Medicine and Health Sciences Commons^™

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …

Nanocellulose Based Foams For Low-Cost Disposable Medical Applications, Dominic Kugell

Electronic Theses and Dissertations

Polyurethane foams have been a staple material for their use in medical positioners, such as post-surgery elevation pillows as well as specific tailored positioners for their use during surgery. Polyurethane foams are preferred because of their lower cost compared to other petroleum derived foams, their versatility, and suitable mechanical properties. However, the environmental impact, including both cost and perception, of these foams is immense. Therefore, alternatives are being explored with biopolymers emerging as a promising class of materials. Cellulose is one such polymer that has recently demonstrated desirable properties. In this study, cellulose nanofibrils (CNF), a household foaming agent, and …

Analyzing Pseudomonas Aeruginosa With Bacteriophage Tags Using Photoacoustic Flow Cytometry, Jennifer C. Schinke

Electronic Theses and Dissertations

The number of daily bacterial infections is climbing and the CDC explains that this is due to the antibiotic-resistant threat in the United States. Finding a faster way of bacterial identification is necessary as it currently takes 1-4 days for a medical lab to culture and identify bacteria. Photoacoustic flow cytometry (PAFC) can be used as an alternative method resulting in swift identification within an hour (Edgar, 2019). Pseudomonas aeruginosa, cell line PA01, will be coated in up to a few hundred red dyed phages making it detectible by the photoacoustic flow cytometry system. Bacteriophages (phages) are viruses that …

The Effects Of Peers For Young Adults On Anxiety And Quality Of Life For Young Adults With Autism Spectrum Disorder, Alysha Cecile Dagg

Electronic Theses and Dissertations

Social skills deficits as well as comorbid anxiety are two characteristics commonly experienced by people with Autism Spectrum Disorder - Level 1 (ASD-1; American Psychiatric Association, 2013). These characteristics are also both contributors to a lower quality of life for young adults (Smith et al., 2019). The current study aimed to identify how the quality of life and anxiety are affected by social skills intervention, specifically the PEERS® for Young Adults program (Laugeson, 2017). PEERS® for Young Adults is an evidence-based social skills intervention intended to support individuals with ASD-1 (Laugeson, 2017). Prior research has demonstrated its success in both …

Hybrid Power Spectral And Wavelet Image Roughness Analysis, Basel White

Electronic Theses and Dissertations

The Two-Dimensional Wavelet Transform Modulus Maxima (2D WTMM) sliding window methodology has proven to be a robust approach, in particular for the extraction of the Hurst (H) roughness exponent from grayscale mammograms. The power spectrum is a computational analysis based on the Fourier transform that can be used to estimate the roughness of a scale-invariant image or region via the calculation of H. We aim to examine how the calculation of H in fractional Brownian motion (fBm) images and mammograms can be improved. fBm images are generated for H ∈ [0.00,1.00] for testing through the previous 2D …

Optimization In Mri Experiment Design And Image Reconstruction, Mark Armstrong

Electronic Theses and Dissertations

Magnetic Resonance Imaging (MRI) is a non-invasive imaging modality with numerous applications due to its flexible contrast and high resolution. Recent improvements in computation power have enabled optimizations which were previously out of reach. This has led to improvements in image reconstruction and experiment design.

Compressed sensing (CS) allows for images to be reconstructed using less data than is normally required leading to faster image acquisitions. In this thesis, CS is applied to experiments tracking individual cells in time lapse MRI. The faster image acquisition with CS reduces blurring from cell motion, improving the Contrast-to-Noise ratio (CNR) of moving cells …

Speciated Isotope Dilution Mass Spectrometry In Combination With Thor’S Hammer Metaspike Technology For The Assessment Of Low-Level Biomarkers For Human Health Evaluation, Ashley Ebert

Electronic Theses and Dissertations

Our research team has been focused on quantifying important biological analytes in human blood samples to delineate the biochemical processes underlying certain states of dysfunction and evaluate treatment efficacy. These efforts have been guided by laboratory measurements with the input of medical experts. Speciated isotope dilution mass spectrometry (SIDMS) explained in detail in EPA Method 6800 has been successfully applied in the quantification of an important biomarker analyte for immune function and detoxification processes: glutathione. Past research has proven the molecule a biomarker for autism spectrum disorder (ASD) in the form of the reduced/oxidized glutathione (GSH/GSSG) ratio, and literature has …

Alpha, Beta-Unsaturated Aldehydes: The Underrepresented Markers Of Disease., Saurin Sutaria

Electronic Theses and Dissertations

The peroxidation of unsaturated fatty acids is a widely recognized metabolic process that creates a complex mixture of volatile organic compounds including aldehydes. Elevated levels of reactive oxygen species in cancer cells promote random lipid peroxidation, which leads to an increase in a variety of aldehydes. Many of these volatile aldehydes are exhaled and are of interest as potential markers of disease. Chapter 1 presents a review of reported aldehydes in the exhaled breath of lung cancer patients. alpha,beta-Unsaturated aldehydes, detected primarily when derivatized during exhaled breath preconcentration, are underreported in the reviewed articles. Chapter 1 concludes with our hypothesis …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Computer Aided Diagnosis System For Breast Cancer Using Deep Learning., Asma Baccouche

Electronic Theses and Dissertations

The recent rise of big data technology surrounding the electronic systems and developed toolkits gave birth to new promises for Artificial Intelligence (AI). With the continuous use of data-centric systems and machines in our lives, such as social media, surveys, emails, reports, etc., there is no doubt that data has gained the center of attention by scientists and motivated them to provide more decision-making and operational support systems across multiple domains. With the recent breakthroughs in artificial intelligence, the use of machine learning and deep learning models have achieved remarkable advances in computer vision, ecommerce, cybersecurity, and healthcare. Particularly, numerous …

Early Detection Of Atypical Motor And Neurobehavior Of Infants At Risk Secondary To Opioid Exposure: A Prospective Study, Kara Boynewicz

Electronic Theses and Dissertations

Prenatal opioid exposure has been studied in relation to infants' medical outcomes. However, large gaps exist in the literature supporting early identification of atypical neurobehavior and motor development of infants with prenatal opioid exposure. The purpose of the study was to investigate whether prenatal opioid exposure has a negative influence on a newborn infant’s neurobehavior and motor development to aid in the early identification of potential delays. Using a prospective quasi experimental design, infants motor development using the Test of Infant Motor Performance (TIMP) and neurobehavior using the NICU Neonatal Network Scale (NNNS) was assessed on 58 infants in a …

Spectroscopic Measurements Of Meibum Compositional, Structural, And Functional Relationships To Elucidate The Role Of Meibum In Dry Eye., Anthony Chigozie Ewurum

Electronic Theses and Dissertations

The major aim of my dissertation was to investigate the etiology of dry eye disease which affects about 7 million people in the United States, causing symptoms that can lead to visual disturbance. Correlation between dry eye and an abnormal lipid layer of the tear film has been found. Tear film lipids originate mostly from the meibomian glands. Cholesteryl ester (CE) and Wax ester (WE) lipids make up most of the human meibum lipidome and the CE/WE ratio has been shown to decrease in patients with meibomian gland dysfunction. Model studies using synthetic CE and WE, although providing some insight, …

Generalization Of Net Benefit Of Diagnostic Tests Into Multi-Stage Clinical Conditions: A Collapsing Approach, Ferdous Ahmed

Electronic Theses and Dissertations

Evaluating diagnostic tests based on benefit-risk involves both the tests’ accuracy and the clinical implications of the diagnostic errors. Diagnostic tests are commonly classified into two stages: either positive or negative for a clinical condition (diseased or non-diseased). However, some diseases have more than two stages, such as Alzheimer’s. In diseases with more than two stages, the benefits and risks of the clinical consequences could differ from stage to stage. I could not find any investigations to account for the difference in benefits and risks of tests with more than two stages in the literature. The benefit to cost values …

A Protocol Driven Stroke Code's Impact On Door-To-Needle Times, Jesse Osborne

Electronic Theses and Dissertations

Tissue plasminogen activator (tPA) is most effective the faster it is able to be administered to a patient that has been affected by stroke. A Stroke Code is a strategy that acute care facilities implement to reduce the time from diagnosing a stroke to administering tPA. The purpose of this study was to determine if the initiation of a Stroke Code in an acute care hospital reduces the door-to-needle time for patients affected by a stroke. In particular, does a Stroke Code reduce door-to-needle times. The research was conducted using data from April 1, 2014 to December 31, 2014 (pre-Stroke …

Evaluating The Occurrence Of Age-Related Peripheral Neuropathy In Het3 Mice And Development Of A Whole Tissue Imaging Technique For Analyzing Total Innervation In The Subcutaneous Adipose Depot, Jake Willows

Electronic Theses and Dissertations

Adipose tissue can be characterized as either being a white (energy storing) depot or a brown (energy expending) depot and both have been found to contain dense networks of neural innervation. This adipose nerve supply regulates numerous metabolic functions and likely plays an important role in the function of adipose blood vessels. Recently our lab has shown in the C57BL/6 mouse model that peripheral neuropathy, or the dying back and dysfunction of the nerves in the superficial tissues such as the skin, can extend into the subcutaneous adipose tissue in conditions commonly associated with the neuropathic phenotype (i.e. diabetes, obesity, …

Non-Viral Transfection Efficiencies For The Advancement Of Car-T Therapy., Emily M Murphy

Electronic Theses and Dissertations

Leukemias are the most common form of childhood cancer making up 30% of total pediatric oncological cases, and Acute Lymphoblastic Leukemia (ALL) makes up a significant portion (12%) of the total pediatric cancer diagnoses. In 2017, the FDA approved a successful immunotherapy called CAR-T therapy for the treatment of pediatric B-cell ALL. This therapy includes a CAR (chimeric antigen receptor) that is loaded into the T-cell and expressed. Currently, the loading of the CAR utilizes viral transduction, but consistency issues lead to adverse symptoms in the patients. Better methods of transduction/transfection are being studied in order to improve these consistency …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

Novel Mechanisms And Biomarkers In Alcohol-Induced Organ Injury., Christine E. Dolin

Electronic Theses and Dissertations

Background. Ethanol (EtOH) consumption is known to affect multiple organs; this is unsurprising, as the concentration of EtOH in the blood at relevant doses reaches the millimolar range. The overarching goal of this dissertation was to elucidate mechanisms of alcohol-induced organ injury, specifically the effects of alcohol on the hepatic extracellular matrix (ECM) proteome, the alcoholic hepatitis (AH) plasma peptidome, and the effects of alcohol on the renal cortex proteome and transcriptome. Methods. Mice were pair-fed ethanol-containing liquid diet chronically, and then some mice were administered lipopolysaccharide (LPS). Liver sections from these mice were processed in a series of increasingly …

Pain, Severity, And Attentional Capacity Following Acute Musculoskeletal Injury, Rebekah F. Roessler

Electronic Theses and Dissertations

Background: As recreational activities grow in popularity, there is a concurrent rise in musculoskeletal injury. Injury severity is determined through clinical evaluation and defined by a grading scale. Pain is included in the definition of each injury grade, despite the lack of any conclusive evidence relating injury severity and the associated pain. Additionally, previous studies report impairments in cognitive performance due to chronic and acute pain. The aim of this study is to determine the relationship between the perceived pain intensity and the clinically diagnosed severity of an acute musculoskeletal injury, and to determine if attentional capacity is influenced by …

The Efficacy Of Equine Assisted Therapy In The Treatment Of Autism Spectrum Disorders, Amy Hofmann

Electronic Theses and Dissertations

This study examines the effects of equine-assisted psychotherapies in children with an autism spectrum disorder. The CARS-2 and Children’s Sleep Habits Questionnaire parent-report questionnaires were used for evaluation, as well open-ended questions. A single researcher contacted and visited many PATH-certified centers in the United States. Facilities that participated were all located in the Mid-Atlantic to Northeast region. There were 16 participants, from 11 different farms, that completed both the initial and follow-up questionnaires which were given 7 weeks apart. A $25 Amazon gift card was used as an incentive to increase participation. Participating facilities also completed a questionnaire.

Overall, results …

3d-Printed Fluidic Devices And Incorporated Graphite Electrodes For Electrochemical Immunoassay Of Biomarker Proteins, Abdulhameed Alabdulwaheed

Electronic Theses and Dissertations

Biomarkers are measurable indicators of health status or disease state that can be used for diagnosis and may help guide patient treatment strategies. Enzyme-linked immunosorbent assays (ELISA) and other many clinical techniques currently used for measuring biomarker proteins lack sensitivity, demand high analysis cost, are often not well-suited for measuring multiple biomarkers in a single sample, and require long analysis times. Here, we demonstrate simple, low-cost 3D-printed flow-through devices with integrated electrodes modified with gold nanoparticles (AuNPs) for electrochemical immunoassays of S100B, a biomarker protein related to conditions like skin cancer and brain injuries. Flow-through devices are fabricated from photocurable-resin …

Bayesian Analytical Approaches For Metabolomics : A Novel Method For Molecular Structure-Informed Metabolite Interaction Modeling, A Novel Diagnostic Model For Differentiating Myocardial Infarction Type, And Approaches For Compound Identification Given Mass Spectrometry Data., Patrick J. Trainor

Electronic Theses and Dissertations

Metabolomics, the study of small molecules in biological systems, has enjoyed great success in enabling researchers to examine disease-associated metabolic dysregulation and has been utilized for the discovery biomarkers of disease and phenotypic states. In spite of recent technological advances in the analytical platforms utilized in metabolomics and the proliferation of tools for the analysis of metabolomics data, significant challenges in metabolomics data analyses remain. In this dissertation, we present three of these challenges and Bayesian methodological solutions for each. In the first part we develop a new methodology to serve a basis for making higher order inferences in metabolomics, …

Precision Gene Therapy For Charcot-Marie-Tooth Disease: From Identifying Genetic Modifiers To Developing Allele-Specific Therapies, Kathryn H. Morelli Ph.D.

Electronic Theses and Dissertations

Charcot-Marie-Tooth Disease (CMT) is a clinically and genetically heterogeneous collection of inherited peripheral neuropathies generally characterized by progressive muscle atrophy, weakness, and loss of sensation in the distal extremities. This inherited disorder, for which there is currently no curative treatment, is the most common inherited disease of the peripheral nervous system, affecting 1:2,500 individuals worldwide.

Clinically, CMT is broadly divided into demyelinating (type 1) and axonal (type 2) forms. Although the clinical presentation can vary greatly in severity and progression within individual patients. Genetically, over 1,000 mutations in over 80 loci in the human genome have been linked to specific …

Maturation Of Human Induced Pluripotent Stem Cell Derived Engineered Cardiac Tissues Using Chief Transfection And Chronic Optical Pacing., Marc M. Dwenger

Electronic Theses and Dissertations

The immaturity of engineered cardiac tissues (ECTs) limits their ability to regenerate damaged myocardium and to serve as in vitro disease models and surrogates for drug toxicity testing. Several chronic biomimetic conditioning protocols, including mechanical stretch, perfusion, and electrical stimulation promote ECT maturation but have significant technical limitations. Non-contacting chronic light stimulation using heterologously expressed light-sensitive ChIEF ion channels, termed optogenetics, may be an advantageous alternative to chronic electrical stimulation. As a proof of principle, we transfected ECTs using an AAV packaged ChIEF and then verified acute optical pacing (OP) by patch clamp. We then chronically OP ECTs for 7 …

Simulating Human Pleura Performance In Medical Training Using Measured Tissue Mechanical Properties, Jack Norfleet

Electronic Theses and Dissertations

Medical simulations provide hands-on training at various levels of medical expertise. Yet these simulators fail to accurately mimic the look, feel and behavior of human tissue. Applying measured mechanical properties from human cadaver tissues promises to improve the fidelity of simulated tissue behaviors when subjected to medical procedures. Samples of human parietal pleura were tested under uniaxial tension to failure and measured characteristics were replicated in synthetic pleura. Context specific parameters were then collected and compared between human pleura and the new synthetics. These comparisons tested the hypothesis; H1 Gaps exist between synthetic and human pleura performance, H2: Human tissue …

Biomechanical Testing Of An Exercise For Strengthening The Proximal Femur., Alyssa Osbourne

Electronic Theses and Dissertations

Based on the principles of cutting edge bone remodeling research, a unique therapeutic exercise device was designed specifically to improve bone quality at the most critical location of the proximal femur prone to fracture: the superior-lateral femoral neck where the fracture first initiates during a fall. The exercise/device is intended to work by inducing enough strain in the bone to stimulate the body’s natural bone remodeling mechanisms to increase bone density in the proximal femur and consequently prevent a fracture from arising if a fall to the side does occur.

In order to test the proposed exercise, experiments simulating the …

The Regulation Of Rotavirus–Infected Ht29.F8 And Ma104 Cells Treated With Arachidin 1 Or Arachidin 3, Caleb M. Witcher

Electronic Theses and Dissertations

Rotavirus (RV) infections cause severe life threatening diarrhea in young children and immunocompromised individuals. Several effective vaccines have been developed for young children but are not protective against all strains of RV, and there are no anti-RV therapeutics. Our laboratory has discovered a decrease in the number of infectious simian RV particles (SA114f) in human intestinal cell line, HT29.f8 cells with the addition of either of two stilbenoids, arachidin-1 (A1) or arachidin-3 (A3). This suggests effects on the host cell and RV replication. We examined the cellular effects of human RV strain (Wa) on a human intestinal cell line (HT29.f8) …

Enhanced Breast Cancer Classification With Automatic Thresholding Using Support Vector Machine And Harris Corner Detection, Mohammad Taheri

Electronic Theses and Dissertations

Image classification and extracting the characteristics of a tumor are the powerful tools in medical science. In case of breast cancer medical treatment, the breast cancer classification methods can be used to classify input images as benign and malignant classes for better diagnoses and earlier detection with breast tumors. However, classification process can be challenging because of the existence of noise in the images, and complicated structures of the image. Manual classification of the images is timeconsuming, and need to be done only by medical experts. Hence using an automated medical image classification tool is useful and necessary. In addition, …

Validity And Reliability Of The Balance Tracking System™ During Static Stance, Cody L. Grotewold

Electronic Theses and Dissertations

Introduction: The Balance Tracking System™ (BTrackS™) is a balance board designed to quickly analyze postural control through center of pressure (COP) analysis.

Purpose: Examine concurrent validity and test-retest reliability of the BTrackS™ during static stance.

Methods: A convenience sample of 51 healthy collegiate students between 18 - 25 years old (21.8 ± 3.1 years) completed four, 20 second (s) trials of feet together static stance during both eyes open and closed trials. Data was simultaneously collected on the BTrackS™ and a laboratory force plate to establish concurrent validity. A second testing session was administered 48 - 72 …

A Multi-Channel 3d-Printed Bioreactor For Evaluation Of Growth And Production In The Microalga Dunaliella Sp, Cristian A. Cox

Electronic Theses and Dissertations

We explored the capabilities of additive manufacturing using a photo-cured jetted material 3D printer to manufacture a milli-microfluidic device with direct application in microalgae Dunaliella sp growth and intracellular compounds biosynthesis tests. A continuous microbioreactor for microalgae culture was CAD designed and successfully built in 1 hour and 49 minutes using black photopolymer cured by UV and a support material. The microreactor was made up of 2 parts including the bioreactor itself and a microchannel network for culture media fluids and microalgae. Both parts were assembled to form a single unit. Additional optical and auxiliar components were added. An external …