Medicine and Health Sciences Commons^™

Threshold Levels Of Patient And Parent Esthetic Concern In The Mixed Dentition, Justin Josell

Theses and Dissertations

Purpose: The mixed dentition is a period of unique dental changes for developing children and their parents. The purpose of this study is to determine threshold levels of concern regarding diastema spacing and angulation of maxillary incisors during the “Ugly Duckling Stage” in pediatric patients and their parents.

Methods: This study is modeled as a cross sectional-survey among pediatric patients and parents. The surveys contain photographs of a sex-neutral, mixed-dentition smile with variations of midline spacing and incisal angulation which randomly differ in quantifiable values. Participants were asked to rate each photograph on a visual analog scale.

Results: The interaction …

Exploring Predictors In The Receipt Of Patient/Family-Centered Care, Arami Anwell

Theses and Dissertations

Study 1

OBJECTIVES: The research aim of this study was to identify predictors associated with the receipt of PFCC among U.S. children/families

METHODS: Caregivers of 38,803 non-institutionalized children, aged 0 to 17 years, were surveyed by the National Survey of Children’s Health (NSCH) 2018–20019. Patient/family-centered care (PFCC) was measured using five components of health care delivery that were answered on a 4-point Likert scale. Logistic regression models were analyzed for the overall receipt of PFCC and each component of PFCC, with survey weighting added to adjust for complex sampling design.

RESULTS: Many predictors were associated with the receipt of PFCC. …

The Economic Value Of Pharmacist-Physician Collaborative Care Models In Hypertension Management, Jessica S. Jay

Theses and Dissertations

Background: Hypertension is highly prevalent in the United States, affecting nearly half of all adults (43%). Studies have shown that pharmacy-physician collaborative care models (PPCCM) for hypertension management significantly improve blood pressure (BP) control rates and provide consistent control of BP. Time in target range (TTR) for systolic BP is a novel measure of BP control consistency that is independently associated with decreased cardiovascular (CV) risk. There is no evidence observed improvement in TTR for systolic BP with PPCCM is cost effective.

Objective: This study aimed to compare the cost-effectiveness of PPCCM with usual care for the management of hypertension …

Using Difference-In-Difference To Assess The Impact Of Medicaid Policy On The Addiction Treatment Provider Workforce And Prescribing Behavior In Virginia, Erin Britton

Theses and Dissertations

This dissertation is unified by both policy opportunity and estimation method, examining the impact of Medicaid behavioral health policy in Virginia using a difference-in-differences framework. Medicaid-covered substance use disorder (SUD) treatment benefits in Virginia were significantly enhanced through a Section 1115 SUD waiver, which are required to be budget neutral. Therefore, it is critical to understand whether the objectives of the waiver are met using reliable, unbiased estimation methods. This dissertation includes two empirical research projects evaluating the impact of Medicaid policy on removing barriers in access to care and one methodological project comparing the performance of alternate approaches to …

Tummy Time In Infancy: Real-World Assessments And Associations With Developmental Outcomes In Early Childhood, Ketaki Inamdar

Theses and Dissertations

Tummy time or awake, supervised, prone play is an important developmental play position in infancy. Engaging in more than 15 minutes of tummy time per day is associated with a lower risk of plagiocephaly, lower body mass index, and achievement of higher motor scores in full-term and at-risk preterm infants. However, there are significant gaps in the measurement of tummy time in current literature. Conventionally used subjective parent reports have not been validated against gold standard direct observation, and the feasibility and real-world validity of objective solutions such as wearable sensors has not been examined in full-term and at-risk preterm …

Targeting Bcl-2 Family Proteins In Therapy Induced Senescent Cancer Cell Models, Wade Cook

Theses and Dissertations

Non-small Cell Lung Cancer (NSCLC) originates from numerous different cell types in the lungs and is among the deadliest of cancers. Head and Neck Squamous Cell Carcinomas (HNSCC) are derived from the mucosal membranes of the oral cavity, pharynx, and larynx. Both NSCLC and HNSCC are predominately caused by tobacco smoke inhalation and as such mutations in the tumor suppressor gene TP53 are common. Since similarities exist in the root cause of NSCLC and HNSCC, they may also share similarities in treatment methods. Cisplatin is a platinum-based DNA damaging agent that has been used as a cancer chemotherapy for decades. …

Loss Of Smad4 Is Associated With Poor Tumor Immunogenicity And Reduced Pd-L1 Expression In Pancreatic Cancer, Daniel R. Principe, Patrick W. Underwood, Sandeep Kumar, Kaytlin E. Timbers, Regina M. Koch, Jose G. Trevino, Hidayatullah G. Munshi, Ajay Rana

Surgery Publications

Transforming Growth Factor β (TGFβ) is a key mediator of immune evasion in pancreatic ductal adenocarcinoma (PDAC), and the addition of TGFβ inhibitors in select immunotherapy regimens shows early promise. Though the TGFβ target SMAD4 is deleted in approximately 55% of PDAC tumors, the effects of SMAD4 loss on tumor immunity have yet to be fully explored. Using a combination of genomic databases and PDAC specimens, we found that tumors with loss of SMAD4 have a comparatively poor T-cell infiltrate. SMAD4 loss was also associated with a reduction in several chemokines with known roles in T-cell recruitment, which was recapitulated …

A Technology-Based, Mixed Methods Approach To Examining The Psychosocial Determinants Of Maternal Health Disparities, Hannah M. Ming

Theses and Dissertations

Background: Exposure to racism and discrimination in the U.S. increases Black women’s risk for experiencing maternal health disparities. Additionally, racism and discrimination affect maternal psychosocial well-being, creating evidence for a biopsychosocial relationship between racism and maternal health outcomes. However, current research does not define the psychosocial Black maternal self well. Given the dynamic relationship between racism, psychosocial well-being, and Black maternal health outcomes, research must comprehensively examine the Black maternal self. The operationalization of a comprehensive construct for Black maternal psychosocial well-being can improve understanding of the relationship between racism, psychosocial well-being, and Black maternal health outcomes.

Purpose: …

Using An Interdisciplinary Case Study To Incorporate Quantitative Reasoning In Social Work, Nursing, And Mathematics, Elizabeth Post, Mischelle Stone, Lauren Cavner Williams, Mary Beaudry

Journal of Mathematics and Science: Collaborative Explorations

Through the national consortium, SUMMIT-P, Ferris State University faculty collaborated to develop and scaffold mathematics and quantitative reasoning across disciplines to reduce math anxiety. Participants in this collaborative group included faculty from social work, nursing, and mathematics who developed a case study on a Hurricane Katrina scenario that necessitated calculating the need for emergency shelter, water, food, and medicine, and as a response to the potential for a Malaria outbreak. This particular case study allowed faculty to use the lens of social justice to teach mathematical concepts and provided an avenue for nursing and social work students to engage in …

Comparison Of Free Versus Encapsulated Drugs On 3t3 Differentiation, Simon H. Friedrich, Gabriel Volpe

Undergraduate Research Posters

The scope of this project was to design, synthesize and test targeted nanoparticles containing hydrophobic and hydrophilic drugs that promote browning in adipose tissue. For hydrophilic drugs the use of liposomes and their hydrophilic core is more useful than the PLGA nanoparticles which have hydrophobic cores. The inhibition of the FOXO1 pathway and modulation of autophagy in adipose tissue can promote browning of white adipose tissue, or an energy burning state where excess energy is burned as heat instead of stored in the cell. If successful, these drugs would offer an alternative treatment for obesity where changes to the patient's …

Mental Health Among Chicanos And Chicanas: Barriers To Mental Health Care, Consequences Of Disparities, And Resources, Roma A. Kankaria, Shaheer Alam, Ananya Udyaver, Alyssa Sievers

Undergraduate Research Posters

Mexican Americans, or Chicanos and Chicanas, face many barriers to mental health care. This literature review was conducted by the Collective Corazón—a VCU student organization, mentored by Dr. Indira Sultanić, that addresses Latinx health equity through service and advocacy—in order to examine the underlying causes and consequences of disparities in mental health in Chicanos and Chicanas. Some of the barriers that affect mental health care in Mexican Americans are racial inequities and discrimination, the societal and/or cultural stigma associated with receiving care, language barriers, lack of health insurance, and legal status. Furthermore, among Chicanos, machismo culture is associated with an …

Man Vs Machine: How Will Artificial Intelligence And Machine Learning Systems Impact Cancer Diagnosis And The Patient-Physician Relationship?, Aditya Kotha, Faye Prichard

Undergraduate Research Posters

Oncologic diagnosticians are physicians who specialize in interpreting diagnostic exams to diagnose cancer in patients. Software companies have been developing artificial intelligence (AI) systems to interpret these exams to diagnose cancer. These AI systems may affect the traditional role of oncologic diagnosticians if they were to be implemented in the clinical setting. Therefore, I set out to answer my research question: How will AI and machine learning systems impact the roles of oncologic diagnosticians in diagnosing cancer and the patient-physician relationship? By analyzing surveys and studies, I examined the attitudes of oncologic diagnosticians versus cancer patients toward implementing AI systems …

Exploring Cell Differentiation Vs. Localization In Engineered Ligament-To-Bone Entheses, Saagar N. Sheth, Michael E. Brown, Jennifer L. Puetzer

Undergraduate Research Posters

The anterior cruciate ligament (ACL) connects to bone via structurally complex insertions known as entheses that translate load from elastic ligament and stiff bone via gradients in organization, composition, and cell phenotype [1]. These gradients are not recreated in graft repair or engineered replacements, yielding limited repair options and high failure rates [2]. Previously, we developed a culture system that uses a tensile-compressive interface to guide ligament fibroblasts to develop early postnatal-like entheses by 6 weeks [3]; however, cells used were isolated from the entirety of the neonatal bovine ACL from bone to bone and likely contained multiple cell phenotypes …

Trajectories Of Medication Non-Adherence With Time-Varying Predictors And Association With Health Outcomes: A Comparison Of Classical Statistical Methods With Machine Learning Algorithms, Vasco Pontinha

Theses and Dissertations

Background: Medication adherence is a major obstacle to improving health care outcomes in long-term therapies for chronic diseases. According to the World Health Organization, interventions for improving medication adherence can have a higher impact on the health of the population than any other advance in medical treatments. Approximately 125,000 individuals die every year in the U.S. because of non-adherence to medication, representing societal costs of $100-289 billion. Previous research has successfully used group-based trajectories methods to identify similar longitudinal medication adherence trajectories. However, medication adherence is not an isolated behavior and is influenced by many factors that current interventions fail …

Effects Of The Selective Gsk3b Inhibitor, Tideglusib, On Ethanol Consumption, Anxiety-Like Behavior, Taste Preference, And Downstream Proteins, Sam Gottlieb, Douglas Bledsoe, Jessica L. Maltman, Alanna Morgan, Jennifer T. Wolstenholme, Michael F. Miles

Graduate Research Posters

Background: We have shown modulations in glycogen synthase kinase 3 beta (GSK3B) abundance or activity regulate ethanol consumption, suggesting potential as a therapeutic target for alcohol use disorder (AUD). Here we report the GSK3B inhibitor tideglusib’s actions on ethanol consumption, basal behaviors, and modulation of GSK3B targets.

Methods: C57BL/6J males and females received i.g. 200mg/kg tideglusib, except drinking-in-the-dark (males;100mg/kg i.p.). Drinking-in-the-dark (DID): Mice given 20% ethanol 4-hours, 4-days/week x 3 weeks and then i.p. tideglusib or vehicle x 4 days in a Latin Square design with ethanol consumption measured daily. Light/Dark Box: Mice gavaged with tideglusib or vehicle …

Clear Aligner Therapy In The Mixed Dentition: Indications And Practitioner Perspectives, Nicholas M. Lynch

Theses and Dissertations

Introduction: This study evaluated current trends and perspectives among orthodontists regarding clear aligner therapy in the mixed dentition (CAMD), including insights into perceived indications, compliance, oral hygiene, and other factors.

Methods: An original, 22-item survey was mailed to both a randomized, nationally representative sample of practicing orthodontic specialists (n = 800) and to a specific, randomized sub-sample of high-aligner-prescribing orthodontists (n = 200). Questions assessed respondents’ demographic information, experience with clear aligner therapy, and perceived advantages/disadvantages of CAMD compared to fixed appliance therapy (FA). Responses were compared using McNemar’s chi-squared and paired t-tests to assess CAMD versus FA. …

Varied Levels Of Fructose Consumption Induce Physiological, Cognitive, And Mitochondrial Alterations In Aged Female Rats, Emilie L. Bjerring

Theses and Dissertations

Since the 1970s, fructose consumption has dramatically increased within the United States, as well as the world. While adolescents tend to be the largest consumer of fructose, mostly seen in the form of sugary beverages, the consequences of a high fructose diet started in adulthood can also have severe implications on physiological parameters as well as cognition. Several studies have linked fructose consumption to metabolic syndrome, a clustering of symptoms related to overall health, with particular emphasis placed on obesity, type II diabetes, and the relationship with Alzheimer’s Disease. These findings largely stem from the outcomes of studies on cognition, …

Parental Attitudes Regarding The Primary Dentition, Dental Decay, And Trauma, Kathryn Dundervill

Theses and Dissertations

Purpose: The purpose of this study is to identify the ability of parents in the VCU Pediatric Dental Clinic to recognize signs of decay and trauma and to determine their knowledge regarding the primary dentition.

Methods: This is a cross-sectional study that determined parental attitude and knowledge toward the function of primary teeth, childhood dental decay and dental trauma. Study data was collected through REDCap, a secure web-based survey application. Parents who brought their child to the VCU Pediatric Dental Clinic for a new patient examination or a recall examination were included in the study. The survey was only formatted …

Direction Modulated Brachytherapy For The Treatment Of Cervical Cancer, Dylan Richeson

Theses and Dissertations

Purpose: To evaluate and compare the performance of 9 experimental DMBT tandem models of varying physical dimensions in relation to 24 previously planned HDR cervical cancer treatment plans from multiple institutions that used conventional tandem and rings or ovoid applicators.

Methods and Materials: The DMBT tandem is designed to be used concurrently with IGABT and is made from an MRI-compatible tungsten-alloy rod with 6 channels grooved out of its periphery. 9 experimental DMBT tandem prototypes were provided. Each of the models was of equal lengths but varied in thickness, channel diameter size, and circle channel diameter size. Replanning …

Exosomal Mirnas As Biomarkers For Radiation Toxicity In Breast Cancer Patients, Mina V. Mcginn

Theses and Dissertations

Radiotherapy (RT) is a standard treatment for most breast cancer patients (BCPs), but is often accompanied by acute and late toxic effects in normal tissue. Exosomes are nano vesicles about 30-150nm in size that originate from the endosomal network and are found in most body fluids. Exosomes are a fundamental driver of intercellular communication by transferring proteins, lipids and microRNA (miRNA). Exosomal miRNA (Exo-miRNA) signatures may serve as non-invasive prediction biomarkers of post-radiation toxicities of BCPs. Eighty six BCPs treated in the Radiation Oncology Department were enrolled in an IRB approved study. BCPs were evaluated weekly during RT and at …

Theta Burst Brain Stimulation In Painful Diabetic Neuropathy Patients: Investigating Neural Mechanisms, Bhushan Thakkar

Theses and Dissertations

Chronic pain (CP) is a significant contributor to disability and disease burden globally. In 2019, approximately 50.2 million adults (20.4% of the US population) experienced chronic pain, contributing to $560-635 billion in direct medical costs. In addition, the worldwide prevalence of diabetes mellitus has reached epidemic proportions and is set to increase to 629 million by 2045. Almost 50% of patients with diabetes present with diabetic neuropathy (DN), and one in five patients with diabetes presents with painful DN (pDN) which is the most common cause of neuropathic pain (NP) in the US. Symptomatic treatment is the mainstay of management …

Anthracyclines Attenuate The Nrf1-Mediated Bounce-Back Response, Bader Albalawi

Theses and Dissertations

Proteasome inhibitors, such as carfilzomib, are FDA-approved to treat multiple myeloma and mantle cell lymphoma. Unfortunately, proteasome inhibitors have only produced clinically significant results in patients with hematologic cancers, despite their predicted pan-cancer utility, and even hematologic cancer types frequently show intrinsic and acquired resistance.

One proposed mechanism responsible for the proteasome inhibitors' shortcomings is the NRF1-mediated bounce-back response. Identification of drugs that can potentiate the action of proteasome inhibitors could overcome resistance in patients with hematologic cancers and expand proteasome inhibitors' use to treat solid tumors. Our previous studies have identified anthracyclines as potential compounds that interfere with the …

Examining Ayahuasca Constituents At 5-Ht2a Receptors In Search Of Antidepressant Action, Jeremy D. Rolquin

Theses and Dissertations

Recently, it has been reported that ligands of the 5-HT_2A receptor can have drastic and fast-acting efficacy towards a number of different mental health disorders, such as depression and anxiety. A mixture of Amazonian plants calledayahuasca contains multiple compounds which have been shown to interact with the serotonergic system, and the 5-HT_2Areceptor in particular.

The structurally similar compounds (DMT, harmine, harmaline, and tetrahydroharmine) found in ayahuasca were examined for differences in their physiochemical properties that might contribute to their binding affinity for the 5-HT_2Areceptor. 3D Molecular modeling and docking studies of these compounds were …

The Role Of Human Dopamine Transporter Threonine 261 And Serine 262 In Amphetamine Regulation Of Transporter Function And Surface Expression, Sina Abdollahi

Theses and Dissertations

Amphetamine (AMPH) has been used clinically and recreationally around the world for years. A 2021 study reports a 67.5% rise in AMPH use from 2010-2017 across all fifty states. Study also shows that 30% of patients with AMPH-induced psychosis end up with primary psychosis over time. AMPH works by inhibiting monoamine (Norepinephrine (NE), Serotonin (5-HT), and Dopamine (DA) reuptake followed by triggering transporter mediated monoamine release and consequently increases monoamine concentrations in extracellular synaptic space. AMPH also works as a substrate for monoamine transporters, enters the neuron, and once its inside the neuron, it will prevent the storage of monoamines …

A Method For Predicting Dose Changes For Hn Treatment Using Surface Imaging, Sarah E. Holler

Theses and Dissertations

Head and neck cancer is commonly treated with a six- to seven-week course of radiotherapy, during which a patient’s anatomy may change substantially, due to target reduction or weight loss. Anatomical changes lead to reduction in treatment quality due to decreased setup reproducibility and altered dose deposition compared to the original plan. Few clinics have developed a standard method for triggering resimulation and replan due to anatomic changes. This work investigates a new method for determining when to resimulate and replan HNC patients by utilizing their topographic anatomical changes to predict differences in planned versus delivered dose distributions. The first …

Outcome Of Vital Pulp Therapy On Immature Permanent Teeth With Calcium Silicate-Based Materials: Retrospective Cohort Study, Brian I. Hone

Theses and Dissertations

Introduction: The purpose of vital pulp therapy is to maintain pulp viability by eliminating bacteria from the dentin-pulp complex and to establish an environment in which apexogenesis can occur. The aim of this retrospective cohort study was to evaluate the clinical and radiographic outcomes of vital pulp therapy on immature permanent teeth using different calcium silicate-based materials. Methods: This study was carried out in the Virginia Commonwealth University Graduate Endodontics department in Richmond, Virginia. Vital pulp therapy cases performed by graduate endodontic residents were retrospectively searched and charts were reviewed to determine inclusion into this study. All cases …

Deoxyribose Phosphate Aldolase Is Required For Development Of Hematopoietic Stem Cells In The Zebrafish Embryo, Anubhav Thapaliya, Sanyam Patel, Teerth Y. Patel, Sivam J. Bhatt, Erich W. Damm

Undergraduate Research Posters

Hematopoietic stem cells (HSCs) are an integral part of modern biomedical research because they are precursors to all blood cell lineages in vertebrates. Further understanding of hematopoietic development will allow for improvements in the success of therapeutic bone marrow transplantation; which is a crucial treatment in management of both malignant and non-malignant blood disorders. Although HSC transplantation is curative for many blood disorders, finding compatible donors is difficult due to a need for immunologic compatibility. Consequently, recent research efforts have been directed towards generating HSCs for the patient, from the patient themselves through the directed differentiation of induced pluripotent stem …

Health Disparities In Afro-Latinx Populations: Chronic Health Diseases, Linguistic And Cultural Competency, And Inequities And Barriers In Richmond, Virginia, Roma A. Kankaria, Avani Hariprashad, Henzee Machado, Teerth Patel, Anubhav Thapaliya

Undergraduate Research Posters

Afro-Latinx individuals face health disparities that differ from those faced by white Latinx individuals. This literature review was conducted by the Collective Corazón—a VCU student organization, mentored by Dr. Indira Sultanić, that addresses Latinx health equity through service and advocacy—in order to examine the underlying causes of Afro-Latinx health disparities. Skin color is a predictor of health, life expectancy, and quality of life for many Latinx individuals. On average, Afro-Latinx individuals in particular have less access to education, fewer financial freedoms, and poorer health outcomes. The Afro-Latinx community also describes higher rates of discrimination compared to white Latinx individuals. As …

The Relationship Between Social Media Use And Depression And Anxiety Symptoms During Covid-19, Tene'sha L. Crews, Christina Sheerin

Undergraduate Research Posters

The rise of the coronavirus (COVID-19) pandemic has caused a global surge in exposure to disaster and crisis-related media. Increases in poor mental health outcomes such as anxiety and depression, are associated with increased exposure to such media content (Abbas et al., 2021; Riehm et al., 2020; Zhao & Zhou, 2020). In recent years, social media has become one of the most widely used sources for news; approximately 48% of adult Americans receive their news from social media (Pew Research Center, 2021). During the COVID-19 pandemic, there has been an increase in social media use due to social distancing and …

A Marginal Identity Model For Those In The "In-Between", Francine S. Singson, Sonia Meyer, Christine A. Reid

Graduate Research Posters

Background: In existing models exploring the formation cultural identity, there is emphasis on development from the perspective of race or country of origin. While these models have made significant contributions to the study of identity development in the fields of counseling and psychology, research on the identity development of people who exist within the spectrum between traditionally acknowledged identities (Deaf/Hearing, LGBTQIA+, first/second generation) is lacking.

Methods: To explore the merit of establishing a distinct theory exploring development of individuals whose identities exist between the existing binaries of identity, a systematic review and analysis of current literature was performed. …