Medicine and Health Sciences Commons^™

Structural Stress And Otherness: How Do They Influence Psychological Stress?, Christine Dewilde

Theses and Dissertations

Background: The Theory of Cultural Distress offers a framework for understanding the potential outcomes in patients who do not receive care that incorporates their cultural beliefs (DeWilde & Burton, 2017).This study represents initial steps in researching the theory byexploring the layering of stressors that place the patient at risk for Cultural Distress. Methods: Utilized aCross-sectional descriptive correlational analysis of intersecting identities (Structural Stressors), ethnicity-related stressors (Otherness) and ethnic-identity (Otherness) to develop understanding of the potential effects of these variables on psychological stress. Independent variables included intersecting identities, perceived ethnic discrimination, concern for stereotype confirmation, own group conformity pressure, and …

Galantamine's Deconstruction In The Quest Of A Pam Pharmacophore, Malaika Argade

Theses and Dissertations

Alzheimer’s disease is a progressive neurodegenerative disorder generally affecting people above the age of 65 years. Even though the pathophysiological hallmarks of AD were established more than a hundred years ago, there is yet to be a drug that can stop its characteristic neuronal damage. Of the five currently FDA-approved drugs, galantamine has a unique mechanism of action. Apart from being an AChE inhibitor, galantamine can effectively potentiate (positive allosteric modulator) the effect of agonists at nAChRs at concentrations lower than those required for its action as an AChE inhibitor. Perhaps the clinical benefits observed with galantamine are associated mainly …

The Role Of Ceramide In Neutrophil Elastase Induced Inflammation In The Lungs, Sophia Karandashova

Theses and Dissertations

Alterations to sphingolipid metabolism are associated with increased pulmonary inflammation, but the impact of inflammatory mediators, such as neutrophil elastase (NE), on airway sphingolipid homeostasis remains unknown. NE is a protease associated CF lung disease progression, and can be found in up to micromolar concentrations in patient airways. While sphingolipids have been investigated in the context of CF, the focus has been on loss of cystic fibrosis transmembrane conductance regulator (CFTR) function. Here, we present a novel observation: oropharyngeal aspiration of NE increases airway ceramides in mice. Using a previously characterized mouse model of NE-induced inflammation, we demonstrate that NE …

Exogenous Fniii 12-14 Regulates Tgf-Β1-Induced Markers, Hilmi M. Humeid

Theses and Dissertations

The extracellular matrix protein Fibronectin (FN) plays an important role in cell contractility, differentiation, growth, adhesion, and migration. The 12th -14th Type III repeats of FN (FNIII 12-14), also referred to as the Heparin-II domain, comprise a highly promiscuous growth factor (GF) binding region. This binding domain aids in cellular signaling initiated from the ECM. Additionally, FN has the ability to assemble into fibrils under certain conditions, mostly observed during cell contractile processes such as those that initiate due to upregulation of Transforming Growth Factor Beta 1 (TGF-β1) [1], [2]. Previous work from our lab has shown that self-assembly of …

Molecular Brain Adaptations To Ethanol: Role Of Glycogen Synthase Kinase-3 Beta In The Transition To Excessive Consumption, Andrew D. Van Der Vaart

Theses and Dissertations

Alcoholism is a complex neuropsychiatric disease that is characterized by compulsive alcohol use and intensifying cravings and withdrawals, often culminating in physiologic dependency. Fundamental alterations in brain chemistry underlie the transition from initial ethanol exposure to repetitive excessive use. Key mediators of this adaptation include changes in gene expression and signal transduction. Here we investigated gene expression pathways in prefrontal cortex and nucleus accumbens following acute or chronic ethanol treatment, to identify genes with potentially conserved involvement in the long-term response of the corticolimbic system to repeated ethanol exposure. We investigated Gsk3b, which encodes glycogen synthase kinase 3-beta, as a …

The Relationship Between Central Venous Catheter And Post-Operative Complications In Patients Undergoing Hepatic Resection, David C. O'Connor

Theses and Dissertations

The Relationship Between Central Venous Catheter and Post-operative Complications in Patients Undergoing Hepatic Resection

David C. O’Connor, Ph.D., DNAP, CRNA

A dissertation submitted in partial fulfillment of the requirements for the degree of

Doctor of Philosophy at Virginia Commonwealth University

Virginia Commonwealth University, 2018

Dissertation Chair: Clarence J. Biddle, Ph.D., CRNA

Hepatic resection is indicated for primary and secondary malignancies. Use of a low central venous pressure technique is associated with decreased blood loss in these cases. This technique has evolved; central venous catheters and high dose morphine are no longer used, and patients are extubated earlier. The purpose of …

Inpatient Utilization Of Computed Tomography: The Influence Of Market, Hospital, And Patient Characteristics, Michael Hanshew

Theses and Dissertations

The use of computed tomography (CT) in the care of patients has grown dramatically since its introduction over 30 years ago. The vast majority of the utilization research has focused on factors associated with the variable use in the outpatient and emergency department settings. This has left much of the inpatient use and variation understudied. This study has multiple aims. The first is to characterize the inpatient variation across multiple states and markets. The second is to evaluate the relationship between inpatient CT use and commercial payers across these areas. The third is to develop a model to evaluate the …

Impact Of Sensory Adapted Dental Environment On Children With Developmental Disabilities, Gail Kim

Theses and Dissertations

Purpose: This was a pilot study assessing the impact of a sensory adapted dental environment (SADE) on children with developmental disabilities (DD) receiving routine dental care.

Methods: A crossover study of 22 children with DD, aged 6 through 21, was conducted at Virginia Commonwealth University Pediatric Dental clinic. Each participant was randomized to a sequence of two dental cleanings, one regular dental environment (RDE) and one SADE with a 3-4-month recall. Outcomes included physiological measures (heart rate and oxygen saturation) and cooperation (Frankl scores).

Results: Study subjects completed a total of 36 visits. None of the physiological measures differed at …

Directing Mesenchymal Stem Cells For Periodontal Regeneration, Charles Stoianovici

Theses and Dissertations

Background: Directing autogenous Mesenchymal Stem Cell (MSC) to defect sites has a great promise in bone regeneration. We designed a MSC specific, bone affinity peptide (E7HA7) by conjugating E7 with a polyglutamate hydroxyapatite (HA) binding motif. We sought to characterize the in-vivo releasing pattern and bioactivity of E7HA7. Methods: HA discs were coated with fluorescent labeled peptides E7HA7, E7HA2 or E7 were subcutaneously implanted in Sprague Dawley rats. In an ectopic bone formation model was used to test the in-vivo bioactivity of E7HA7 conjugated to DBM. Results: E7HA7 showed slower peptide release from scaffolds in comparison to other groups, being …

Usefulness Of The Captia Syphilis Igg Eia Test Method And Reverse Algorithm For Detection Of Syphilis Infection In A Public Health Setting, Patricia Armour

Theses and Dissertations

Syphilis, a systemic sexually transmitted disease, is on the rise in the US, with infection rates the highest recorded since 1994 according to the CDC. Useful laboratory testing is an important diagnostic tool for determining individual syphilis infection and preventing community-wide disease spread.

The purpose of this study was to determine the usefulness of a specific automated treponemal test method, the Captia^TM Syphilis IgG EIA, and the syphilis reverse algorithm interpretation for detecting syphilis infection among patients seeking care in a public health clinic. The study employed a retrospective, nonexperimental descriptive correlational design with data collected between 2012-2013 from …

The Effect Of Instrumentation Taper On Dentin Conservation, Megan E. Green

Theses and Dissertations

Introduction: The aim of this in vitro study was two part. The first being to assess and compare the amount of dentin removed by an instrument with a taper of 0.04 versus an instrument with a taper of 0.06 using the Edge Evolve® file system at different increments within the canal system. Secondly, this study evaluated whether instrumentation with either taper resulted in a remaining dentin thickness (RDT) of less than 0.3mm. If this RDT was imposed upon, fracture resistance was compromised. Both pre and post instrumentation measurements were taken of samples instrumented with the 0.04 and 0.06 tapered files. …

The Cognitive And Functional Impact Of Open Heart Surgery: A Pilot Study Including Three Common Procedures (Coronary Artery Bypass Graft, Heart Valve Replacement, And Left Ventricular Assist Device), Robert Fix

Theses and Dissertations

This study investigated the impact of open heart surgery (Coronary Artery Bypass Graft, Heart Valve Replacement, or Left Ventricular Assist Device placement) on cognition, functional performance, and mood in the three months following surgery. The Montreal Cognitive Assessment (MoCA), Kettle Test (KT), Physical Self Maintenance Scale (PSMS), and Hospital Anxiety and Depression Scale (HD) measured global cognition, functional cognition, functional performance, and mood states, respectively.

Thirteen male participants (ages 38 – 75) completed assessments at four time points -- when they were scheduled for surgery, within one week prior to surgery, before hospital discharge after surgery, and three months after …

Investigating The Role Of Nicotinic Acetylcholine Receptors (Nachrs) In The Development And Maintenance Of Chemotherpy-Induced Peripheral Neuropathy In Mice, Wisam B. Toma

Theses and Dissertations

Chemotherapy-Induced Peripheral Neuropathy (CIPN) is a major dose-limiting side effect of several anticancer drugs. The prevalence of CIPN ranges from one-third to two-thirds of cancer patients. CIPN can persist for months to years after completion of chemotherapy. Despite the efficacious use of paclitaxel in the treatment of tumors, it can induce many sensory symptoms, such as paresthesia, numbness, tingling and burning pain, and mechanical and cold allodynia, which typically are present in the hands and feet. Similar to other types of chronic pain, paclitaxel-induced CIPN is comorbid with depression and anxiety in cancer survivors, and paclitaxel induces changes in affect-like …

An Innovative Use Of Technology And Associative Learning To Assess Prone Motor Learning And Design Interventions To Enhance Motor Development In Infants, Tanya Tripathi

Theses and Dissertations

Since the introduction of the American Academy of Pediatrics Back to Sleep Campaign infants have not met the recommendation to “incorporate supervised, awake “prone play” in their infant’s daily routine to support motor development and minimize the risk of plagiocephaly”. Interventions are needed to increase infants’ tolerance for prone position and prone playtime to reduce the risk of plagiocephaly and motor delays. Associative learning is the ability to understand causal relationship between events. Operant conditioning is a form of associative learning that occurs by associating a behavior with positive or negative consequences. Operant conditions has been utilized to encourage behaviors …

Shared Genetic And Environmental Influences On Fear, Anxiety, Posttraumatic Stress, And Brain Morphometry, Chelsea Sawyers

Theses and Dissertations

Anxiety disorders (ADs) and stress-related disorders are some of the most common psychiatric disorders in the United States. Like other c0mplex psychiatric illness, genetics and neuroimaging research has focused on understanding their underlying neurobiology. Areas within the fear-network play important roles in threat perception, fear conditioning/learning, cognitive processing, and modulation of fear responses including contextual modulation and extinction and have been implicated in ADs as well as stress disorders such as posttraumatic stress disorder (PTSD). The primary gap in the current search for underlying biological mechanisms is in whether biomarkers associated with disorders share genetic influences with the disorders they …

5-Ht2b Receptor-Mediated Cardiac Valvulopathy, Pallavi Nistala

Theses and Dissertations

5-HT_2B receptor agonism causes cardiac valvulopathy, a condition characterized by thickening of the heart valves and as a result, regurgitation of blood within the heart. The anti-obesity drug fenfluramine, which was originally prescribed as an anorectic, was withdrawn from the market due to causing cardiac valvulopathy. Fenfluramine, after metabolism by N-dealkylation, produces the metabolite norfenfluramine, which acts as a more potent valvulopathogen. The same was seen with MDMA (ecstasy), a popular drug of abuse, which is metabolized by N-dealkylation to produce MDA, a more potent valvulopathogen. Glennon and co-workers. studied a series of 2,5-dimethoxy-4- substituted phenylisopropylamines (DOX type) hallucinogens …

Speech Recognition Technology: Improving Speed And Accuracy Of Emergency Medical Services Documentation To Protect Patients, Tan Tran

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Because hospital errors, such as mistakes in documentation, cause one in six deaths each year in the United States, the accuracy of health records in the emergency medical services (EMS) must be improved. One possible solution is to incorporate speech recognition (SR) software into current tools used by EMS first responders. The purpose of this research was to determine if SR software could increase the efficiency and accuracy of EMS documentation to improve the safety of patients of EMS. An initial review of the literature on the performance of current SR software demonstrated that this software was not 99% accurate, …

Cataract Blindness: Socioeconomic Factors Associated With Treatment Barriers And High Blindness Rates For Women In Rural Regions Of Andhra Pradesh, Kiranpreet Kaur

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Despite efforts of Vision 2020 in India, the 2001 Andhra Pradesh Eye Disease Study (APEDS) extrapolated that approximately 18.7 million blind people resided in India and projected an increase to 31.6 million blind people by 2020. Within the Andhra Pradesh state itself, the preventable blindness population had increased from approximately 1,143,150 people in 1990 to 1,402,264 people in 2001, against reformation attempts by the National Program for Control of Blindness. Of this, cataracts were consistently the leading cause of avoidable blindness. Numerous public health studies have been conducted to outline factors that preclude treatment of avoidable cataract blindness in the …

On Lgbt Studies At Vcu: An Interview With Richard Godbeer, Amita Rao, Emily Furlich

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

No abstract provided.

Reduction Of Oxidative Stress And Storage Lesions (Rcsl) In Red Blood Cells: Analysis Of Ascorbic Acid (Aa), N-Acetylcysteine Amide (Ad4), And Serotonin (5-Ht), Shanmuka Gadiraju

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Oxidative stress is a common occurrence in red blood cell (RBC) storage in blood banks throughout the world. Typically RBC units stored under routine standard protocol (stored in SAGM-CPD additive solution) can only be kept up to forty-two days for transfusion usage before being discarded. I am studying the effects of Ascorbic Acid (AA), N-acetylcysteine amide (AD4), and Serotonin or 5-hydroxytryptamine (5- HT) as additives in blood bank storage to find out if these additives can reduce storageinduced oxidative stress on red blood cells (RBCs), as well as to understand how potential blood storage additives can affect the shelf life …

Mapping Opioid Mortality Rates Across Treatment Capacity To Identify Need And Access, Garrett K. Wong, Justin R. Chang, Chase Greco, Yadunandan Pillai, Mohammad A. Shahrezaei, Melissa H. Burton, Rob Lawrence, Alan Dow

Graduate Research Posters

Background: The opioid and heroin overdose epidemic is a public health emergency in the state of Virginia, resulting in the death of more than 1,100 people in 2016. In order to overcome this epidemic, we need to match the places with the greatest need for services related to substance use disorders with the appropriate healthcare workforce.

Aims: As the data about the overdose outbreak and related socioeconomic factors grow in size and complexity, data scientists have attempted to utilize big data techniques to identify communities and risk factors contributing to addiction.

Methods: Using data obtained from the …

Visualizing The Opioid Overdose With A Dynamic Heat Map To Identify And Predict Vulnerable Communities, Justin R. Chang, Garrett K. Wong, Chase Greco, Yadunandan Pillai, Mohammad A. Shahrezaei, Melissa H. Burton, Rob Lawrence, Alan Dow

Graduate Research Posters

Background: Opioid and heroin overdose epidemic is a public health emergency in the state of Virginia. In order to prevent overdose deaths, we need the target expertise in substance use disorders to areas with high rates of overdose. In particular, an area with an acute spike in overdoses might represent an urgent need for intervention.

Aims: The CDC urges the use of near real-time surveillance to effectively identify overdose incidence, and to coordinate community responses in the states affected by the epidemic, including Virginia. However, current opioid overdose datasets for Virginia lack adequate consistency, granularity, and temporality for …

Virginia Dental Journal (Vol. 95, No. 4, 2018)

Virginia Dental Journal

No abstract provided.

Effects Of Chemotherapy On Motivated Behavior And Opioid Reward In Rats, Luke P. Legakis

Theses and Dissertations

Paclitaxel, vincristine, oxaliplatin, and bortezomib are cancer chemotherapy drugs with adverse effects that include chemotherapy-induced neuropathic pain (CINP) as well as depression of behavior and mood. In the clinical setting, opioids are often used concurrently with or following chemotherapy to treat pain related to the cancer or CINP, but repeated opioid exposure can also increase the risk of opioid abuse. This dissertation evaluated the effect of chemotherapy treatment on motivated behaviors and opioid reward in rats. The main findings of this evaluation are as follows: (1) Chemotherapy, at doses that produce robust and sustained mechanical hypersensitivity produce only weak or …

Genetic And Environmental Influences Of Bullying Involvement: A Longitudinal Twin Study, Ellyn Dunbar

Theses and Dissertations

Introduction—Bullying involvement is associated with many long-term adverse outcomes. Bullied children are at risk for internalizing disorders including anxiety, depression and suicidal behavior in childhood and adulthood. Bullies are also at risk for psychiatric disorders, specifically externalizing disorders. Bully victims—children who are both bullied and bullies—have a particularly poor prognosis, with a higher risk for internalizing and externalizing disorders. The purpose of this study is to study the epidemiology, risk of psychiatric disorders, and genetic and environmental influences of being bullied, a bully, and a bully victim—in the sample and individually in males and females.

Methods—Twins (N=2,844, aged …

Anxious?: Re-Designing Women’S Jewelry To Help Manage Symptoms Of Anxiety Disorders, Nourbanu Feras Hijazi

Theses and Dissertations

Anxiety is a common and often stigmatized condition. Destigmatizing mental disorders can positively impact people’s interaction and communication with others and can prompt conversations in which people share their experiences with mental health, leading to improved societal understanding and perception.

My design solution tackles behavioral symptoms of anxiety, specifically two conditions that fall under obsessive-compulsive behavior: Dermatillomania and Trichotillomania. By redesigning women’s jewelry to specialized accessories, my intention is for these objects to help destigmatize these conditions and relieve symptoms of maladaptive behaviors and hurtful impulses. By redirecting these irresistible urges to an external artifact, the objects are designed to …

Impaired Cardiorespiratory Fitness Following Thoracic Radiotherapy, Justin M. Canada

Theses and Dissertations

Cancer (CA) is the second leading cause of death in the United States preceded only by cardiovascular disease (CVD). Over the past 30 years, the 5-year survival rate for all cancers combined has increased by more than 20%. This improved survival rate is due to early diagnosis and advances in treatment involving a multimodality treatment approach that includes radiotherapy [RT] with about half of all CA patients receiving some type of RT sometime during the course of their treatment. Cardiotoxicity is one of the most important adverse reactions of RT and leads to a meaningful risk of CVD-related morbidity and …

Aerobic Exercise Exposure Targeting Anxiety Sensitivity: Effects On Associated Health Behaviors In Young Adults, Autumn Lanoye

Theses and Dissertations

Anxiety sensitivity (AS) is associated with health behaviors such as low rates of physical activity, overeating, alcohol use, and poor sleep; however, interventions targeting AS via exercise-based interoceptive exposure have not assessed these as outcomes. In addition, previous studies are limited by brief follow-up periods. This study aimed to replicate previous aerobic exercise interoceptive exposures with an extended (6-week) follow-up and measurement of health behaviors.

Participants were 44 sedentary young adults with elevated AS randomized to intervention (6 20-minute sessions of moderate-intensity treadmill walking) or assessment-only control. Assessments took place at baseline, week 2 (post-treatment), week 4, and week 8 …

Penalized Mixed-Effects Ordinal Response Models For High-Dimensional Genomic Data In Twins And Families, Amanda E. Gentry

Theses and Dissertations

The Brisbane Longitudinal Twin Study (BLTS) was being conducted in Australia and was funded by the US National Institute on Drug Abuse (NIDA). Adolescent twins were sampled as a part of this study and surveyed about their substance use as part of the Pathways to Cannabis Use, Abuse and Dependence project. The methods developed in this dissertation were designed for the purpose of analyzing a subset of the Pathways data that includes demographics, cannabis use metrics, personality measures, and imputed genotypes (SNPs) for 493 complete twin pairs (986 subjects.) The primary goal was to determine what combination of SNPs and …

Aerosolized Surfactants: Formulation Development And Evaluation Of Aerosol Drug Delivery To The Lungs Of Infants, Susan Boc

Theses and Dissertations

The overall aim of this research project was to develop surfactant dry powder formulations and devices for efficient delivery of aerosol formulations to infants using the excipient enhanced growth (EEG) approach. Use of novel formulations and inline delivery devices would allow for more efficient treatment of infants suffering from neonatal respiratory distress syndrome and bronchiolitis.

A dry powder aerosol formulation has been developed using the commercial product, Survanta ® (beractant) and EEG technology to produce micrometer-sized hygroscopic particles. Spray drying and formulation parameters were initially determined with dipalmitoylphosphatidylcholine (DPPC, the dominant phospholipid in pulmonary surfactant), which produced primary particles 1 …