Medicine and Health Sciences Commons^™

Cb1 Allosteric Modulation: Preclinical Insights Into Therapeutic Potential And Misuse Liability, Mohammed A. Mustafa

Theses and Dissertations

Cannabinoid type-1 (CB1) allosteric modulators represent a promising approach to modulate CB1 receptor signaling by binding to distinct receptor sites, without producing adverse cannabimimetic and dependence-related effects associated with Δ9-tetrahydrocannabinol (THC) and other CB1 agonists. This dissertation investigates the pharmacological, behavioral, and dependence-related profiles of CB1 allosteric modulators for their therapeutic potential and misuse liability. Presented here, the chiral CB1 positive allosteric modulator (PAM) ZCZ011 was resolved into its R- and S-enantiomers and characterized across in vitro and in vivo assays. Both enantiomers enhance CB1 agonist activity and produce intrinsic effects in vitro. Behaviorally, they produce antinociceptive effects in the …

Dietary Acculturation, Dietary Inflammatory Potential, And Metabolic Syndrome Among Immigrants In The United States: A Mixed-Methods Approach Using Nhanes And Qualitative Data, Esse G. Foka Nzaha

Theses and Dissertations

Background and Objectives: Immigrants in the United States undergo acculturation — a process of sociocultural and behavioral adaptation to the host country. Increasingly, behavioral adaptations have been associated with cardiometabolic health and chronic disease risk. Metabolic syndrome (MetS), a cluster of conditions including abdominal obesity, elevated blood pressure, impaired fasting glucose, elevated triglycerides, and reduced HDL cholesterol, is a major risk factor for type 2 diabetes mellitus, cardiovascular diseases and other chronic diseases, including cancer. Despite the growing immigrant population in the U.S., the role of diet and dietary acculturation in MetS development remains poorly understood in this population. This …

24-H Circadian Rest-Activity Rhythms And Physical Frailty In Older Adults: A Biopsychosocial Perspective On Sex Differences And Social Capital, Jisu Kim

Theses and Dissertations

Physical frailty is a prevalent geriatric syndrome characterized by age-related decline across multiple physiological systems. Physical frailty is associated with an elevated risk of adverse health outcomes, including chronic disease progression and all-cause mortality, representing a significant and growing public health concern. Disrupted circadian rest-activity rhythms (RARs) are increasingly recognized as clinically meaningful markers of physical frailty in older adults. However, the extent to which biological sex and social determinants of health (SDoH), particularly social capital, contribute to or modify the associations between RARs and physical frailty remains underexplored.

Therefore, this dissertation summarizes the existing literature on age-related changes in …

What’S Sleep Got To Do With It? A Mixed Methods Exploration Of The Feasibility, Acceptability, And Initial Outcomes Of Group Cbt For Insomnia In Parkinson’S Disease, Claire M. Williams

Theses and Dissertations

Parkinson’s disease is a progressive neurodegenerative disease that is commonly associated with sleep disturbances, affecting up to 80 percent of individuals with Parkinson’s. Effective and accessible treatments for sleep problems in Parkinson’s disease remain limited. Cognitive Behavioral Therapy for Insomnia (CBTi) is a well-established, non-pharmacological treatment for insomnia but has been minimally studied in Parkinson’s populations. This study evaluated the feasibility, acceptability, and preliminary outcomes of a group-based CBTi intervention adapted for individuals with Parkinson’s disease. Participants engaged in a six-week group intervention that incorporated Parkinson’s-specific adaptations. Preliminary findings indicated that the adapted group CBTi intervention was generally feasible and …

Comparison Of Artificial Intelligence Vs Human Observer For Periapical Radiolucency Detection, Adam J. Pink

Theses and Dissertations

Objective: The aim of this study was to assess the performance of an Artificial Intelligence (AI) program (OverJet AI) with that of experienced endodontic residents, endodontists, a radiologist, and dental students in detecting periapical radiolucencies using radiographic images.

Methods: One hundred and fifty periapical radiographic images were analyzed using the OverJet AI software to determine the presence/absence of a periapical radiolucency as well as the size (small 1-3mm, medium 4-6mm, and large 6+mm). The unaltered images were also evaluated by two endodontic residents, two practicing endodontists, an oral radiologist and two 4th year dental students.

Results: Agreement between the AI …

Endodontic Access Through Zirconia Crowns: A Comparative Evaluation Of 3d Guided Versus Free-Handed Techniques, Maryam Alrughaib

Theses and Dissertations

Objective:

Accessing canals through full-coverage zirconia crowns is challenging and may increase the risk of misdirection, excessive dentin removal, and prolonged chair time. Guided endodontic access has been proposed to improve efficiency and precision. This study compared the accuracy and time efficiency of guided versus free-hand endodontic access through zirconia restorations. The hypothesis was that guided access would enhance canal localization precision and significantly reduce access time.

Methods:

Thirty-two extracted maxillary premolars were restored with 1-mm–reduced monolithic zirconia crowns (3Y-TZP, Katana HTML, Kuraray, Japan) and mounted in Modupro models. Teeth were assigned to two groups (n = 16 each): guided …

Use Of Transcranial Magnetic Stimulation As An Assessment Of Corticospinal Excitability In Individuals With Persistent Postural Perceptual Dizziness, Elizabeth Cornforth

Theses and Dissertations

Persistent postural-perceptual dizziness (PPPD) is a common, disabling, chronic vestibular disorder whereby individuals experience symptoms of non-vertiginous dizziness, unsteadiness, and sway or rocking that are present most hours of the day, most days of the week. Individuals with PPPD have been noted to have an increased burden of dizziness and reduced quality of life compared to other dizziness diagnoses. The cause of PPPD is not well understood which can lead to years of diagnostic testing, failed therapies, and poor symptom management. It is important to understand PPPD pathophysiology so that optimal treatment interventions can be developed for this disorder to …

Local Lung Delivery Of Ginkgetin For Therapeutic Intervention In Lung Fibrosis, Cimone L. Richardson

Theses and Dissertations

Lung fibrosis (LF) is a progressive, irreversible pathological condition in the lungs that is ultimately fatal. Current drug treatments (nintedanib, pirfenidone, and nerandomilast) slow disease progression but cause significant systemic adverse effects due to oral administration. Transient receptor potential vanilloid 4 (TRPV4), a mechanosensitive ion channel, may play a role in LF progression and represent a novel anti-LF target. Ginkgetin (GKT), a natural biflavonoid, is a potent TRPV4 inhibitor with anti-inflammatory and antioxidative properties. Local lung delivery could achieve high local lung concentrations while minimizing systemic exposure. Accordingly, this project evaluates GKT's therapeutic intervention efficacy in LF via local lung …

Implementation Of Tg-351 Reference Dosimetry For A 6 Mv Photon Beam In An Mr-Guided Radiotherapy System, Nicholas A. Castellano Jr.

Theses and Dissertations

Magnetic resonance guided radiation therapy (MRgRT) combines magnetic resonance imaging (MRI) and radiation therapy to enable the visualization of anatomy in real time during treatment. The presence of a magnetic field in MRgRT affects charged particle radiation and detector responses, necessitating changes to traditional reference dosimetry procedures. The American Association of Physicists in Medicine (AAPM) Task Group 351 (TG-351) provides a formalism for reference dosimetry in MRgRT. In this study, the TG 351 formalism is used to perform reference dosimetry for a 6 MV flattening filter-free (FFF) photon beam from a Viewray MRIdian MR-Linac radiation therapy system. Beam quality determination, …

The Integration Of Video Recording In Health Assessment Simulation To Improve Feedback Quality, Stephanie Bork, Meredith Deegan, Allison Gregory

School of Nursing Publications

Introduction

Simulation-based learning is integral in preparing nursing students, especially graduate-level nurse practitioner (NP) students. Simulation bridges the gap between theory and practice, providing a safe space for students to practice clinical skills, communication, and develop appropriate clinical judgment and reasoning before delivering care to patients in healthcare settings. Video recording in the simulated environment enhances educators’ ability to assess student competency and performance. During a faculty-observed simulation, it can be challenging to deliver consistent, meaningful, and competency-based feedback to each student. This project aims to integrate Echo360 video recording in graduate health assessment simulation to enhance the quality of …

Utilizing Epic To Improve Efficiency Of Pre-Anesthesia Evaluations For Surgical Patients, Karol Harshaw-Ellis¹,, Sarah B. Budrovic, Christopher Henriques, Olga Suarez-Winowiski

VCU Health Nursing

Background: Preoperative anesthesia evaluations of elective procedures are important to anesthesia care and imperative to prevent postoperative complications and unnecessary surgical cancellations¹. Triaging cases are complex, requiring clinical skills to facilitate the process. Triaging is cumbersome and, in most organizations, done manually. In 2021, our healthcare institution transitioned to EPIC² and formed a team of anesthesiologists, surgeons, informaticists, and EPIC analysts to automate the triage process which was nonexistent.

Purpose: Utilizing EPIC logic and a surgical risk classification (SRC) (Table 1) developed by the team cases are triaged as high, medium, or low. The SRC is based on blood loss, …

Understanding The Relationship Between Children's Oral Health Utilization And Parent's Use Of Healthcare Services, Shillpa Naavaal, Rashmi Lamsal

Dental Public Health and Policy Publications

Introduction: Parents play an influential role in their children's lives, but little is known about how their healthcare experiences connect. This study examined the relationship between parent's healthcare use and their child's overall and preventive dental care use.

Methods: We pooled three years (2017–2019) of Medical Expenditure Panel Survey (MEPS) data and merged child (0–17 years) and parent data. Our outcomes included any dental visit, preventive visit, and receipt of sealant or fluoride. The primary exposure variable was the parents’ medical and dental care use, grouped into four categories. Descriptive and bivariate analyses were conducted, and multivariable logistic regression analyses …

Investigating The Association Between Parental Paid Sick Leave Benefit And Children's Dental Care Utilization, Rashmi Lamsal, Shillpa Naavaal

Dental Public Health and Policy Publications

Objective: The purpose of this research is to examine the association between paid sick leave (PSL) benefit for employed parents and their child's dental care utilization, including preventive, diagnostic, and treatment services.

Methods: Using pooled data from the 2017–2019 Medical Expenditure Panel Survey, we created a dyadic observational unit linking children aged 0–17 years with their parents (n = 7652) specifically focusing on the younger children of employed parents. Descriptive statistics and a multivariate logistic regression model were employed to examine the association between parental PSL benefit and child dental care utilization, accounting for various child and …

Oral Health Impact And Cost-Effectiveness Of Resealing First Permanent Molars, Christina Scherrer, Pritam Deb, Jayden Ayash, Shillpa Naavaal

Dental Public Health and Policy Publications

Introduction: This study examined the cost-effectiveness and health impact of various dental sealant resealing scenarios for first permanent molars from the payer perspective.

Methods: The authors used a discrete event simulation model for 4,000 recently sealed first molars in a hypothetical cohort of 1,000 children aged 7 years over a 10-year time horizon. Scenarios included a base case of no resealing, resealing at first dental visit, and resealing at the age of 12 years.

Results: Without resealing, only 34.88% of teeth retained sealants after 10 years, whereas resealing at the age of 12 years increased this to …

Role Of Oral Health Providers In Supporting Hpv-Related Cancer Prevention In The Dental Setting, Megan Cloidt, Sarah Vivo, Aubree Thelen, Shillpa Naavaal

Dental Public Health and Policy Publications

Background: Human papillomavirus (HPV) vaccination can prevent HPV-related illness and associated cancers, including oropharyngeal. The safety and efficacy of HPV vaccination has been well-established, but national HPV vaccination rates remain unacceptably low with persistent disparities for certain populations. While vaccination has been one of the biggest public health accomplishments of the last century, vaccine hesitancy continues to grow in the United States, and remains a challenging element of low HPV vaccine uptake.

Description: Oral health providers have been traditionally siloed and largely uninvolved in vaccination counseling and administration, but the COVID-19 pandemic brought oral health providers, pharmacists and …

Untreated Hyperthyroidism And A Mediastinal Mass: To Remove Or Not To Remove?, Jennifer M. Alvis, Olga Suarez-Winowiski, Faizaan Khan

Anesthesiology Publications

CASE PRESENTATION: J.W. was seen by the PACE (Preoperative Assessment, Communication and Education) Center prior to a mediastinal mass resection. Medical history includes well-controlled rheumatoid arthritis, anxiety and a recent diagnosis of hyperthyroidism. Labs were significant for TSH DISCUSSION: Untreated GD is rarely correlated with thymic hyperplasia; however the pathogenesis is not well understood. Regardless of the association, contextualization of this patient's history and lab values prompted the provider to seek specialized management. This finding was then communicated with the surgical team, who often rely on PACE providers to screen patients with the ultimate goal of risk reduction and optimization …

Building An Interdisciplinary Simulation Orientation For The Mobile Health And Wellness Program, Meredith Deegan, Lauren Goeke

School of Nursing Publications

No abstract provided.

Roadmap To Developing Clinical Competency For Novice Nursing Students, Meredith Deegan, Lauren Goeke

School of Nursing Publications

No abstract provided.

Effectiveness Of School Fluoride Delivery Programs: A Community Guide Systematic Review, Susan O. Griffin, Mei Lin, Christina Scherrer, Shillpa Naavaal, David P. Hopkins, Anita A. Jones, Tammy Alexander, Virginia A. Black, Elizabeth Clark, Lori K. Cofano, Raúl Isidro García, Anna Goddard, Jane Grover, Susan M. Kansagra, Thomas E. Kottke, Elizabeth C. Lense, Tooka Zokaie, The Community Preventive Services Task Force

Dental Public Health and Policy Publications

Introduction: Although preventable, dental caries remains highly prevalent. Many children do not receive preventive dental services routinely in clinical settings. This review examined the effectiveness of school (preschool through high school) fluoride varnish delivery programs in preventing caries.

Methods: Community Guide systematic review methods were followed. In 2024, databases were searched for studies published through December 2023 on school flouride varnish delivery program effectiveness in increasing fluoride varnish receipt and decreasing caries. Included studies had to be written in English, published in peer-reviewed journals, and conducted in upper-middle– or high-income countries. Data synthesis conducted in 2024 used median …

Improving Dental Hygiene Students' Knowledge, Attitudes, And Confidence Toward Prenatal Oral Health Through Experiential Learning, Denise C. Mckinney, Sinjini Sikdar, Shillpa Naavaal

Dental Public Health and Policy Publications

Purpose Maintaining optimal oral health is essential for maternal health as well as the health of their child. The purpose of this pilot study was to examine dental hygiene (DH) students' knowledge of prenatal oral health before and after receiving an asynchronous prenatal oral health care training (POHCT), and their attitudes and self-perceived confidence before and after receiving an experiential learning opportunity with a pregnant and/or post-partum client at a Women's Infants and Children nutrition program (WIC) clinic.

Methods A one-group pre/post-test design was used. This IRB-approved study (#2027439-4) utilized a convenience sample of DH student participants (n=37) in their …

An Asthma Patient Education Pilot: Utilizing A Hand-Held Tablet To Enhance Self-Management Knowledge, Stephanie Bork, Dana L. Ladd, Li Liu, Rami Hawila, Ashley Reluzco, Le Kang, Farrukh Abbas

VCU Health Nursing

Purpose:

This study aimed to evaluate the impact of pre-recorded educational videos on a hand-held tablet for improving asthma self-management knowledge. Content focused on disease processes, medication management, and medical device usage in an adult asthma clinic at an academic medical center.

Methods:

Pre-recorded asthma education videos were created by study personnel and uploaded to the institutional research electronic data capture (REDCap) platform. Adult participants (≥18 years, English-speaking, with a new or existing asthma diagnosis) were enrolled at an outpatient asthma clinic. The Asthma Self-Management Questionnaire, a validated and reliable tool, was administered before and after participants watched five 1-minute …

Investigating The Potential Of Broccoli Seed Extract To Attenuate Morphine Tolerance, Atharv Ashwin Battu, Minho Kang, Hamid Akbarali

Pharmacology and Toxicology Publications

Opioids remain one of the most effective treatment strategies for managing severe and persistent pain. However, its long-term use leads to pharmacological tolerance, requiring progressively higher doses to achieve analgesia. This dose escalation increases the risk of life-threatening side effects and dependence, underscoring the urgent need for safe adjuncts to preserve opioid efficacy. Emerging evidence suggests that morphine tolerance is linked to intestinal inflammation and disruption of gut barrier integrity. Broccoli Seed Extract (BSE), rich in the bioactive compound sulforaphane, exhibits antioxidant and anti-inflammatory properties that may protect against these effects. We hypothesized that BSE could prevent the development of …

Validating Search Strategies For Healthy People 2030’S Leading Health Indicators: An Update On The Ph/Ha Caucus’S Structured Evidence Queries Project, Samantha Guss, Anita Kuiken, Erin Wentz, Dani Lapreze, Erin Reardon, Laura Zeigen, Courtney Pyche

VCU Libraries Faculty and Staff Presentations

The Public Health/Health Administration (PH/HA) Caucus’s work in developing Structured Evidence Queries (SEQs) for Healthy People 2030’s leading health indicators, an initiative from the U.S. Department of Health and Human Services (HHS) aimed at improving the nation’s health in measurable ways highlights their search validation strategy and plans for outreach and assessment as the project nears completion. The SEQs, developed for PubMed, are designed to measure progress toward specified health outcomes while addressing health disparities and promoting health equity. The team collaboratively developed and peer-reviewed these SEQs, refining criteria and creating a validation strategy using resources from HHS. Plans for …

Exploring Maternal-Infant Attachment And Its Relationships With Perinatal Depression And Anxiety Symptoms And Breastfeeding Self-Efficacy Among Predominantly Hispanic, Latina, And African American/Black Marginalized Populations, Leslie B. Lantz, Amy Salisbury, Sara Moyer, Sally Russell, Leroy Thacker, Candice Gault, Josselyn Valenzuela, Merilyn Arikkat, Maria Mooney, S Bodnar-Deren, Patricia Kinser

School of Nursing Publications

The purpose of this study is to explore maternal-infant attachment at 26 weeks PP as it relates to concurrent postpartum depression and anxiety symptoms and breastfeeding self-efficacy in ethnically diverse postpartum mothers (from a larger RCT [“Mindful Moms Study”]).

Measures Of General Intelligence And Risk For Alcohol Use Disorder, Ananya Aengula

VCU's Medical Journal Club: The Work of Future Health Professionals

Alcohol Use Disorder (AUD) is a medical condition that involves an individual having an impaired ability to control their alcohol usage. To understand the factors that contribute to this disorder, researchers wanted to investigate the relationships among General Intelligence (IQ), Educational Attainment (EA), and Alcohol Use Disorder (AUD). They arranged an observational cohort to assess IQ levels and the development of AUD in 573,855 Swedish men and 5,424 individuals from the United States. Ultimately, their results indicate that lower IQ levels are strongly associated with an increased risk of developing AUD later in life. They concluded that low IQ and …

Ozanimod In Patients With Moderate To Severe Ulcerative Colitis Naive To Advanced Therapies, Alisha Mehere

VCU's Medical Journal Club: The Work of Future Health Professionals

The drug studied was Ozanimod which is an oral sphingosine-1 -phosphate (S1P) receptor modulator, and was experimented in patient suffering from Ulcerative colitis (UC) who weren’t exposed to biological or Janus Kinase (JAK) inhibitors previously. The effects of Ozanimod treatment led to promising results such as greater rates of clinical remission, endoscopic movement as well as histologic remission as compared to the placebo group. The safety profile neither improved nor declined with regard to the side effects of previously conducted experiments with Ozanimod, thus had no serious concerns observed. Ozanimod treatment thus could strongly help patients with moderate to severe …

Ashwagandha And Sexual Health In Women With Hypoactive Sexual Desire Disorder: Exploring Extent Of Adaptogenic Properties, Rhea Chatterjee

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Hypoactive Sexual Desire Disorder (HSDD) affects 40% of women and potentially decreases their quality of life. Currently, the primary treatment for HSDD is Flibanserin, which is a serotonergic agonist and an antidepressant. However, the limited efficacy of Flibanserin encourages the exploration of the utilization of traditional drugs such as Withania somnifera, otherwise known as Ashwagandha, as an alternative treatment for HSDD. Minimal studies examine ayurvedic medications or the symptoms of illnesses that traditional Western medicines are unable to treat. This comprehensive literature review investigated the efficacy of Ashwagandha in improving sexual function in women with HSDD. The paper evaluated …

Exploring The Role Of Pain Severity Versus Central Sensitization In Predicting Opioid-Related Outcomes Among Adults With Chronic Pain, Miyah Taylor, Taylor Crouch Ph.D.

IRBEH/Spit for Science Publications and Presentations

Chronic opioid therapy is widely used for managing persistent pain, yet its long-term efficacy is questionable and often associated with adverse outcomes such as opioid misuse and dependence. This study investigated whether central sensitization (CS), a condition of heightened neural response to pain stimuli, better predicts opioid-related outcomes compared to self-reported pain severity. Among adults with chronic pain currently using long-term opioid therapy, participants completed measures assessing CS, pain severity, and opioid-related outcomes including readiness and confidence to change opioid use, misuse, and dependence. Regression analyses revealed that while CS did not significantly predict readiness or confidence to change opioid …

Alpha-2 Agonist And Fentanyl Reinforcement Interactions In Male And Female Sprague Dawley Rats, Angeline Lopez, Allison Ortiz, Matthew L. Banks

IRBEH/Spit for Science Publications and Presentations

In the two studies that I participated in, a behavioral economic demand curve and choice procedure, we assessed whether two alpha-2 adrenergic agonists (i.e., xylazine, clonidine, and lofexidine) altered fentanyl reinforcement in male and female sprague dawley rats. We hypothesized that xylazine and clonidine would enhance fentanyl reinforcement in a proportion-dependent manner. Lofexidine interactions with fentanyl were more difficult to predict. The data showed that xylazine did not enhance fentanyl reinforcement. Furthermore, these results were consistent with those of clonidine and lofexidine. In opposition to xylazine, clonidine and lofexidine are approved for human use for antinociception, reduction of blood pressure, …

The Distinctive Role Of Atp In Hsp110’S “Holdase” Chaperone Activity, Justin M. Kidd, Cancan Sun, Mitchell Keplinger, Alissa Garay, Colin Ritcher, Qinglian Liu

Physiology and Biophysics Publications and Presentations

Hsp110s are a unique class of heat shock proteins (HSPs) and distant homologs of Hsp70s. They act not only as nucleotide exchange factor co-chaperones for Hsp70s (i.e., NEF activity) but also as independent chaperones capable of preventing the aggregation of proteins exposed to cellular stresses (i.e., ”holdase” activity). While Hsp110 NEF activity is well characterized, the mechanisms of holdase activity are less clear. In particular, the role of ATP-binding in regulating holdase activity is poorly understood and has been disputed. In this study, we discovered an undocumented divalent cation inhibitory effect that is reversed by ATP. This finding led us …