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Pseudo-Soft-Switching Switched-Capacitor Drive Circuits For Small-Scale Dielectric Actuators, Yanqiao Li Aug 2025

Pseudo-Soft-Switching Switched-Capacitor Drive Circuits For Small-Scale Dielectric Actuators, Yanqiao Li

Dartmouth College Ph.D Dissertations

Applications including micro-robotics and haptics have motivated extensive exploration of dielectric actuators due to their high bandwidth and high efficiency at cm and mm scales. To maximize their benefits, dielectric actuators, including piezoelectric and electrostatic actuators, typically require high driving voltages, ranging from 100V to several kV. Generating such high driving voltages presents a challenge for drive circuits, particularly when powered by a small battery. Dielectric actuators are predominantly capacitive in most circumstances, necessitating the drive circuits to deliver and recover reactive energy for efficient operation. In some applications, such as micro-robotics, the drive circuits may need to have a …


Chance Or Strategy? Assessing The Unanticipated Policy Window For Active Transportation During The Covid-19 Pandemic: A Systematic Review, Deborah Salvo, Justin Richards, J Jaime Miranda, Pedro C Hallal, Andrea Ramírez Varela Aug 2025

Chance Or Strategy? Assessing The Unanticipated Policy Window For Active Transportation During The Covid-19 Pandemic: A Systematic Review, Deborah Salvo, Justin Richards, J Jaime Miranda, Pedro C Hallal, Andrea Ramírez Varela

Faculty, Staff and Student Publications

Physical activity (PA) policy is essential for promoting population-level PA by coordinating efforts across various sectors. Global crises like the COVID-19 pandemic can open policy windows, enabling rapid implementation of innovative policies. This study examined how policy windows shaped active transportation (AT) policies during the pandemic, resulting in infrastructural changes.

Methods: A systematic review using PubMed, Scopus, ProQuest-Coronavirus Research Database, Web of Science, WHO COVID-19 Research Database, PsycInfo, and SPORTDiscus conducted to characterize AT policy during the pandemic (2020-2023). Descriptive analyses were conducted in Stata. PROSPERO registration number: CRD42025644930.

Results: The search retrieved 3879 articles; 1162 were duplicates, leaving 2716 …


Trends In Glucagon-Like Peptide 1 Receptor Agonist Prescribing Patterns, Trudy M Krause Aug 2025

Trends In Glucagon-Like Peptide 1 Receptor Agonist Prescribing Patterns, Trudy M Krause

Faculty, Staff and Student Publications

Objective: Obesity affects more than 40% of US adults, increasing risks for cardiovascular disease and type 2 diabetes. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs), initially indicated for diabetes, show promise in weight loss but face coverage issues, high costs, and premature prescribing from physicians. Research is needed to assess prescribing patterns, especially in patients without diabetes.

Study design: We conducted a retrospective, population-based, observational study using the Merative MarketScan Commercial Database and the Merative MarketScan Medicare Supplemental Database, which capture person-specific clinical utilization and expenditures. We analyzed GLP-1 RA prescribing rates from 2018 to 2023, comparing semaglutide with other …


Impaired Rest-Activity Rhythm Characteristics Predict Higher Risk Of Incident Type 2 Diabetes In Uk Biobank Participants, Andrew J K Phillips, Qian Xiao Aug 2025

Impaired Rest-Activity Rhythm Characteristics Predict Higher Risk Of Incident Type 2 Diabetes In Uk Biobank Participants, Andrew J K Phillips, Qian Xiao

Faculty, Staff and Student Publications

Objective: Circadian rhythms play a key role in metabolic health. Rest-activity rhythms, which are in part driven by circadian rhythms, may be associated with diabetes risk. There is a need for large prospective studies to comprehensively examine different rest-activity metrics to determine their relative strength in predicting risk of incident type 2 diabetes.

Research design and methods: In actigraphy data from 83,887 UK Biobank participants, we applied both parametric and nonparametric algorithms to derive 13 different metrics characterizing different aspects of rest-activity rhythm. Diabetes cases were identified using both self-reported data and health records. We used Cox proportional hazards models …


A Novel Diastolic Doppler Index Less Affected By Aortic Arch Anomalies Co-Existing With Coarctation, Arash Ghorbannia, Andrew D. Spearman, Shahd Sawalhi, Ronald K. Woods, Mehdi Maadooliat, John F. Ladisa Jr. Aug 2025

A Novel Diastolic Doppler Index Less Affected By Aortic Arch Anomalies Co-Existing With Coarctation, Arash Ghorbannia, Andrew D. Spearman, Shahd Sawalhi, Ronald K. Woods, Mehdi Maadooliat, John F. Ladisa Jr.

Mathematical and Statistical Science Faculty Research and Publications

Severity assessment for coarctation of the aorta (CoA) is challenging due to concomitant morphological anomalies (complex CoA) and inaccurate Doppler-based indices. Promising diagnostic performance has been reported for the continuous flow pressure gradient (CFPG), but it has not been studied in complex CoA. Our objective was to characterize the effect of complex CoA and associated hemodynamics on CFPG in a clinical cohort. Retrospective analysis identified discrete juxtaductal (n = 25) and complex CoA (n = 43; transverse arch and/or isthmus hypoplasia) patients with arm-leg systolic blood pressure gradients (BPG) within 24 h of echocardiography for comparison to BPG …


Investigation Of Wireless Communication Sub-Optimizing Factors And Ai-Based Optimization For Ber Reduction, Lalan Jee Mishra Aug 2025

Investigation Of Wireless Communication Sub-Optimizing Factors And Ai-Based Optimization For Ber Reduction, Lalan Jee Mishra

Theses and Dissertations

The increasing demand for high-throughput, low-latency, and reliable wireless communication has led to significant advancements of cellular wireless technologies since the early ‘80s. However, in dynamic and interference-prone environments—particularly those involving Unmanned Aerial Vehicles (UAVs)—signal degradation due to pathloss, multipath propagation, co-channel interference, and weather-induced attenuation continues to undermine performance. These factors contribute to elevated bit error rates (BER), inefficient spectrum usage, and unreliable communication links, thereby limiting the practical utility of wireless systems in aerial applications. Traditional mitigation techniques, while effective under certain conditions, often fail to adapt to rapidly changing wireless environments. This shortcoming underscores the need for …


Experiences Of The Emergency Department Environment: A Qualitative Study With Caregivers Of People With Dementia, Norvin Hernandez, Ana Paulina Rivera, Ed Boyer, Mark E Kunik, Manish N Shah, Christine Ritchie, Aanand D Naik, Shan W Liu, Maura Kennedy Aug 2025

Experiences Of The Emergency Department Environment: A Qualitative Study With Caregivers Of People With Dementia, Norvin Hernandez, Ana Paulina Rivera, Ed Boyer, Mark E Kunik, Manish N Shah, Christine Ritchie, Aanand D Naik, Shan W Liu, Maura Kennedy

Faculty, Staff and Students Publications

ED crowding and boarding adversely impact older patients' care and outcomes. Little is known about how ED crowding impacts persons living with dementia, a vulnerable population. This study sought to explore ED experiences of caregivers of people with dementia during a period of ED crowding and boarding. We performed semi-structured interviews with caregivers of people with dementia with an ED visit during a period of ED crowding and boarding at two public hospitals experiencing a threefold increase in boarding from pre-pandemic levels. Participants were recruited via chart review. We coded data using an inductive approach. Three themes emerged from 29 …


Community-Engaged Medical Student Elective To Improve Knowledge And Attitudes Toward Individuals With Intellectual And Developmental Disabilities, Elisha Acosta Aug 2025

Community-Engaged Medical Student Elective To Improve Knowledge And Attitudes Toward Individuals With Intellectual And Developmental Disabilities, Elisha Acosta

Faculty, Staff and Students Publications

Individuals with intellectual and developmental disabilities (IDD) face multiple barriers to inclusion throughout life. One barrier is the medical knowledge and biases of adult healthcare providers with diagnoses traditionally associated with childhood. Medical school curricula have limited content related to IDD, and students have limited opportunities to engage with community organizations during their clinical years. Methods: We created a one-month clinical elective to address medical students' attitudes and knowledge regarding individuals with IDD using experiential learning. Students saw adult patients in our primary care clinic with a variety of IDD diagnoses and spent 30% of their time at community sites …


Hospital Experiences And Medical Traumatic Stress In Adults With Spina Bifida, Monique Ridosh Aug 2025

Hospital Experiences And Medical Traumatic Stress In Adults With Spina Bifida, Monique Ridosh

Faculty, Staff and Students Publications

Purpose

This study examined hospital and emergency department (ED) experiences of adults with spina bifida (SB), medical traumatic stress (MTS) and participant characteristics including anxiety, depression, post-traumatic stress disorder (PTSD) symptoms, and resiliency scores.

Methods

Adults with SB who had a hospital or ED encounter within the last five years were recruited from a medical home clinic and completed a structured interview and validated questionnaires. Narrative inquiry was used and descriptive analyses were conducted. MTS scores were reported per participant characteristics and emotional health questionnaire score counts and percentages.

Results

Twenty-five adults with SB representing 37% of eligible patients were …


Effect Of Aerobic Or Resistance Exercise, Or Both On Insulin Secretion, Ciliary Neurotrophic Factor, And Insulin-Like Growth Factor-1 In Dieting Older Adults With Obesity, Reina Armamento-Villareal, Clifford Qualls, Antonio Giordano, Dennis T Villareal Aug 2025

Effect Of Aerobic Or Resistance Exercise, Or Both On Insulin Secretion, Ciliary Neurotrophic Factor, And Insulin-Like Growth Factor-1 In Dieting Older Adults With Obesity, Reina Armamento-Villareal, Clifford Qualls, Antonio Giordano, Dennis T Villareal

Faculty, Staff and Students Publications

Background and aims: Obesity exacerbates age-related changes in metabolic and physical function. The effect of distinct exercise modalities combined with diet-induced weight loss on insulin secretion in older adults with obesity and frailty is unknown, and the potential mediators of the metabolic and functional improvements induced by lifestyle therapy still need to be identified. We aimed to assess the effects of various exercise therapies coupled with diet-induced weight loss on insulin secretion and sensitivity and on the levels of circulating Ciliary Neurotrophic Factor (CNTF), its receptor (CNTFRα), and Insulin-like Growth Factor-1 (IGF-1) in older adults with both obesity and frailty. …


Mood And Sleep In Young Adults With Type 1 Diabetes, Sarah K Lyons, Randi Streisand, Barbara J Anderson, Siripoom V Mckay, Tricia S Tang, Sara Nowakowski, Ashley M Butler, Sridevi Devaraj, Marisa E Hilliard Aug 2025

Mood And Sleep In Young Adults With Type 1 Diabetes, Sarah K Lyons, Randi Streisand, Barbara J Anderson, Siripoom V Mckay, Tricia S Tang, Sara Nowakowski, Ashley M Butler, Sridevi Devaraj, Marisa E Hilliard

Faculty, Staff and Students Publications

Objective: Depression is associated with sleep problems, and both are associated with higher HbA1c in people with type 1 diabetes (T1D). However, little is known about depressed mood and sleep in young adults with T1D. The aims of this secondary analysis were to provide descriptive statistics of multiple aspects of mood and sleep in young adults with T1D and evaluate associations of depressed mood, diabetes distress, and sleep quality and duration.

Methods: At baseline of a behavioral intervention trial, young adults with T1D completed self-report measures of sleep, diabetes distress, and depressive symptoms. We described sleep metrics across racial/ethnic groups …


Parabolic Flight As A Research Platform To Investigate Ophthalmic Changes In Microgravity, Alex Weaver, Ana Garcia, Amy Song, Fatma Shakarchi, Ethan Waisberg, Andrew G Lee Aug 2025

Parabolic Flight As A Research Platform To Investigate Ophthalmic Changes In Microgravity, Alex Weaver, Ana Garcia, Amy Song, Fatma Shakarchi, Ethan Waisberg, Andrew G Lee

Faculty, Staff and Students Publications

Parabolic flight serves as an important terrestrial analog to study acute physiological changes in microgravity without the need for space travel. During a parabolic flight, alternating hypergravity and microgravity phases, lasting up to 40 seconds, enable research into ophthalmic changes. In this review, we discuss the application of parabolic flight as a platform to study microgravity-related changes that might impact ophthalmology including intraocular pressure, intracranial pressure, choroidal blood flow, and modified eye movement patterns. We further highlight how these insights could aid our understanding of vestibulo-ocular reflexes and conditions such as Spaceflight Associated Neuro-ocular Syndrome (SANS). While the brief duration …


Biomarkers Of Cellular Senescence In Type 2 Diabetes Mellitus, Thomas A White, Elizabeth J Atkinson, Amanda Tweed, Allyson K Palmer, Nathan K Lebrasseur, Jad G Sfeir, Sundeep Khosla Aug 2025

Biomarkers Of Cellular Senescence In Type 2 Diabetes Mellitus, Thomas A White, Elizabeth J Atkinson, Amanda Tweed, Allyson K Palmer, Nathan K Lebrasseur, Jad G Sfeir, Sundeep Khosla

Faculty, Staff and Students Publications

Although animal studies have linked cellular senescence to the pathogenesis and complications of type 2 diabetes mellitus (T2DM), there is a paucity of corroborating data in humans. Thus, we measured a previously validated marker for senescent cell burden in humans, T‐cell expression of p16 mRNA, along with additional biomarkers, to compare the senescence phenotypes of postmenopausal control (lean, N = 37) and T2DM (N = 27) participants. To control for effects of obesity alone, we included a third group of obese but non‐diabetic women (N = 29) who were matched for body mass index to the T2DM participants. …


Rest-Activity Rhythm Phenotypes In Adults With Epilepsy And Intellectual Disability, Vaishnav Krishnan Aug 2025

Rest-Activity Rhythm Phenotypes In Adults With Epilepsy And Intellectual Disability, Vaishnav Krishnan

Faculty, Staff and Students Publications

Objective: Rest-activity rhythms (RARs) are perturbed in many forms of neuropsychiatric illness. In this study, we applied wrist actigraphy to describe RAR perturbations in intellectually disabled adults with epilepsy ("E + ID"), using a cross-sectional case-control design. We examined whether RAR phenotypes correlated with epilepsy severity, deficits in adaptive function, and/or comorbid psychopathology.

Methods: Caregivers of E + ID subjects provided informed consent during routine ambulatory clinic visits and were asked to complete standardized surveys of overall epilepsy severity (GASE, Global Assessment of Severity of Epilepsy), adaptive function (ABAS-3, Adaptive Behavior Assessment System-3) and psychopathology (ABCL, Adult Behavior Checklist). Caregivers …


Evaluation Of A Region-Wide Hospital-Based Violence Intervention Program : A Pilot Cohort Study, Daphne Lew, Vicki Moran, Rachel M Ancona, Kateri Chapman-Kramer, Melik Coffey, Keyria Page, Abigail Batha, Stephanie Harris, Larita Rice-Barnes, Marsha Williams, Lindsay M Kranker, Marguerite W Spruce, Christopher Behr, Michael A Mancini, Douglas J E Schuerer, Lindsay D Clukies, Nicole Santucci, Anne Trolard, Victoria Anwuri, Megan L Ranney, Randi E Foraker, Matt Vogel Aug 2025

Evaluation Of A Region-Wide Hospital-Based Violence Intervention Program : A Pilot Cohort Study, Daphne Lew, Vicki Moran, Rachel M Ancona, Kateri Chapman-Kramer, Melik Coffey, Keyria Page, Abigail Batha, Stephanie Harris, Larita Rice-Barnes, Marsha Williams, Lindsay M Kranker, Marguerite W Spruce, Christopher Behr, Michael A Mancini, Douglas J E Schuerer, Lindsay D Clukies, Nicole Santucci, Anne Trolard, Victoria Anwuri, Megan L Ranney, Randi E Foraker, Matt Vogel

Faculty, Staff and Students Publications

Background: Violent injury survivors are at risk for revictimization. The St. Louis area hospital-based violence intervention program (HVIP), Life Outside of Violence (LOV), is the first multisystem, region-wide HVIP in the United States.

Objective: To describe the LOV program during its pilot phase and evaluate violent reinjury 1 year after index injury among LOV participants.

Design: Pilot observational cohort study of violently injured patients.

Setting: Data were queried from the program's multisystem data repository, which contains individual encounter-level data for all violent injury visits from the 2 adult and 2 pediatric LOV-partner level 1 trauma hospitals.

Participants: Patients eligible for …


Sugar Functionalized Collagen Material For Local Modulation Of Innate Immunity, John Otto Martinez, Silvia Minardi, Laura Pandolfi, Xing Wang, Ennio Tasciotti, Kavindra V Singh, Cesar A Arias, Bruna Corradetti Aug 2025

Sugar Functionalized Collagen Material For Local Modulation Of Innate Immunity, John Otto Martinez, Silvia Minardi, Laura Pandolfi, Xing Wang, Ennio Tasciotti, Kavindra V Singh, Cesar A Arias, Bruna Corradetti

Faculty, Staff and Students Publications

Small alterations during the early stages of the innate immune response to an implant can drive large changes in adaptive immunity. Biomaterials for regenerative purposes can be engineered to modulate this immune response in beneficial ways. This study presents an innovative patch designed and functionalized to target the innate immunity at the implant site. Mannose moieties are incorporated into collagen patches, resulting in a technology called Local Immunotuning Patch (LIP), designed to directly interact with antigen presenting cells through their mannose receptor. In vitro, LIP shows anti-inflammatory effects on bone marrow-derived macrophages and inhibitory properties even on methicillin-resistant bacterial strains. …


Associations Between Social Support, Social Control, And Stage Of Change With Self-Reported And Objectively Assessed Physical Activity In Adult Latino Dyads, Deanna M Hoelscher, Larkin L Strong Aug 2025

Associations Between Social Support, Social Control, And Stage Of Change With Self-Reported And Objectively Assessed Physical Activity In Adult Latino Dyads, Deanna M Hoelscher, Larkin L Strong

Faculty, Staff and Student Publications

Health behaviors such as physical activity (PA) are socially influenced, such that individuals from shared social networks or living environments may exhibit similar habits. This cross-sectional study examined associations of social support, social control, and family member stage of change with moderate-to-vigorous self-reported and objective PA in dyads of adult Hispanic family members. We used the Godin Leisure-Time Physical Activity Questionnaire to assess self-reported PA and accelerometry for objective PA. Validated scales assessed social support, social control, and stage of change. We performed multivariable multilevel analysis using generalized estimating equations (GEE) to account for within-dyad correlations. We conducted multivariable negative …


Accelerometer-Measured Chronoactivity And Type 2 Diabetes Risk: A Prospective Study In Uk Biobank Participants, Qian Xiao Aug 2025

Accelerometer-Measured Chronoactivity And Type 2 Diabetes Risk: A Prospective Study In Uk Biobank Participants, Qian Xiao

Faculty, Staff and Student Publications

Objective: We assessed whether timing of physical activity, independent from the total activity amount, - which we refer to as chronoactivity - is associated with type 2 diabetes (T2D) risk.

Methods: We included UK Biobank participants with valid accelerometry data (UK, exposure measurement: 2013-2015, follow-up till November 2023) and without diabetes mellitus at baseline (N = 89,439; mean age: 61.7 [SD:7.9] years). Relative hourly physical activity was calculated by dividing the average hourly clock time physical activity by the average hourly physical activity in a week. Participants were categorized into different chronoactivity clusters using k-means cluster analysis on relative hourly …


First Assembly Of A Draft Genome Of The Critically Endangered Northern Muriqui ( Brachyteles Hypoxanthus , Primates, Atelidae) Including Non‐Invasive Genotyping Strategies For The Species, Tomas Marques-Bonet, Lukas Kuderna, Kyle Farh, Jeffrey Rogers, Mariane Da Cruz Kaizer, Jean Philippe Boubli, Fabiano Rodrigues De Melo, Rhewter Nunes, Mariana Pires De Campos Telles Aug 2025

First Assembly Of A Draft Genome Of The Critically Endangered Northern Muriqui ( Brachyteles Hypoxanthus , Primates, Atelidae) Including Non‐Invasive Genotyping Strategies For The Species, Tomas Marques-Bonet, Lukas Kuderna, Kyle Farh, Jeffrey Rogers, Mariane Da Cruz Kaizer, Jean Philippe Boubli, Fabiano Rodrigues De Melo, Rhewter Nunes, Mariana Pires De Campos Telles

Faculty, Staff and Students Publications

Genomic resources, such as draft genomes, are vital for biodiversity monitoring and conservation. For endangered species, they enable the development of tools like organellar genomes and molecular markers, which are crucial for population genetics. Advances in sequencing technologies now allow high‐throughput genotyping with detailed amplicon sequences, enhancing genetic variation studies. The northern muriqui ( Brachyteles hypoxanthus ), a critically endangered primate endemic to Brazil's Atlantic Forest, currently lacks both nuclear and mitochondrial genome data and species‐specific microsatellite markers for population genetic studies. We assembled a 2.52 Gb draft genome for B. hypoxanthus with 202,243 contigs (N50 = 29,134 bp), and …


Privacy In Perspective: Research Participants’ Priorities And Concerns Related To Sharing Data Generated In Human Neuroscience Studies, Mary A Majumder, Kathryn Maxson Jones, Whitney Bash Brooks, Sameer A Sheth, Amy L Mcguire Aug 2025

Privacy In Perspective: Research Participants’ Priorities And Concerns Related To Sharing Data Generated In Human Neuroscience Studies, Mary A Majumder, Kathryn Maxson Jones, Whitney Bash Brooks, Sameer A Sheth, Amy L Mcguire

Faculty, Staff and Students Publications

The societal benefits from sharing and reusing data collected in human neuroscience studies are widely appreciated. However, there are persistent barriers to data sharing as well as privacy concerns related to unauthorized access, misuse, and reidentification of deidentified data. Thus far, few studies have been conducted with neuroscience research participants to understand their data sharing priorities and concerns. We conducted a survey utilizing an experimental design with N=52 participants in neuroscience studies funded by the U.S. National Institutes of Health representing diverse neurotechnologies and health conditions. Respondents prioritized sharing practices that maximize reuse of data to benefit patients and reduce …


Relapse Patterns Among Children And Adolescents With Kaposi Sarcoma In Malawi, William Kamiyango, Jimmy Villiera, Parth S Mehta, Erin Peckham-Gregory, Mark Zobeck, Michael E Scheurer, Carl E Allen, Rizine Mzikamanda, Nmazuo W Ozuah, Nader Kim El-Mallawany Aug 2025

Relapse Patterns Among Children And Adolescents With Kaposi Sarcoma In Malawi, William Kamiyango, Jimmy Villiera, Parth S Mehta, Erin Peckham-Gregory, Mark Zobeck, Michael E Scheurer, Carl E Allen, Rizine Mzikamanda, Nmazuo W Ozuah, Nader Kim El-Mallawany

Faculty, Staff and Students Publications

Kaposi Sarcoma (KS) is a common childhood cancer in Malawi, but few studies have exploredclinical characteristicsofrelapsed disease. We aimed to characterize clinical patterns of relapse to improve treatment and, ultimately, long-term survival in patients with pediatric KS.A retrospective cohort study was conducted among patients ages < 19 years of age at time of KS diagnosis in Lilongwe, Malawi between August 1, 2010 and March 15, 2020. Specifically, emphasis was placed on patients who had relapsed disease and excluded patients with refractory disease or those who died whilst receiving front-line treatment. Salvage therapy typically involved an intensified chemotherapy regimen compared to front-line therapy—namely nonliposomaldoxorubicin plus bleomycin/vincristine or paclitaxel monotherapy.One-hundred and ninety patients with pediatric KS were included in this analysis, 50 of whom experienced relapse (26%).Older median age was associated with occurrence of relapse (10 vs 6.7 years, p-value = 0.004). Median time from diagnosis to first relapse was 10.6 months (range 2.3–49 months). Three-year post-relapse overall survival (OS) for the entire cohort was 60% with a median follow-up time of 4.7 years after relapse.Survival was significantly higher for patients who relapsed with the woody edema clinical phenotype of pediatric KS versus those with visceral/disseminated disease—3-year OS 79% (95% CI 62–100) versus 29% (14–61).These data demonstrate potential for continued survival after KS relapse in the pediatric population and identify subsets of high-risk patients. The higher mortality observed in patients with visceral/disseminated KS highlights the need for improved therapeutic strategies.


Addressing Anxiety And Depression In The Allergy Clinic Through Motivational Interviewing, Brief Cognitive Behavioral Therapy, And Curious Questions, Jonathan A Bernstein, Don Bukstein, Aikaterini Anagnostou, Matthew Greenhawt, S Shahzad Mustafa, Julie Wang, Anna Nowak-Wegrzyn, Elissa M Abrams, John Oppenheimer, Alexandra E Conway, Andrew A White, Taylor A Doherty, Richard P Morse, Marcus Shaker Aug 2025

Addressing Anxiety And Depression In The Allergy Clinic Through Motivational Interviewing, Brief Cognitive Behavioral Therapy, And Curious Questions, Jonathan A Bernstein, Don Bukstein, Aikaterini Anagnostou, Matthew Greenhawt, S Shahzad Mustafa, Julie Wang, Anna Nowak-Wegrzyn, Elissa M Abrams, John Oppenheimer, Alexandra E Conway, Andrew A White, Taylor A Doherty, Richard P Morse, Marcus Shaker

Faculty, Staff and Students Publications

Allergic diseases, particularly food allergy, can be associated with significant psychosocial impairment. Allergist-immunologists can provide evidence-based information to correct misperceptions and misunderstandings regarding food allergy that may perpetuate cycles of fear and anxiety. Whereas motivational interviewing can be an empathetic approach to empower patients to actualize health goals, cognitive behavioral therapy (CBT) aims to provide disease-state insight to facilitate an understanding of risk that can transform health beliefs and behaviors. Brief CBT is a clinical approach that can help address ineffective management paradigms through conversations that begin with curious questions. In this review, we discuss evidence supporting implementation of an …


Construct And Predictive Validity Of The Kansas City Cardiomyopathy Questionnaire In Adult Congenital Heart Disease, Swati Choudhry, Edward J Hickey, Alexis C Wood, Savitri Fedson, Biykem Bozkurt, Christopher R Broda Aug 2025

Construct And Predictive Validity Of The Kansas City Cardiomyopathy Questionnaire In Adult Congenital Heart Disease, Swati Choudhry, Edward J Hickey, Alexis C Wood, Savitri Fedson, Biykem Bozkurt, Christopher R Broda

Faculty, Staff and Students Publications

Background: The Kansas City Cardiomyopathy Questionnaire (KCCQ) is an Food and Drug Administration-approved health status measure for patients with heart failure (HF) but has not been directly assessed in adult congenital heart disease (ACHD).

Objectives: This study evaluates construct and predictive validity of the KCCQ in ambulatory ACHD patients.

Methods: We performed cross-sectional and prospective cohort studies of ACHD patients who completed the KCCQ to assess construct and predictive validity, respectively. KCCQ scores were compared across ACHD complexity categories, disease characteristics and physiologic failure, and within 2 primary composite outcomes: death or all-cause hospitalization (DH) and death or interventional cardiac …


Mixture Effects On Metal Accumulation In The Asian Clam, Corbicula Fluminea, Mark A. Huff Aug 2025

Mixture Effects On Metal Accumulation In The Asian Clam, Corbicula Fluminea, Mark A. Huff

Electronic Theses and Dissertations

Field collected Corbicula fluminea were exposed to trace level copper, lead, and zinc with the aim of examining the preferential accumulation between the soft tissue and shell. Metal levels were based on those in a permitted industrial effluent. At 1X effluent and 2X effluent exposure levels, copper was found to preferentially accumulate in the clam soft tissue, lead was found to preferentially accumulate in the clam shell, and zinc was found to excrete back into the diluent after preferentially accumulating in the clam soft tissue. When exposed as a mixture at 1X effluent levels, copper and lead were found to …


Exploring Factors Influencing Care And Outcome Among Stroke Patients In Tennessee, Omodele Agbejimi Aug 2025

Exploring Factors Influencing Care And Outcome Among Stroke Patients In Tennessee, Omodele Agbejimi

Electronic Theses and Dissertations

Introduction: Stroke is the fifth leading cause of death in Tennessee. Socioeconomic variables influence the delivery of stroke treatment and its outcomes. Despite advances in acute stroke care, the burden of stroke keeps increasing. This study aimed to explore literature on factors contributing to stroke care and outcomes in the U.S., assess the determinants of stroke patients’ outcomes, and examine the geographical disparities in stroke hospitalization and stroke death rate and their association with stroke care accessibility in Tennessee.

Methods: A scoping review was conducted using socio-ecological models to explore literature on factors contributing to stroke care and outcomes. A …


In A Safe-Space Of Her Own: Alice's Journey Through A Traumatized Wonderland To Find Attunement And Recovery, Cheston A. Axton Aug 2025

In A Safe-Space Of Her Own: Alice's Journey Through A Traumatized Wonderland To Find Attunement And Recovery, Cheston A. Axton

Electronic Theses and Dissertations

Throughout Alice’s Adventures in Wonderland/Through the Looking-Glass’s 160-year existence, Lewis Carroll’s seven-year-old protagonist has experienced many changes and alterations. With an ever-growing pop culture interest, Alice’s original narrative has undergone numerous adaptations, with each new variation diving deeper into the impact of trauma on Wonderland.

This thesis continues this existing discourse by examining Wonderland’s capacity to facilitate recovery in the aftermath of severe trauma. Through this research, the traumatic experiences of Alice, from Christina Henry’s The Chronicles of Alice: Alice and American McGee’s Alice: Madness Returns, are examined concerning their effect(s) on her construction of Wonderland, as …


The Diversity Of Our Weightlifting Uniforms: A Qualitative Analysis Of The Experiences Of Gender And Sexual Minorities In Gyms, Rachel M. Schott Aug 2025

The Diversity Of Our Weightlifting Uniforms: A Qualitative Analysis Of The Experiences Of Gender And Sexual Minorities In Gyms, Rachel M. Schott

Electronic Theses and Dissertations

Gender and sexual minority (GSM) populations experience significant mental and physical health disparities compared to their cisgender, heterosexual counterparts. A particularly understudied modality that may contribute to these disproportionate health outcomes is decreased engagement in physical activity (PA). Gyms are a primary source for PA, yet understanding GSM experiences in these spaces is relatively understudied. The purpose of the present study is to better understand the experiences of GSMs in gym spaces with an emphasis on barriers and facilitators to their engagement. We conducted semi-structured phone interviews among self-identified gender and sexual minorities across the U.S. Thematic analysis was used …


Examining The Lived Experiences Of International Students At East Tennessee State University, John The Baptist Anodjo Aug 2025

Examining The Lived Experiences Of International Students At East Tennessee State University, John The Baptist Anodjo

Electronic Theses and Dissertations

This research investigates the lived experiences of international students at East Tennessee State University (ETSU), specifically examining how they navigate social, academic, and structural challenges. Through in-depth interviews with 20 international students from a variety of nationalities, I analyzed issues related to legal status, housing, food insecurity, healthcare, and social integration. I found that students encounter barriers due to immigration policies, financial constraints, and limited access to essential resources. Additionally, international students benefit significantly from support provided by campus services, community organizations, and their social networks, which play a vital role in their adjustment process. While institutional resources are beneficial …


The Intersection Of Appalachian Identity And Gambling Behavior, Noah S. Anderson Aug 2025

The Intersection Of Appalachian Identity And Gambling Behavior, Noah S. Anderson

Electronic Theses and Dissertations

This study examined the relation between Appalachian identity and gambling behavior among students in central Appalachia (n = 395). One-way ANOVAs revealed no significant differences in engagement, F(2, 392) = 0.65, p = .523, or severity, F(2, 392) = 0.33, p = .718, across identification groups. Moderated regression showed that identity did not significantly moderate the engagement–severity relation (B = 0.073, p = .099), though engagement itself was a strong predictor of harm (B = 0.696, p < .001, R² = .521). Negative affect predicted both engagement (B = 0.074, p = .001) and severity (B = 0.069, p = .001), while identity remained non-significant. Logistic regression found that identity predicted gambling engagement (Exp(B) = 1.18, p = .034) only when controlling for severity. These findings relay the importance of empirical efforts in Appalachia and suggest that Appalachian identity may not be an independent risk factor in gambling behavior.


Isolation And Characterization Of Siderophore(S) From Pseudomonas Mosselii, Casey J. Stophel Aug 2025

Isolation And Characterization Of Siderophore(S) From Pseudomonas Mosselii, Casey J. Stophel

Electronic Theses and Dissertations

Iron is essential for growth of most microorganisms. It functions as an important cofactor in many important biological processes. However, iron found in soil is rendered insoluble and unavailable to microorganisms for use. To overcome this, many bacterial species produce siderophores, a small organic molecule that has high affinity for iron. Siderophores allow for bacterial cells to obtain otherwise insoluble iron. Pseudomonas mosselii, a Gram negative bacterium, was isolated from a local soil sample. P. mosselii was found to produce siderophore(s) under iron restricted environment, however, they have not been characterized. Therefore, it was of interest to isolate, purify and …