029

Pediatric acute lymphoblastic leukemia (ALL) survivors face treatment-related risk for late-emerging cognitive difficulties. Chemotherapy can disrupt white-matter structure leading survivors to experience subtle but persistent challenges with processing speed, working memory, and executive functioning. However, cognitive outcomes vary widely even among survivors with similar treatment exposures. To better understand this variability, this study examines how the brain adapts after treatment and how that adaptation is shaped by the environment. This study used diffusion magnetic resonance imaging (MRI) connectomics to characterize white matter network organization in 18 pediatric ALL survivors compared with 20 typically developing controls (ages 10-18). Structural connectomes were …

Epidemiology And Outcomes Of Geriatric Trauma At Uab, Lindy Reynolds

ETDs from 2020-2029

Adults over the age of 65 are the fastest growing portion of the population and account for a growing percentage of the trauma patient volume at trauma centers around the country. Older adults experience longer length of stays, higher mortality and complication rates than their younger counterparts. As a result, there has recently been an increased focus on models of geriatric trauma care, one of which is the addition of geriatric medicine consults for older trauma patients. The primary objectives of this dissertation were to examine the effect of the consult policy on outcomes using an interrupted time series approach, …

A Retrospective Analysis Of Dental Needs Identified By Intraoral Videography In Elderly Patients With Mild To Moderate Dementia In Long-Term Care Facilities: Feasibility Of A Novel Screening Mechanism For Oral Health, Kevin Hahn

ETDs from 2020-2029

This retrospective analysis explores the viability of employing intraoral videography to identify dental needs among long-term care (LTC) facility residents with cognitive impairment and/or mild to moderate dementia. Inadequate oral hygiene in these individuals can lead to dental plaque buildup, oral dysbiosis, gingivitis, dental caries, and periodontitis. Such conditions can impact both oral and systemic health. However, delivering oral hygiene in LTC facilities faces challenges due to care-resistant behavior triggered during mouth care. And many individuals in residential LTC facilities do not have access to dental care outside of severe emergencies due to cost, reimbursement patterns, lack of access to …

Optimization Of Post-Curing Conditions For 3d-Printed Dental Restorations: Mechanical And Color Stability Analysis, Mohammed Hammamy

ETDs from 2020-2029

Additive manufacturing has become increasingly utilized in dentistry for the fabrication of definitive restorations and provisional prostheses. However, the performance of 3D-printed materials is highly dependent on post-processing procedures, particularly post-curing, which influences the degree of polymerization and final material properties. The purpose of this study was to evaluate the effect of different post-curing protocols on the mechanical performance and color stability of a 3D-printed dental restorative material.Disc-shaped specimens were fabricated using a digital light processing (DLP) 3D printer and subjected to various post-curing conditions, including standard dental LED curing, nitrogen-assisted curing, glycerin immersion curing, Phrozen UV curing, VALO LED …

A Modular Saponin Adjuvant Platform: Development, Structure–Activity Relationships, And Applications, Di Bai

ETDs from 2020-2029

ABSTRACT Saponin-based vaccine adjuvants have attracted considerable attention owing to the clinical success of QS-21, a potent immunostimulant capable of inducing balanced humoral and cellular immune responses, yet its widespread application is limited by supply constraints, chemical instability, and dose-dependent toxicity. To address these challenges, we previously developed two semisynthetic saponin adjuvants, VSA-1 and VSA-2, derived from abundant Momordica saponins through a single-step modification, which exhibit QS-21–comparable immunopotentiating activity with improved accessibility and stability. Here, we first performed a systematic structure–activity relationship (SAR) study of the VSA series using MS I as the lead scaffold. Modulation of the side-chain length …

Histone Deacetylases In Kidney Injury: Distribution, Injury-Specific Regulation, And Fibroblast Hdac1 Function, Huy Nguyen

ETDs from 2020-2029

Acute kidney injury (AKI) is increasingly recognized as a major contributor to the development of chronic kidney disease (CKD) through maladaptive repair and interstitial fibrosis. Epigenetic regulation has emerged as a critical factor of kidney injury responses, however the injury-specific and cell-type specific roles of histone deacetylases (HDACs) remain poorly defined. This dissertation investigates the regulation and functional significance of HDACs in kidney injury, with a particular focus on fibroblast HDAC1 as a mediator of interstitial fibrosis development following AKI. In my cisplatin-induced AKI model, a single dose of cisplatin caused a significant decline in kidney function in both male …

Toothbrush Resistance Of Resin-Based Stain And Glaze Materials Applied To 3d-Printed Denture Resins, Panisa Homyai

ETDs from 2020-2029

Background: Three-dimensionally printed (3D-printed) dentures are commonly fabricated using a single tooth-colored resin, after which surface stain and glaze coatings are applied to reproduce gingival coloration, enhance the esthetic appearance and improve clinical longevity of characterized prostheses. However, daily oral hygiene procedures such as toothbrushing degrade surface coatings, leading to discoloration, increased plaque retention, and deterioration of esthetic appearance. Objectives: To evaluate the effect of stain timing and glaze application on the surface gloss and roughness of a three-dimensionally printed denture resin before and after simulated toothbrushing Methods: 80 disc-shaped specimens (12 mm in diameter and 3 mm in thickness) …

Mindfulness Across Media: Examining The Effects Of Audio, Audio-Visual, And Virtual Reality Mindfulness Interventions On Social Media Mindsets And Psychological Wellbeing, Rashmi Salian

ETDs from 2020-2029

Social media is so deeply ingrained and integrated into daily life that concerns about its impact on psychological wellbeing continue to grow, prompting pressing questions about how to foster healthier and more intentional use of technology. Recent studies suggest that low-agency mindsets toward social media lead users to develop habitual usage patterns and ambiguous information consumption behaviors, both of which negatively impact psychological outcomes. However, limited research is available on mechanisms that could effectively alter these mindsets. This study uses an experimental methodology to investigate whether mindfulness interventions delivered through varying levels of media immersion can improve psychological mindsets toward …

Mechanisms Of Cyst Initiation And Expansion In Polycystic Kidney Disease: Alterations In Tubule Flow Dynamics And P21- Driven Epithelial Reprogramming, Isis Thomas

ETDs from 2020-2029

Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited disorder characterized by progressive cyst formation, kidney enlargement, and eventual renal failure. Mutations in PKD1 or PKD2 disrupt polycystin-mediated mechanosensory signaling in renal epithelial cells, altering calcium signaling, epithelial architecture, and cellular homeostasis. Although cyst expansion has historically been attributed to epithelial hyperproliferation or tubule pinching off to form a cyst that no longer remains connected with the tubule, the early physiological and molecular events that initiate cyst formation remain incompletely understood. This dissertation investigates how alterations in tubule flow dynamics and epithelial stress responses contribute to cyst initiation and …

Investigation Of Air Emissions With A Local Composites Industry, Chris White

ETDs from 2020-2029

Workers at an office space raised complaints about a sweet-smelling odor directly outside their building. After an initial assessment of the surrounding businesses and their processes, it was determined that the workers were most likely exposed to styrene emissions from a nearby composites company. This investigation utilizes multiple weeks of direct readings with a photoionization device and active environmental sampling with a charcoal tube and pump to confirm the styrene exposure hypothesis. Weather trends were also recorded to determine correlation between weather and exposure to the sweet-smelling chemical. The direct readings found an exposure maximum of less than 2 ppm …

Holding The Dying: Worldview, Community, And The Practice Of End-Of-Life Doula Care, Amy J. Shields

ETDs from 2020-2029

As populations age and chronic illness increasingly characterizes the final stages of life in the United States, end-of-life doulas (EOLDs) have emerged as non-medical practitioners who support dying people and their families through education, companionship, advocacy, and ritualized care. Drawing on a thematic analysis of 18 semi-structured interviews with practicing EOLDs across the United States, this thesis examines how EOLDs conceptualize a “good death,” navigate emotionally intensive work, and sustain themselves in an unregulated and often marginal professional landscape. Situating EOLD practice within anthropological scholarship on death and dying, the study highlights the ways EOLDs challenge dominant biomedical narratives that …

Enhancing Dynamic Balance And Mobility In Adolescents With Cerebral Palsy Or Spina Bifida, Phuong Thi Minh Quach

ETDs from 2020-2029

Cerebral Palsy (CP) and Spina Bifida (SB) are among the most prevalent pediatric neuromotor impairments, posing significant challenges to independent mobility and dynamic balance. Although arising from different neurological origins, CP from non-progressive brain disruptions during development and SB from lower motor neuron lesions in the neural tube, both the conditions often lead to similar functional limitations, including muscle weakness, impaired gait and limited mobility. Affected children typically exhibit compromised postural control and an increased dependence on assistive devices. Over time, this decline in independent physical activity often triggers secondary health issues, such as early onset of osteoporosis, hypertension, and …

The Role Of 14-3-3 Proteins In The Pro-Inflammatory Response Of Microglia And The Neuronal Stress Response To Trichloroethylene Exposure, William Stone

ETDs from 2020-2029

ABSTRACT This dissertation examines how 14-3-3 proteins, with a focus on the 14-3-3θ iso-form, regulate signaling pathways relevant to neurodegeneration. While tradition-ally described as molecular hubs that organize protein–protein interactions, our work reveals how 14-3-3 function is shaped by environmental insults, namely bac-terial and neurotoxicant exposures, and how its disruption contributes to disease-associated processes. Two complementary approaches were used, focusing on microglial inflammatory signaling and neuronal responses to an environmental neurotoxicant, to define a broader role for 14-3-3 proteins in disease associated pathways in the brain. Chapter I identifies 14-3-3 proteins as modulators of microglial activation. Disrup-tion of 14-3-3 interactions …

Small Rna Sequencing Identifies Tsrna-05020 As A Potential Regulator Of Cervical Cancer Progression, Cheng Peng, Cong Liang, Jie Liu, Yunlu Liu, Ping Liu

Turkish Journal of Biology

Background/aim: Cervical cancer (CC) is a malignant gynecologic tumor. Small RNAs derived from tRNA (tsRNAs) have been reported to play regulatory roles in tumor progression and suppression. However, the functional role of tsRNAs in CC remains largely unclear.

Materials and methods: Small RNA sequencing was performed on normal, cervical intraepithelial neoplasia (CIN), and CC clinical cell samples to identify differentially expressed tsRNAs (DEtsRNAs). qRT-PCR was used to validate the selected DEtsRNAs. The effects of tsRNA-05020 on HeLa cell proliferation, apoptosis, and epithelial-to-mesenchymal transition were assessed.

Results: Compared with the normal group, 215 tsRNAs were significantly differentially expressed in CIN tissues, …

Cover And Contents

Turkish Journal of Biology

No abstract provided.

An In Vitro Mechanistic Study Of Cholinergic-Associated Mechanisms Relevant To Masld In Hepg2 Cells, Gamze Sönmez, Müslüm Gök, Suat Sari, Ebru Bodur

Turkish Journal of Biology

Background/aim: Polyunsaturated fatty acids (PUFAs) and the hepatic cholinergic axis are critical regulators of lipid metabolism and inflammatory signaling; however, their time-dependent interplay in hepatocytes remains incompletely understood. Clarifying how n-6 and n-3 PUFAs interact with cholinergic pathways may provide mechanistic insight into metabolic dysfunction-associated steatotic liver disease (MASLD).

Materials and methods: HepG2 cells were used to examine the combined effects of butyrylcholinesterase (BChE) overexpression and PUFA exposure. Cells were treated with linoleic acid (LA; n-6) or α-linolenic acid (α-LA; n-3) for 24 or 48 h. Gene expression analyses were performed to assess pathways involved in de novo lipogenesis, β-oxidation, …

Efficient Heterogeneous Photo-Fenton Degradation Of Azo Dyes Using The Nanocomposite Mgfe2o4/Mos2, Zahra Zeinali, Leila Ershadi Afshar, Naz Chaibakhsh, Farnaz Isapour

Turkish Journal of Chemistry

In the present work, a facile hydrothermal route was employed to synthesize the nanocomposite MgFe2O4/MoS2, which acted as a heterogeneous photo-Fenton catalyst for the degradation of a synthetic diazo dye, Acid Blue 113 (AB113). The nanocatalyst produced underwent analysis using multiple characterization techniques. The parameters influencing the oxidative reaction were statistically modeled and optimized using response surface methodology. Optimal degradation efficiency for AB113 (94.92%) was attained at pH 8.79 using 10 mg of MgFe2O4/MoS2 nanocatalyst, 1.6 mL of H2O2, and a reaction duration of 27 min. The synergistic effect resulting from the formation of electron-hole pairs renders the combined photocatalysis …

Electrochemical Biosensing Of Alpha-Fetoprotein Based On Carboxylated Multi-Walled Nanotube-Polyazur A (In Des)-Gold Nanoparticles, Merve Yilmaz Çilçar, Meli̇ke Bi̇lgi̇ Kamaç

Turkish Journal of Chemistry

AFP, a cancer biomarker, is monitored during fetal development and in the serum of pregnant women. Sensitive and rapid monitoring of AFP is crucial for effective management. In this study, screen-printed carbon electrodes (SPCEs) modified with multi-walled carbon nanotubes (MWCNT-COOH), polyAzur A (PAA), which was prepared in a deep eutectic solution (DES), and gold nanoparticles (AuNP) were fabricated. AFP biosensors were developed for practical, sensitive, low-cost, and rapid detection of AFP. Optimizations of nanostructures (MWCNT-COOH, AuNP) and polymers (PAADES) were performed. The MWCNT-COOH, PAADES, and AuNP-modified SPCEs were characterized by FE-SEM-EDX, FTIR, and XRD techniques. The amounts of 6-MOH, APTES, …

Reading Between The Lines: An Exploration Of Censorship In United States Public School Libraries, Sally Anne Perz

ETDs from 2020-2029

Between 2021 and 2025, PEN America documented over 22,000 book bans across the United States (US). Yet, with only 451 districts banning out of over 13,000, 97% of US school districts are not engaging in banning. The 451 banning districts represent only 3% of US school districts. While most research examines individual stakeholders, such as librarians and teachers, this study focused on district and community data which do not change as fast as microsystem variables. Since banning occurs at the district level, understanding school district demographics and values may help situate the sociopolitical context of school board decisions to ban …

Evaluation Of Occupational Exposure To Noise And Respirable Particulate Matter In Dentistry, Kabe Fetner

ETDs from 2020-2029

Dental procedures can result in occupational exposures to both noise and particulate matter. Dental professionals routinely operate high-speed instruments and mechanical tools that may produce elevated sound levels and aerosolized particles during clinical treatment. Although these exposures are common in dental environments, limited data exist describing full-shift occupational exposure levels during routine dental procedures. The purpose of this study was to evaluate occupational exposure to noise and respirable particulate matter (RPM) during routine dental procedures in a clinical setting. Area noise monitoring and real-time aerosol monitoring were conducted over six clinical days while common dental procedures were performed, including fillings, …

Statistical Methods For Mendelian Randomization Under Nonlinearity And Non-Normality, Mary Appah

ETDs from 2020-2029

Instrumental variable (IV) methods are widely used for estimating causal effects in observational studies where unmeasured confounding may bias traditional regression estimates. The core idea is to use a variable referred to as an instrument that is associated with the exposure of interest, independent of unmeasured confounders, and influences the outcome only through the exposure. While originally developed in econometrics, IV methods have been increasingly adopted in epidemiology and genetic research under the framework of Mendelian Randomization (MR), where genetic variants, most commonly single nucleotide polymorphisms (SNPs), serve as instruments. MR provides a powerful tool for investigating causal relationships between …

The Role Of Interorganizational Linkages In Shaping Hospital Reporting Burden: A Relational View Analysis, Robert Howard

ETDs from 2020-2029

Administrative burden associated with health information exchange represents a persistent challenge for U.S. hospitals, contributing to provider burnout and operational inefficiency. This study examined whether interorganizational linkages, specifically hospital system affiliation, participation in Accountable Care Organizations (ACOs), and participation in Health Information Exchanges (HIEs), are associated with perceived barriers to electronic health information exchange. Guided by the Relational View, linkages were conceptualized as potential conduits for shared assets, knowledge-sharing routines, and complementary capabilities that might reduce barriers to exchange. Data from 2018–2023 were drawn from the American Hospital Association Annual Survey and IT Supplement, merged with community-level measures from the …

Early Adoption Of Thyroid Radiofrequency Ablation In Canada: Physician Experiences, Barriers, And Facilitators To Implementation, Harrison Gao, David Liu, Ben B. Levy, Justin Shapiro, Kevin M. Higgins, Diana E. Khalil, Elizabeth E. Cottrill, Courtney Poon, Pabiththa Kamalraj, Justine Philteos, Antoine Eskander

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

IMPORTANCE: Thyroid radiofrequency ablation (RFA) is a minimally invasive alternative to surgery for thyroid nodules. Despite strong international evidence, thyroid RFA was only approved by Health Canada in April 2023. Understanding the experiences of early adopters can inform the broader adoption of RFA in Canada and other healthcare systems.

OBJECTIVE: To describe the implementation experiences of early adopters of thyroid RFA in Canada and identify barriers and facilitators to adoption.

DESIGN: Multiple methods.

SETTING: All 8 listed RFA facilities in Canada.

PARTICIPANTS: Physicians performing thyroid RFA (n = 9).

MAIN OUTCOME MEASURES: Survey and semi-structured interviews.

RESULTS: Most participants reported …

Driving Innovation: Transatlantic Attitudes To The Bionics Bus As A Vehicle For Health Transformation And Stem Engagement, Christopher James, Sarang Shankar, Madeleine Dale, Bhathika Perera, Richard Laugharne, Matthew Allen, Maria Feijoo‐Renones, Rohit Shankar

Peninsula Medical School

Emerging mobile health and STEM engagement platforms are increasingly recognised as catalysts for improving public understanding of biomedical technologies and supporting digitally enabled models of healthcare delivery. The Bionics Bus (https://bionicsbus.org/) is a novel mobile laboratory designed to democratise access to robotics, artificial intelligence, prosthetics and digital diagnostics by delivering hands-on experiences directly to schools, communities and healthcare settings. This study provides the first transatlantic comparison of public attitudes toward the Bionics Bus within the United Kingdom and the United States of America (USA), two countries with contrasting healthcare systems and digital transformation priorities. Using a mixed-methods cross-sectional design, 78 …

Non-Tobacco Nicotine Dependence Is Associated With Increased Complications Following Clavicle Open Reduction Internal Fixation, Akin A. Adio, Rahul K. Goyal, Abby Skiena, Mohammad Daher, John G. Horneff, Hafiz F. Kassam, Brian W. Hill, Joseph A. Abboud

Rothman Institute Papers

BACKGROUND: Tobacco dependence is well established to impair bone healing and increase postoperative complications. However, the independent effects of nicotine, separate from combustion-related factors, remain unclear. This study aimed to evaluate the impact of non-tobacco nicotine dependence (NTND) following open reduction and internal fixation (ORIF) of clavicle fractures, including midshaft and lateral fracture subtypes.

METHODS: A retrospective cohort study was performed using a large national database. Patients undergoing ORIF of clavicle fractures were identified using procedural and diagnostic codes. Patients with non-tobacco nicotine dependence (e.g., vaping, patches, or gum) were identified and propensity score matched to (1) patients without nicotine …

Until The Cages Are Empty: Transgender Criminal Defense As A Necessary Tactic Of Prison-Industrial Complex Abolition, Lark Mulligan

UC Law Journal of Race and Economic Justice

This article is a practical guide in the fight to abolish the prison-industrial complex as well as institutionalized transphobia and cissexism. Focusing specifically on the practice area of criminal defense, this article proposes a model that must be replicated across jurisdictions wherever transgender people are criminalized. By instituting an interdisciplinary team approach that is non-hierarchical, strengths-based, trauma-informed, community focused, holistic, harm-reductionist, and abolitionist, practitioners will find their role in this movement as one of consensus building, knowledge sharing, community empowerment, institutional navigation, and access distribution. As discrimination and violence against trans people continues to rise, practitioners must learn to not …

Retinoic Acid-Loaded Nanoparticles Enhance Macrophage-Mediated Control Of Leishmania Infantum, Zeynep İşlek, Merve Gündoğdu, Zeynep Di̇la Yüksel

Turkish Journal of Biology

Background/aim: Visceral leishmaniasis, primarily caused by Leishmania infantum, remains a major global health challenge due to limitations in current chemotherapeutic options, including toxicity and emerging drug resistance. Host-directed therapeutic approaches are increasingly recognized as promising alternatives. All-trans retinoic acid (ATRA) is an immunomodulatory molecule with host-dependent effects on macrophage function; however, its therapeutic use is hindered by instability and poor solubility. Solid lipid nanoparticles (SLNs) offer a controlled and biocompatible delivery platform capable of enhancing intracellular drug accumulation.

Materials and methods: ATRA-loaded SLNs were prepared and characterized for size, polydispersity index, zeta potential, and morphology. Their antileishmanial activity was evaluated …