Medicine and Health Sciences Commons^™

Adaptive Self-Attention For Enhanced Segmentation Of Adult Gliomas In Multi-Modal Mri, Evan P. Savaria, Jiangwen Sun

Computer Science Faculty Publications

Every year there are an estimated 80,000–90,000 new glioma cases, highlighting the need for reliable imaging-based decision support. Although deep learning has improved tumor sub-region segmentation, many state-of-the-art models fail to fully capture complementary information across T1, T1Gd, T2, and FLAIR MRI modalities and often operate as “black boxes,” limiting physician trust when precise delineation is critical for surgical planning, radiation targeting, and treatment monitoring. To address these limitations, we propose AIMS, an Adaptive Integrated Multi-Modal Segmentation framework that maintains modality-specific feature streams and employs adaptive self-attention within a hierarchical CNN-Transformer architecture to prioritize and fuse multi-modal MRI features. We …

Sage: Spatially Aware Gene Selection And Dual-View Embedding Fusion For Domain Identification In Spatial Transcriptomics, Yi He, Yunpei Xu, Liqing Ding, Hong-Dong Li, Yaohang Li, Shaokai Wang

Computer Science Faculty Publications

Despite enabling high-resolution mapping of gene expression within tissues, spatial transcriptomics (ST) still faces challenges in accurately segmenting spatial domains due to complex tissue architecture and limitations of current methods. Most approaches rely on local spatial priors, lack gene-level interpretability, and fall short in capturing structure-discriminative genes or long-range functional relationships, limiting their ability to resolve biologically meaningful architectures. We present Spatially Aware Gene selection and dual-view Embedding fusion (SAGE), a unified and reproducible framework for domain identification in spatial transcriptomics that combines topic-driven gene selection with dual-view embedding fusion to address these gaps. SAGE integrates non-negative matrix factorization (NMF)-based …

A Phenomenological Analysis Of Sense Of Belonging Among Community College Educators, Muhammad Owais Aziz

EVMS School of Health Professions Theses & Dissertations

This phenomenological study explored the complex phenomenon of sense of belonging (SB) among diverse health professions educators (HPEs) and non-health professions educators (non-HPEs) at a Canadian community college. SB, as a dynamic construct shaped by an individual's perception of being valued and respected, is influenced by personal preferences and by complex interactions with the individual's surroundings. To better understand SB and foster a more inclusive environment for diverse educators, it is necessary to investigate SB among these educators. This qualitative study used eleven semi-structured interviews and seven steps of data analysis. The results of this study can inform strategies, policies, …

Exploring The Impact Of Identity-Based Bullying On Suicidal Thoughts And Behaviors Among 6th-12th Grade Youth In Virginia, Camille N. Johnson

Psychology Theses & Dissertations

Suicidal thoughts and behaviors (STBs) are a growing public health concern among youth. Bullying victimization is a robust risk factor for STBs and identity-based bullying (IBB) or bullying that occurs due to a person’s actual or perceived social-identity/identities that is ingrained in discrimination, prejudice, or bias, has been found to be more strongly associated with STBs compared to bullying that was unrelated to identity. The current study used data from the Virginia School Survey of Climate and Working Conditions (N=399,493) to examine associations between general bullying, adult-perpetrated bullying, and IBB with depression and STBs among 6th-12th grade youth. This study …

Identifying Alcohol Intervention-Relevant Constructs For Greek Life: Examining Across Greek Membership And Gender Among College Students, Emily Susan Renzoni

Psychology Theses & Dissertations

Among college populations, students who are members of social Greek life organizations (i.e., social fraternities and sororities) drink more and experience higher rates of negative alcohol-related consequences than their non-affiliated peers. Although there has been success of alcohol interventions in general college populations, research has shown that college drinking interventions that are delivered to students in Greek life are not efficacious in reducing alcohol consumption or related consequences. It is meaningful to investigate if the content commonly addressed in these interventions, although well-documented as being linked to drinking in the general college population, has the same associations for students who …

Schema, Stigma, And The “We-Them” Divide: Perspectives On Ageism From Everyday Life To Healthcare, Temple D. West

English Theses & Dissertations

Ageism remains a pervasive and often underexamined form of discrimination, affecting older adults across both everyday and clinical contexts. This paper explores how cognitive schemas—mental frameworks that shape perception and experience—and stigma interact to reinforce a “we–them” divide between and older patients and healthcare providers, as well as between older and younger individuals in broader society. Through focus groups and listening to the voices of older patients, this study examines how assumptions of age-based decline are embedded in society and inform schemas of ageism. It considers how those schemas shape the spoiled identity of older people as a stigmatized group, …

Assessing The Impact Of Maternal Oral Health On The Risk Of Adverse Birth Outcomes, May Amr Salama

Health Services Research Dissertations

Preterm birth (PTB) and low birth weight (LBW) are leading causes of neonatal morbidity and mortality. Maternal periodontal disease (PD) has been increasingly linked to these adverse birth outcomes (ABOs), yet questions about causality and treatment effectiveness persist due to study design heterogeneity and potential unmeasured confounding. These gaps hinder the development of clear clinical and public health guidelines. This dissertation addresses these gaps through three interconnected studies assessing the relationship between maternal oral health and ABOs.

The first study employed a meta-epidemiological analysis of 62 original studies from nine systematic reviews to evaluate the impact of unmeasured confounding on …

Graduate Physical Therapy Students Perceived Benefit Of Prior Anatomy Experiences Following Their First Semester Graduate Physical Therapy Anatomy Course, Austin Alexander

EVMS School of Health Professions Theses & Dissertations

Human anatomy stands as a cornerstone prerequisite for admission into graduate-level Physical Therapy Programs. As such, prior anatomy experiences need to prepare students for success in graduate-level coursework. However, studies have demonstrated that undergraduate anatomy courses vary in their ability to predict success in graduate Physical Therapy anatomy coursework. This research aimed to utilize students' perceptions of their undergraduate anatomy experiences to predict grades in graduate-level Physical Therapy anatomy coursework. The multinomial logistic regression in this study revealed that the absence of perceived preparedness was a significant predictor of membership in the C graduate anatomy grade group. Students who did …

Unraveling The Links Between Substance Use And Academic Motivation In Higher Education, Melissa Lynn Goins

STEMPS Theses & Dissertations

Self-Determination Theory (SDT) posits that the quality of students’ motivation regulation (i.e., autonomous versus controlled) shapes both learning and health behavior, yet few studies have examined the relations among motivation regulation, alcohol and cannabis use, and achievement. In this study, I surveyed 459 undergraduates at a mid-sized public university in the southeastern United States. Participants completed the Academic Motivation Scale-College version 28 to assess autonomous and controlled motivation regulation, a typical-week alcohol grid, a seven-day cannabis grid, and self-reported grade point average (GPA). Results indicated that autonomous academic motivation was uniquely related to GPA; however, neither motivation variable related to …

Mitochondria-Mediated Epigenetic Transfer Between Chondrosarcoma And Wild-Type Cells, Caleb C. J. Wyckoff

Biomedical Sciences Theses & Dissertations

Glioblastoma (GB), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), cholangiocarcinoma, and chondrosarcoma (CS) cancers all contain mutations in the gene isocitrate dehydrogenase 2 (IDH2). The mutant IDH2 enzyme exhibits transformation of alpha-ketoglutarate (αKG) into the oncometabolite D-2-hydroxyglutarate (D2HG) in the mitochondria of these cancers. Mitochondrial-mediated transfer between cancer cells and recipient cells is a significant event that impacts the physiology of the receiving cell, specifically the epigenetic landscape. Previous experiments indicating increased DNA methylation in mesenchymal stem cells exposed to IDH1 or IDH2 conditioned medium underscore the potential role of D2HG to alter methylation states. Additionally, the presence of …

Book Review: "Take Your Own Advice" By Jeffrey Marsh, Kristy Carlisle

Journal of Human Services Scholarship and Interprofessional Collaboration

This review examines Take Your Own Advice by Jeffrey Marsh as a teaching tool for cultivating ethical presence, mindfulness, and professional identity in human services and counseling education. Grounded in compassion-based, trauma-informed principles, Marsh’s eight guiding rules invite readers to shift from control and perfectionism toward authenticity, acceptance, and values-based living. These concepts directly reflect mindfulness and Acceptance and Commitment Therapy (ACT) practices and expound upon self-compassion, boundary awareness, and cultural humility. Through workbook activities, students find ways to practice emotional regulation and ethical reflection. Drawing connections to the Council for Standards in Human Service Education (CSHSE) and Council for …

Information & Schedule Flyer, Macon & Joan Brock Virginia Health Sciences At Old Dominion University

Cardiovascular Research Symposium

Information and schedule for Cardiovascular Research Symposium: Bridging Gaps and Advancing Care.

Novel Percutaneous Repair Of Femoral Pseudoaneurysms Using Perclose Proglide™: A Case Series, Ryan Mancoll, Emily Burnett, Nicholas Bandy, Benjamin Samberg, Thomas Cook, Jacob Hoffman, Christopher Murter, Matthew Rossi, David Dexter, Hosam El Sayed, Animesh Rathore Md

Cardiovascular Research Symposium

BACKGROUND - This case series details the novel use of the Perclose ProGlide closure device to successfully repair three separate cases of iatrogenic femoral pseudoaneurysms (PSAs) without attempting other modalities first. Conventional treatment methods of ultrasound-guided compression, duplex-directed thrombin injection (DDTI), or open surgical repair were contraindicated in these patients due to unique anatomy or advanced comorbidities.

METHODS – Details were gathered via a retrospective chart review.

RESULTS - In the first case, a 73-year-old female had an access site PSA off the superficial femoral artery (SFA) with concomitant arteriovenous fistula (AVF) and advanced cardiac disease. The ProGlide device was …

A Diagnostic Dilemma Due To A Large Chiari Network, Kyle Admire, Xian Qiao

Cardiovascular Research Symposium

INTRODUCTION: Chiari networks are reticulated networks of fibers that result from incomplete reabsorption of the right valve of the sinus venosus. While the true clinical significance of these is currently unknown, there are associations with dysrhythmias, paradoxical emboli, and thrombi formation. Here, we describe a large, incidentally found Chiari network which encompasses most of the right atrium.

CASE: A 42-year-old female with a past medical history of obesity (BMI 58) and well-controlled asthma presented to the emergency department in respiratory distress with hypercapnia and hypoxemia. Computed tomography (CT) with angiography of the chest was performed and did not show a …

Challenging Case: Acute Type A Aortic Dissection With Multi-Organ Malperfusion, Rishab Agarwal, Allebelle Bradshaw Md, Jennifer S. Lawton Md

Cardiovascular Research Symposium

Description of case: A 57-year-old male with hypertension and obesity presented with acute, severe chest pain. He developed a cold, numb right leg with motor deficits. He was hypotensive with a lactate of 7.4. CT imaging revealed an acute Type A aortic dissection (TAAD) with malperfusion involving the right internal carotid, right subclavian, and right coronary arteries, as well as the superior mesenteric artery, and right iliac artery (Fig 1A/B). He was transferred to our tertiary center for emergent surgery.

Five hours after presentation, he underwent emergent ascending aortic replacement, deep hypothermic circulatory arrest, and retrograde cerebral perfusion. The …

Emergent Aorto-Bi-Iliac Bypass For Collapsed Gore Excluder Endograft, Ryan Mancoll, Khushie Martharoo, Emidio Germano Md, David Dexter Md, Animesh Rathore Md

Cardiovascular Research Symposium

No abstract provided.

Peri-Graft Sheath Anchor Technique For Target Vessel Cannulation In Fenestrated Aortic Repair, Ryan Mancoll, Khushie Martharoo, Emidio Germano Md, David Dexter Md, Animesh Rathore Md

Cardiovascular Research Symposium

No abstract provided.

Association Between Cardiovascular Risk And Kidney Function In A Real-World Peruvian Cohort, Juan Munoz-Moreno, Gina Sanchez, Johanna Contreras

Cardiovascular Research Symposium

Background: Cardiovascular risk and kidney function are interrelated, with variations by sex and age. Middle-aged women often have slightly lower kidney function than men, increasing susceptibility to early renal effects of elevated cardiovascular risk, but data from Latin America remain limited.

Methods: Cross-sectional study of adults aged 40-79 years evaluated at a tertiary hospital in Peru between January and June 2024. We excluded individuals with established cardiovascular disease, statin use, LDL >190 mg/dL, or incomplete ASCVD risk data. Ten-year ASCVD risk was estimated using the 2013 Pooled Cohort Equations with race set as “Other” and classified as low, borderline, intermediate, …

Six-Year Survival Following Liver Transplant In Val30met Hereditary Transthyretin Amyloidosis, Juan Munoz-Moreno, Johanna Contreras

Cardiovascular Research Symposium

Background: Hereditary transthyretin amyloidosis (ATTRv) is a progressive, multisystem disorder caused by pathogenic TTR mutations affecting the heart and peripheral nerves. While disease-modifying agents such as tafamidis are available, liver transplantation (LTx) remains an option in selected genotypes, with over 50% of Val30Met carriers surviving up to 20 years post-transplant.

Case: A 53-year-old male with a permanent pacemaker for complete atrioventricular block presented with NYHA class II dyspnea, syncope, and lower extremity paresthesias. ECG showed atrial fibrillation. Transthoracic echocardiography revealed preserved ejection fraction, biventricular wall thickening with granular appearance, moderate left atrial dilation, and moderate mitral regurgitation. Speckle-tracking echocardiography demonstrated …

Mechanical Circulatory Support As A Bridge To Early Recovery Of Left Ventricular Function In Fulminant Myocarditis, Juan Munoz-Moreno, Gina Sanchez, Johanna Contreras

Cardiovascular Research Symposium

Background: Fulminant myocarditis (FM) is a rare cause of acute heart failure that can lead to a rapid left ventricular ejection fraction (LVEF) decline within four weeks. With in-hospital mortality up to 18.2%, timely mechanical circulatory support (MCS) is essential to stabilize hemodynamics and bridge to recovery or transplantation.

Case: A 49-year-old Japanese man with hypertension and diabetes presented with two weeks of dyspnea and angina after a flu-like illness. On admission, he developed ventricular fibrillation requiring advanced CPR. Physical exam revealed pulmonary congestion. ECG showed repolarization abnormalities. TTE demonstrated severe biventricular dysfunction (LVEF 9%, RVFAC 9%). Labs showed elevated …

Inferior Vena Cava Thrombosis In Nephrotic Syndrome: Two Cases Managed With Endovascular Thrombectomy, Rishab Agarwal, Benjamin Samberg, David Dexter Md

Cardiovascular Research Symposium

Background: Nephrotic syndrome (NS) confers a hypercoagulable state that can precipitate venous thromboembolism (VTE), rarely involving the inferior vena cava (IVC).

Cases: We describe two patients with NS who developed IVC thrombosis. One underwent mechanical thrombectomy using the ClotTriever®/Protrieve™ system (Inari Medical, Irvine, CA, USA); the other underwent aspiration thrombectomy using the AngioVac® system (AngioDynamics, Latham, NY, USA), with adjunct balloon maneuvers for renal vein thrombus.

Outcomes: Both patients achieved immediate IVC recanalization with symptom improvement and patent IVC on short‑term duplex follow‑up.

Conclusions: In NS‑associated IVC thrombosis, device‑based endovascular thrombectomy can be performed safely with restoration of caval patency. …

Cardiopulmonary Bypass Facilitates Emergent Tavr And Bifurcation Pci In A Highly Comorbid 72-Year-Old Female With Acute Valvular Shock, Omar Sale Bs, Nicholas Valle Do, Matthew Rossi Md, Joshua Cohen Md, Paul Lavigne Md, Matthew Summers Md

Cardiovascular Research Symposium

Title:

Cardiopulmonary Bypass Facilitates Emergent TAVR and Bifurcation PCI in a Highly Comorbid 72-year-old Female with Acute Valvular Shock

Introduction:

Transcatheter aortic valve replacement (TAVR) has emerged as a critical minimally invasive option for patients with severe AS who present in valvular shock, particularly those at prohibitive surgical risk. Multicenter registry data demonstrate that emergent TAVR in this population is associated with promising procedural success, significant improvements in functional status, and lower short- and long-term mortality compared to medical management or balloon aortic valvuloplasty, with outcomes approaching those of surgical aortic valve replacement in selected patients [1] [2]. We present …

Acute Valve Syndrome And 1-Year All-Cause Mortality Post-Avr: A Retrospective Cohort Study, Omar Sale Bs, Nicholas Valle Do, Israa Saleh, Omar Jafar Md, Matthew Summers Md

Cardiovascular Research Symposium

Background: Acute Valve Syndrome (AVS) identifies a high-risk cohort of aortic stenosis (AS) patients with poor outcomes following aortic valve replacement (AVR), but the spectrum of risk within this group has yet to be fully explored. We sought to evaluate whether admission markers facilitated risk stratification of 1-year mortality in an AVS cohort.

Methods: In a retrospective cohort study (MIMIC-IV v3.1), we identified 2,380 adults who underwent AVR between 2008–2019. Patients were classified as AVS or progressive valvular disease (PVD). AVS was defined by criteria of acute decompensation, including advanced heart failure symptoms, cardiogenic shock, or significant hyperlactatemia. The AVS …

Investigating Extracellualr Vesicles Role In The Pathogenesis Of Acute Lung Injury, Ruben Manuel Luciano Colunga Biancatelli, Pavel Solopov, Tierney Day, Anca Dobrian, John D. Catravas

Cardiovascular Research Symposium

Background: Extracellular vesicles (EVs) are small lipid-bound particles containing proteins and RNAs, whose role in intercellular communication and signaling is critical for homeostasis or inflammatory responses. Patients with acute lung injury display changes in EVs number, cargo content and signature compared to healthy individuals.

Hypothesis: We have hypothesized that EVs may play a role in the pathogenesis of acute lung, by transferring harmful mediators of inflammation and disrupting recipient cells homeostasis.

Methods: C57BL/6j mice (8-10 weeks old, 25g BW) were intratracheally instilled with 50µL of 5*1010- 11 EVs isolated from Human Lung Microvascular Endothelial cells (HLMVEC) exposed to 1 µg …

Characteristics And Outcomes Of Axillary And Subclavian Artery Injuries, Benjamin Samberg, Nicholas Bandy, Michael Martyak

Cardiovascular Research Symposium

INTRODUCTION: Subclavian and axillary artery injuries are rare but life-threatening. Optimal management strategies remain debated. This study compares injury characteristics and outcomes.

METHODS: Retrospective analysis was conducted on 181 PROOVIT Database patients categorized by injury location, mechanism, and treatment (open, endovascular, nonoperative). Collected data includes ISS, PRBC, mortality, hospital and ICU LOS, and hard signs.

RESULTS: Subclavian injuries had higher ISS (μ=25, 19; p=0.004) and mortality (18%, 3.4%; p=0.004), but fewer hard signs (41%, 63%; p=0.004) than axillary. Axillary injuries were more frequently treated with open repair (51%, 32%; p=0.016), while subclavian injuries were more often managed nonoperatively (45%, 29%; …

B Cell Subset Specific Regulation Via Desmosterol In An Atherosclerotic Environment, Shelby Ma, Alina Morty, Kathleen Coleman, Basudha Habisyasi, Elena Galkina

Cardiovascular Research Symposium

No abstract provided.

New Onset Heart Failure Of Sodium-Glucose Cotransporter 2 (Sglt2) Inhibitors In Patients With End-Stage Renal Disease (Esrd) And Dialysis, Daiwik Munjwani, Amin Yehya

Cardiovascular Research Symposium

Introduction: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardioprotective and renoprotective benefits in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). However, the effects of these agents in patients with end-stage renal disease (ESRD) or on dialysis remain underexplored, as previous clinical trials often excluded this population. With the recent removal of ESRD as a contraindication by the U.S. Food and Drug Administration, understanding the cardiovascular risks of SGLT2 inhibitors in this group is imperative. This study aimed to assess the incidence of new onset heart failure (HF), including HF with reduced ejection fraction (HFrEF) and …

"Lost To Follow Up:" A Case Of An Adult Congenital Heart Defect Patient Who Faced Morbidity In Adulthood After Lacking Transitional Care Following Medical Intervention In Childhood, Mackenzie Kelley, Ashish Saini

Cardiovascular Research Symposium

CASE PRESENTATION: This patient is a 40 y.o. male with a BMI of 46.2 kg/m2 who presented to the ED with fluid overload, shortness of breath, and orthopnea. The patient was tachycardic and physical exam revealed anasarca and ascites. The patient reported chronic lower extremity and scrotal edema so severe that he had been unable to walk and was mainly homebound for the past two years. The patient’s past medical history was significant for hypertension, alcohol use disorder with history of withdrawal, and a cardiac murmur which the patient attributed to a “hole in the heart” for which he had …

Ice Guided Percutaneous Pseudoaneurysm Coil Embolization, Moudar Jano, Amir M. Hassani, Matthew R. Summers

Cardiovascular Research Symposium

Background: Pseudoaneurysm formation following cardiac procedures can be a significant complication due to the high risk of rupture. Traditionally managed through sternotomy and cardiac surgery, innovative percutaneous interventions have shown promise for high-risk patients. This case report highlights the successful application of ICE-guided percutaneous coil embolization for the treatment of aortic pseudoaneurysms, presenting a less invasive alternative for patients for whom traditional surgery poses significant risks.

Case Summary: A patient with a complex cardiovascular history, including aortic root and ascending aorta replacement and CABG x2, developed two pseudoaneurysms below the right coronary button and at the distal aortic graft-native aorta …

Association Of Physical Activity And Neighborhood Deprivation With Extracellular Vesicle Characteristics In African American Women With Obesity, Anca D. Dobrian, Yvonne Baumer, Tiffany Powell-Wiley, Lizzy Aquino-Peterson, Noel Miller

Cardiovascular Research Symposium

Association of Physical Activity and Neighborhood Deprivation with Extracellular Vesicle Characteristics in African American Women with Obesity