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Arthroscopy And The Future Of Surgery: Personal And Public Health Benefits, Preston T. Koski

Honors Thesis

Arthroscopy focuses on operating on the body using probes and working through keyhole incisions on the skin. This rapidly evolving field has seen many innovations in its technology, aided by advances in optical and surgical capabilities. Moreover, it presents many advantages over traditional surgery that directly impact the patient. Shorter recovery time and lessened scarring, reduced postoperative pain and opioid dependence, and less risk of infection are key benefits over open surgery. These benefits can also be applied to areas of public health. Minimizing the burden on hospital resources, reducing the environmental impact of surgery, and improving cost-effectiveness in healthcare …

Compartmental Disaggregation: Bridging Simulation And Sampling Methods For Synthetic Population Data Generation, Dylan Mack

McKelvey School of Engineering Graduate Student Theses & Dissertations

As agent-based models (ABMs) grow increasingly widespread in public health, their associated challenges have become all the more significant. Lauded for their ability to capture population heterogeneity, nonlinear dynamics, and emergent behaviors, disease ABMs are also computationally expensive and often require detailed inputs that describe each agent at the individual-level, known as synthetic population data. Current approaches for synthetic population data generation generally fall into one of two categories: sampling or simulation. These methods are both feasible only under restricted conditions and suffer from challenges surrounding data availability and computing power. This thesis proposes compartmental disaggregation, an intermediate method for …

Shortage To Surge - Studying The Post-Covid-19 Guitar Retail Market, Jed H. Kim

Data Science Undergraduate Honors Theses

The COVID-19 pandemic was one of the most catalyzing events of the 21st century, leading to supply chain disruptions, lifestyle changes, and a massive shift towards digital technologies. During the COVID-19 lockdown, many people had more free time, and over 16 million individuals learned to play guitar in the first 2 years of the pandemic. According to a study by Fender, 62% of these new guitar learners cited the pandemic as their primary reason for learning the instrument. However, pandemic policies and supply chain disruptions meant that many guitar retailers were unable to satisfy demand, and backorders accumulated. After the …

Drug-Induced Hyperpigmentation Due To Levofloxacin, Miriam Motlak, Steven Manders

Cooper Rowan Medical Journal

Drug-induced hyperpigmentation is responsible for up to 20% of acquired hyperpigmentation cases, especially among the elderly population. The pathogenesis varies depending on the medication involved and may include melanin accumulation, drug deposition, production of special pigments, and iron deposition. We report the case of an elderly, immunocompromised patient with a history significant for leukemia presenting with black-blue hyperpigmentation of the upper and lower extremities, associated with iron deposition following levofloxacin exposure.

Detection Of Covid-19 Variants, Christina Aglieco

Honors Scholar Theses

The outbreak of Covid-19 in December 2019 was devastating to many but led to major advancements in vaccine research and development. The development of a vaccine against SARS-CoV-2 infection offers protection for the public but cannot eliminate the risk of contracting Covid-19 due to the many viral mutations since the initial wild-type strain isolation in 2019. Analysis of these viral mutations will allow for the development of vaccines with greater protection against the new variants of the coronavirus. Secondary to Covid-19 infection seen in the pediatric population is Multisystem Inflammatory Syndrome in Children or MIS-C. Through qPCR analysis of pediatric …

The Role Of Myosin L In The Survival Of Toxoplasma Gondii And The Importance Of Mlc1 For In Vitro And In Vivo Myosin F Motility, Victoria K. Yi

Honors Scholar Theses

My thesis discusses the work that I have conducted on two myosins in Toxoplasma gondii, which is an obligate intracellular parasite that has chronically infected around 10% of the American population. It causes toxoplasmosis and severe health consequences for individuals with compromised immune systems or when infections occur in utero. However, immunocompetent individuals are asymptomatic or present with subclinical symptoms. In the Heaslip lab, I investigated two myosins in the parasite: Myosin L and Myosin F. MyoL is an uncharacterized motor that localizes at the apical end of the parasite. It was shown to be important for parasite …

Administrative Law And The Pandemic, Gillian E. Metzger

Faculty Scholarship

American administrative law’s relationship to change is, as they say, compli­cated. On the one hand, continual evolution has been an endemic feature of American administrative law. Doctrines such as Chevron deference to agency statutory interpretations were born, grew, and declined in just the period from the 1980s to today. On the other, the United States (US) Supreme Court regularly rejects such common law development in administrative law as illegitimate and insists that federal judges must adhere to the original terms of the 1946 Administrative Procedure Act (APA) and other statutes, unless the Constitution requires otherwise. And to this day scholars …

Atomic Level Characterization For The Transport Cycle Conformational Pathways Of Multidrug Resistance Protein 1 (Mrp1), Samuel Wamwere Mwatha

Graduate Theses and Dissertations

The multidrug resistance-associated protein 1 (MRP1/ABCC1) is an ATP-binding cassette (ABC) transporter that mediates the cellular efflux of endogenous and xenobiotic substrates, including therapeutic drugs. Its overexpression is a major contributor to multidrug resistance in cancer, which tends to result in negative clinical results. Even with considerable progress made in structural biology, the intricate details of how membrane lipid composition affects the conformational changes and functional switches of MRP1 still lack explanation.

This thesis employs long-timescale, all-atom molecular dynamics (MD) simulations to study the influence of various lipids on MRP1 lipid bilayer environments. Both inward-facing and outward-facing conformations of MRP1 …

In Vitro And In Vivo Evaluation Of The Effect Of A Commercial-Dried Enterococcus Faecium Fermentation Product As Quorum Sensing Inhibitors Of Salmonella Enterica Typhimurium, Ileana Loeza

Graduate Theses and Dissertations

The purpose of the present research was to evaluate Enterococcus faecium fermentation peptides (EFP) for antibacterial activity, inhibition of biofilm formation, and anti-quorum sensing properties against Salmonella Typhimurium (ST) in in vitro trials and individual body weight and ST organ colonization in therapeutic and prophylactic models in broiler chickens. Ninety-six day-of-hatch Cobb 500 broiler chickens were randomized and assigned to one of four treatments: NC) Negative Control, no EFP treatment and no ST challenge; NC+EFP) Negative Control, EFP treatment and no ST; PC) Positive Control, no EFP treatment and ST challenge, and PC+EFP) EFP treated and ST challenged. Independent trials …

Case Report: Cold Urticaria Diagnosed In The Emergency Department, Philip Carhart, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Cold urticaria can be primary (idiopathic) or can be due to underlying hematologic or infectious diseases. Here we present the case of a young female patient with no past medical history who was diagnosed with cold urticaria in the emergency department setting, using a cold stimulation test. Most cases are idiopathic. The reaction can be triggered in individual cases by exposure to cold objects or to generalized cold ambient temperatures, as was the case in the patient presented here. The physical response is most commonly pruritic wheals (urticaria). However, more severe symptoms may occur up to angioedema with hoarseness and …

Anterior Nasal Swabs Compared To Nasopharyngeal Swabs For Detection Of Respiratory Viruses In Children, Abby Kietzman, Nicole Neeley, Rangaraj Selvarangan, Dithi Banerjee, Jennifer Goldman, Jennifer Schuster

Research at Children's Mercy Month 2025

Background: Respiratory viral testing often uses invasive nasopharyngeal (NP) swabs, which can be painful and require trained personnel. Anterior nasal swabs (NS) are less invasive and can be self-collected. The sensitivity of NS compared to NP specimens for detecting multiple respiratory viruses in children are not well described.

Methods: Hospitalized children in Kansas City, MO, from January 2023 to February 2024, who had NP specimens obtained for standard of care multiplex respiratory viral testing in the previous 72 hours, were enrolled. NS specimens were collected and tested alongside salvaged NP specimens for adenovirus, seasonal coronaviruses, human metapneumovirus, respiratory syncytial virus, …

Unsupervised Machine Learning Techniques To Categorize Genomic Islands, Lijie Zhou

All Theses

Unsupervised Machine Learning (ML) techniques are powerful tools for identifying similarity patterns and can be utilized to categorize the data into related groups. This study showcased the applications of unsupervised methods, namely hierarchical clustering to carefully determine related groups of newly identified genomic islands (GIs). Genomic islands are mobile genetic elements integrated into bacterial chromosomes. Gis can impact the evolution of bacteria for example by carrying virulence or metabolic genes. Precisely identifying Gis calls for a sophisticated process which we recently implemented as an already-published tool called TIGER which stands for Target/Integrative Genetic Element Retriever (TIGER). TIGER identifies mobile DNAs …

Epidemiological Inferences Of The Impacts Of Winter Ticks On Moose Health, Krishna S. Woerheide

Department of Entomology: Dissertations, Theses, and Student Research

The North American Moose (mooz in Anishinaabemowin, Ojibwe language, Alces alces), a culturally significant subsistence species for the Anishinaabe people, faces population decline due to calf predation, pathogen transmission, and parasitism by the winter tick (Dermacentor albipictus), all exacerbated by climate change. This study explores the impact of winter tick infestations on moose health, with a focus on natural mineral seeps as potential transmission hotspots in moose habitats within the Grand Portage Indian Reservation (Gichi Onigaming), on Isle Royale National Park (Minong), and within the 1854 Ceded Territory (greater northeastern Minnesota) - ancestral and present homelands of …

Treating The Black Fever: Evaluating Combination Chemotherapy For Leishmania Donovani, Robert Frank Mickatavage

Biochemistry and Molecular Biology

Visceral leishmaniasis (VL) is a neglected tropical disease (NTD) endemic to Africa, Asia, and the Americas, caused by the parasite L. donovani and spread by the Phlebotomine sandfly. If left untreated, VL is almost always fatal, bearing a mortality rate of over 95%. Many individuals within endemic regions are often too poor to afford treatment, and the financial burden of current treatments may only exacerbate their poverty. Antimonials and more modern treatments display varying effectiveness, but are nonetheless toxic to the host, commonly inducing hepatotoxicity, nephrotoxicity, and renal failure. The development of more effective and safer treatments is crucial, particularly …

Case Report: Dysphagia In Inclusion Body Myositis Leading To Respiratory And Gastrointestinal Complications, Veroneka Mikhail, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Inclusion body Myositis (IBM) stands as a rare and complex neuromuscular disorder (NMD) characterized by progressive muscle weakness and atrophy. Among its cardinal symptoms are dysphagia and respiratory distress, which are the most common cause of death in this disease. While the differential diagnosis of respiratory distress is vast and includes aspiration, pneumonia, acute coronary syndrome, emphysema, and congestive heart failure, a clinician should recognize that respiratory distress can also be secondary to dysphagia in NMDs like IBM and can quickly become life threating. Here we present the case of a 68-year-old female with a history of IBM who presented …

Case Report: Dissecting Retroperitoneal Abscess With Gas Formation, David F. Koziel Jr.

Rowan-Virtua Research Day

Presenting as a case to the emergency department was a 53-year-old male with a complaint of diffuse abdominal pain and focal right flank pain at site of recent percutaneous abscess drain site performed exactly one month prior. This followed hospitalization in the preceding year for complicated multifocal intra-abdominal infections requiring surgical interventions including exploratory laparotomy and surgical debridement for intra-abdominal abscess and scrotal abscess formation. Despite prior aggressive management and extensive coverage with broad-spectrum antibiotics, this patient was found to have fulminant recurrance of infection in the right retroperitoneal space with an expanding abscess dissecting through the retroperitoneal structures into …

Expanding The Narrative: Rural Educators' Perceptions Of The Achievement Gap, Erika N. Martin

College of Education

This dissertation explores the perceptions of rural educators in Alabama in relation to the achievement gap. It places a special emphasis on how these teachers understand, articulate, and address the challenges facing rural schools. This study is guided by three research questions: (1) How do rural teachers in the state of Alabama understand and describe the achievement gap, particularly in relation to rural schooling? (2) How do rural teachers in Alabama identify the variables that impede the closing of the achievement gap for rural students and schools? (3) What do rural teachers in Alabama receive as necessary for improving student …

Recombinant Expression And Purification Of Porphyromonas Gingivalis Tyrosine Kinase 1 In Escherichia Coli., Laura K. Hanna

College of Arts & Sciences Senior Theses

The goal of this study was to optimize the expression and purification of Porphyromonas gingivalis Tyrosine Kinase 1 (Ptk1) in recombinant Escherichia coli containing the plasmids Gro_ESL and Ptk1, with a His₆ tag_, to obtain a highly pure protein sample. Various experimental conditions were tested to determine the most effective parameters for protein expression and purification, including adjustments in induction timing, buffer composition, and purification techniques.

Optimal protein expression was achieved when cells were induced at an optical density (OD) of 0.3 to 0.4. β-D-1-thiogalactopyranoside (IPTG), which activates the lac operon, was used to induce Ptk1 expression. A …

Maternal Cardiometabolic Risk Factors In Pregnancy And Offspring Blood Pressure At Age 2 To 18 Years., Zhongzheng Niu, Ako Adams Ako, Sarah Dee Geiger, Caitlin G. Howe, Wei Perng, Rachana Singh, Margaret R. Karagas, Amy J. Elliott, Andrea Cassidy-Bushrow, Carlos A. Camargo, Keia Sanderson, Cynthia T. Mcevoy, Emily Oken, Dana Dabelea, Tina V. Hartert, Brian S. Carter, Annemarie Stroustrup, Andrea Lampland, Thomas G. O'Connor, Semsa Gogcu, Mark L. Hudak, Lyndsey E. Shorey-Kendrick, Qi Zhao, Yu Ni, Jeffrey Vanwormer, Assiamira Ferrara, Monique Hedderson, Yeyi Zhu, Akram Alshawabkeh, Jose Cordero, Daphne Koinis-Mitchell, Susan Carnell, Carrie V. Breton, Theresa M. Bastain, Shohreh F. Farzan, Echo Cohort Consortium

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Higher blood pressure in early life may signal cardiovascular disease over the life course, but determinants of blood pressure in early life are poorly understood.

OBJECTIVE: To examine the association of maternal cardiometabolic risk factors during pregnancy with offspring blood pressure from age 2 to 18 years and explore whether the association is modified by offspring sex and race and ethnicity.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed data from the Environmental Influences on Child Health Outcomes program between January 1, 1994, and March 31, 2023. Three common maternal cardiometabolic risk factors during pregnancy were examined: prepregnancy obesity, …

Enterovirus D68-Associated Respiratory Illness In Children., Benjamin R. Clopper, Adriana S. Lopez, Leah A. Goldstein, Terry Fei Fan Ng, Ariana P. Toepfer, Mary A. Staat, Elizabeth P. Schlaudecker, Leila C. Sahni, Julie A. Boom, Jennifer E. Schuster, Rangaraj Selvarangan, Natasha B. Halasa, Laura S. Stewart, John V. Williams, Marian G. Michaels, Geoffrey A. Weinberg, Peter G. Szilagyi, Eileen J. Klein, Janet A. Englund, Meredith L. Mcmorrow, Heidi L. Moline, Claire M. Midgley

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Enterovirus D68 (EV-D68) typically causes mild to severe acute respiratory illness (ARI). Testing and surveillance for EV-D68 in the US are limited, and important epidemiologic gaps remain.

OBJECTIVE: To characterize the epidemiology and clinical severity of EV-D68 among US children seeking care for ARI from 2017 to 2022, using a multisite, active, systematic surveillance network.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study collected data from the New Vaccine Surveillance Network, an active, prospective, population-based surveillance system of emergency departments (EDs) and hospitals at 7 US academic medical centers. Children with ARI and EV-D68-positive results were enrolled during platform-wide EV-D68 …

Natural Killer T Cell-Mediated Control Of Francisella Tularensis-Induced Cytokine Storm Syndrome, Cameron M. Torres

Open Access Theses & Dissertations

Inflammation is critical for the effective clearance of viral and bacterial challenges, while simultaneously a mechanism utilized by many highly infectious pathogens to cause disease. The bacterium Francisella tularensis, the causative agent of human tularemia, elicits a cytokine storm, wherein the immune system over-responds to the presence of the bacterium causing a dysregulated release of proinflammatory and regulatory cytokines. Without treatment, tularemia mortality can be as high as 30%, with inhalation of as few as 10 CFUs inducing respiratory tularemia. Natural Killer T (NKT) cells are innate-like T lymphocytes with a diverse array of regulatory functions. Unlike conventional T cells, …

Treatment Rates In A Two-Step Clostridioides Difficile Diagnostic Testing Algorithm, Renee Ringler, Matthew Sims

Posters

Clostridioides difficile is a Gram-positive obligate anaerobe long associated with healthcare-acquired infections in the United States. 1 Clostridioides difficile infection (CDI) has thus become a key metric for assessing facility cleanliness and iatrogenic infection. C. difficile carriage is common, present in approximately 8% of hospitalized patients.2 Therefore, appropriate patient selection for testing and careful testing procedures is crucial to appropriately identify CDI while avoiding the detection of chronic colonization.

Considerable variability exists among institutions regarding standardized CDI laboratory diagnostic methods. Historically, the gold standard for CDI testing was the clinically inefficient toxigenic culture (TC). 3 This was followed by cytotoxic …

The Prevalence Of Cytauxzoon Felis In Southern United States, Anna Haynes

Biological Sciences Undergraduate Honors Theses

Cytauxzoonosis, caused by transmission from a tick infected with the pathogen Cytauxzoon felis, is considered an emerging tick-borne disease in domestic felines. While not as fatal in other vertebrates such as the reservoir host Lynx rufus (bobcat), in domestic cats, infection is fatal nearly 100% of the time. This study sought to screen ticks pulled from felines for the pathogen across three states in an area identified as a hotspot. Out of 80 ticks screened, 12 tested positive for the pathogen. The positive population of ticks came from 3 neighboring counties in Southern Missouri: Jasper, McDonald, and Newton. McDonald …

Antimicrobial Peptides Improve Antibiotic-Mediating Killing Of Methicillin-Resistant Staphylococcus Aureus (Mrsa) Biofilms, Alya R. Theriault

All Theses And Dissertations

Staphylococcus aureus can cause drug-resistant, biofilm-associated infections. These infections place methicillin-resistant S. aureus (MRSA) as one of the sixth leading bacterial pathogens associated with deaths due to antimicrobial resistance. Traditional antibiotics are no longer enough to treat these resistant infections and novel therapeutics are needed. Antimicrobial adjuvants are a potential strategy for improving efficacy of existing antibiotics, and antimicrobial peptides (AMPs) may have adjuvant activity. Recent reports showed that AMPs improve antibiotic activity against planktonic staphylococci, but whether AMPs might alter antibiotic efficacy against biofilm-resident staphylococcus is less clear. We tested the effect of nine AMPs on staphylococcal biofilm susceptibility …

Evidence Based Research Review Of Remote Independent Chemotherapy/Immunotherapy Verification, Katrina Perkins, Hannah Holder, Marie St. Clair

Covenant Nurses Week 2025

No abstract provided.

Pseudomonas Aeruginosa Exoenzyme Y Enzymatic Activity Inhibits Exoenzyme S-Induced Caspase Activation But Not Cytotoxicity In Pulmonary Microvascular Endothelial Cells, Connor Holm

Honors Theses

Pseudomonas aeruginosa (P. aeruginosa) is the most common cause of ventilator-associated pneumonia in intensive care unit patients. P. aeruginosa utilizes a type III secretion system that injects exoenzymes U, S, T, and/or Y into the host cell cytosol. A majority of clinically isolated P. aeruginosa strains express ExoY often in combination with ExoU and ExoT, or ExoS and ExoT. Host signaling mechanisms in response to intoxication with individual exoenzymes have been extensively studied, yet little is known about host cell response to co-intoxication. In this study, pulmonary microvascular endothelial cells (PMVECs) were infected with P. aeruginosa strains expressing different combinations …

Improving Blood Culture Contamination Rates In The Emergency Department: An Evidence-Based Quality Improvement Project, Kerri Maciejko

DNP Projects

Background/Significance

Blood culture (BC) contamination in the Emergency Department (ED) leads to false-positive results, unnecessary antibiotic use, prolonged hospital stays, and increased healthcare costs. Contamination rates at the project site ranged from 2.2% to 6.8%, exceeding the hospital goal of <1%. Addressing this issue is critical for accurate diagnosis, effective treatment, and optimal resource utilization.

Purpose

The purpose of this project was to reduce BC contamination rates in the ED by implementing a modified BC kit, providing staff education, and conducting real-time blind audits with feedback over three months.

Methods

An evidence review, appraisal, and synthesis using Melnyk and Fineout-Overholt’s EBP process confirmed that BC kits and diversion devices are effective interventions to reduce contamination. …

Which Costimulatory Domains In Chimeric Antigen Receptor T Cells Induce Cytokine Responses That Are Linked To A More Toxic Car T Cell Therapy In Acute Lymphocytic Leukemia?, Elisabeth Cohen

Longwood Senior Thesis Proposal

No abstract provided.

Activity Of Novel Ceftibuten-Avibactam, Ceftazidime-Avibactam, And Comparators Against A Challenge Set Of Enterobacterales From Outpatient Centers And Nursing Homes Across The United States (2022–2024), Aliaa Fouad, April M. Bobenchik, Robin Chamberland, Andrew E. Clark, Holly K. Huse, Isabella W. Martin, A. Brian Mochon, Erik Munson, Maroun M. Sfeir, Monica Srodon, Kimberly Taylor, Yungchou Wang, Lars F. Westblade, David P. Nicolau, Tomefa E. Asempa

Clinical Lab Sciences Faculty Research and Publications

Ceftibuten is being developed in combination with the oral prodrug of avibactam. Outpatient isolates (n = 500) from 11 US states underwent susceptibility testing with manual broth microdilution. Ceftibuten had susceptibility rates of 64% (CLSI) and 23% (EUCAST). Ceftibuten-avibactam achieved 96.4% inhibition at MIC ≤ 1 µg/mL. Susceptibility rates were as follows: cefpodoxime (2.6%), ceftriaxone (1%), ceftazidime-avibactam (99.6%), tebipenem (89%), ertapenem (94.4%), levofloxacin (26.6%), trimethoprim-sulfamethoxazole (40.2%), and fosfomycin (96.8%). Ceftibuten-avibactam demonstrates potent in vitro activity against cephalosporin non-susceptible isolates.

Bang!: Real-Time Measurements And Transcriptomics Of Metabolic Reprogramming In Activated Macrophages At Fever Temperature, Kenneth Howard Taylor

Graduate Theses and Dissertations

We investigated the real-time metabolic rates of activated macrophage cell lines derived from mouse, chicken and rainbow trout. Each species showed a different kinetic signature with metabolic rates accelerating under fever conditions specific to each organism. Upon activation mouse macrophages increased their rate of glycolysis early and then a later reprogramming phase occurred with a dramatic decrease in oxidative phosphorylation (OXPHOS) accompanied by a reciprocal second increase in glycolytic rates. Chicken macrophages showed an initial increase in both glycolytic and OXPHOS rates. The late drop OXPHOS rates also occurred in chicken however there was no reprogramming that occurred as glycolytic …