Medicine and Health Sciences Commons^™

Examining Multiple Stakeholder Perspectives On The Acceptability Of Pain-Mitigation As A Tool To Manage Needle Fear, Sarah C M Morton

Theses and Dissertations

Needle fear affects up to 63% of the global adult population and is associated with significant fear-based medical care avoidance (e.g., blood donation refusal, vaccine hesitancy, insulin injection adherence). Current behavioral treatments have low acceptance in this population, and often fail to address the experience of pain associated with needle procedures. Despite the existence of evidence-based pain-mitigation for needle procedures, these interventions are not commonly used in clinical settings. The current study used qualitative methods to examine patient and provider perceptions of: 1) current methods of needle fear management, and 2) the acceptability of pain-mitigation as an effective tool to …

Improving Telehealth Education And Training: A Needs Assessment Of Healthcare Providers And Trainees, Conor Duffy

Theses and Dissertations

Telehealth utilization has increased dramatically since the start of the COVID-19 pandemic. There are many positive impacts of this shift to telehealth, including increasing access to care and reducing patient burden. However, healthcare providers report several consistent challenges that limit their ability to deliver telehealth, such as effective communication, technological difficulties, and difficulty performing physical examinations. To address these concerns, it is necessary to integrate telehealth education and training into healthcare professional training programs and healthcare systems. While many institutions have implemented telehealth education and training since the start of the pandemic, there is little consistency in the content, duration, …

Non-Enzymatic Glycoxidation Reports On Society, Environment And Biology To Inform On Enduring Cancer Disparities, Fariha Imtiaz, Boxiao Ding, Bradley A. Krisanits, Katherine A. Walter, Lindsay L. Peterson, Susan Steck, Marvella E. Ford, Gayenell Magwood, Victoria J. Findlay, David Turner

Annual Research Day

Background: Despite advancements in cancer treatment, disparities in incidence and mortality persist among different races and ethnicities. These disparities are influenced by an intricate interplay between environmental, biological and social factors that underscore the need for a multifaceted approach to understand this relationship. Objective/Aim: To show that advanced glycation end products (AGEs) due to non-enzymatic glycoxidation represent informative and functional markers that report on the combined impact of environmental, biological and social factors on enduring cancer disparities. Methods: To address this objective, a more holistic approach to disparities research was used ranging from basic research, population-based investigations, preclinical and clinical …

Learning Curve And Patient Outcomes Of Minimally Invasive Esophagectomy: One Surgeon’S 10-Year Experience, Moamad Chehab M.D., Cody Tragesser M.D, Franklin Geroudis M.D., Rebecca Deitch M.D., Anthony Cassano M.D., Rachit Shah M.D.

Annual Research Day

Objective: To examine the learning curve of one surgeon performing minimally invasive esophagectomy (MIE) over a 10-year period since the beginning of their practice with a focus on patient outcomes. Methods: This is a retrospective study of all patients undergoing MIE for malignancy by one surgeon at an academic high-volume tertiary center over a 10-year period (10/2012 to 9/2022). Patients were stratified into 2 equal groups based on chronological order and termed Early MIE and Late MIE. Primary outcomes included operative measures and patient outcomes over a 1- year period post-operatively. Results: A total of 128 patients were identified, divided …

Maternal-Infant Attachment, Depression, Anxiety, And Breastfeeding Self-Efficacy Among Marginalized Populations, Leslie B. Lantz, Merilyn Arikkat, Amy Salisbury, Sara Moyer, Sally Russell, Leroy Thacker, Candice Gault, Josselyn Valenzuela, Kimberly Cruz-Lopez, S Bodnar-Deren, Patricia Kinser

School of Nursing Publications

No abstract provided.

What Are The Genetic Influences Of Alcohol Sensitivity And Alcohol Metabolism? A Narrative Review Of Human Studies, Erwin Murray, Karen G. Chartier Phd, Msw

Undergraduate Research Posters

Background: Alcohol sensitivity and alcohol metabolism are two phenotypes associated with alcohol use disorder (AUD) influenced by genetics. This narrative review aims to answer “What are the genetic influences of alcohol sensitivity and alcohol metabolism?” to gain a better understanding of the genetic aspects of AUD.

Methods: A database search was performed in PubMed. Empirical human genetic studies published between 2009 and 2025 that focused on alcohol sensitivity (measured by the Self-Rating of the Effects of Alcohol scale) or alcohol-metabolizing genes were eligible for review. Studies were screened to determine inclusion for the current review.

Findings: Fifteen …

The Diseased Extracellular Matrix In Chronic Obstructive Pulmonary Disease Modeling, Leigh-Ann M. Antczak

Theses and Dissertations

Chronic obstructive pulmonary disease (COPD) is currently the fourth leading cause of death in the world, with an increasing prevalence as the world’s population ages. In the distal regions of the lungs, COPD is characterized by progressive emphysema due to an imbalance of proteases that continuously degrade essential extracellular matrix (ECM) proteins within the alveolar walls, causing fatal tissue impairment. This dissertation examines the unique properties of this diseased lung ECM in two parts: (1) As a key constituent in inflammatory signaling that leads to increased inflammation and progression of COPD, and (2) as a tool in three-dimensional (3D) in …

Smear Layer Removal By Irrigation Adjuncts: A Scanning Electron Microscopy Study, Triet D. Vuong

Theses and Dissertations

Purpose: This study aimed to compare the intracanal smear layer removal ability of two adjunctive irrigation modalities: the AdvErL EVO laser, the GentleWave^® Procedure, and their combination, after minimally invasive canal instrumentation.

Methods: Forty molars were accessed, the mesiobuccal canals of maxillary and mandibular molars were prepared up to apical size 25.04 using rotary instrumentation, then irrigated using: conventional needle irrigation (CNI), laser-assisted irrigation (LAI), the GentleWave^® Procedure (GWP), and LAI followed by GWP (LAI+GWP). The teeth were then decoronated and split longitudinally. One-half of each root was selected for preparation and analysis under scanning electron microscope. Blinded …

Financial Health Literacy Of Community-Dwelling Older Adults: A Qualitative Research Study, Kimberly Davis

Theses and Dissertations

Background: Financial health literacy (FHL) is an emerging concept with unique application to older adults. Multiple complexities converge in older age that create increased financial vulnerability (e.g., retirement, chronic disease). However, low financial and health literacy are common in older adults, impacting their ability to self-manage. The AWV’s focus on prevention offers an opportunity to incorporate a proactive approach to financial-related assessment. This study will explore the perceived value of assessing FHL in primary care settings and the financial-related barriers and facilitators to implementing the personalized prevention plan.

Methods: The conceptual framework was guided by the Individual and Family Self-Management …

On! Original Flavor Oral Nicotine Pouch Characterization: Biorelevant In Vitro Nicotine Release Apparatus Assessment, Jason C. Funderburk, Melissa Morgan, Maria Lasaosa Garcia, Andreas S. L. Mendez, Matthew S. Halquist

Graduate Research Posters

Background: Oral nicotine pouch (ONP) use is rising. The sales of ONPs in 2019 were 126 million units, increasing to 808 million units in 2022. Understanding ONP in vitro release is critical for assessing exposure to ONP products.

Methods: The commercial brand ON! ONPs with nicotine label claims of 2, 4, and 8 mg, were evaluated in vitro for cumulative nicotine release using the bidirectional transmucosal apparatus (BTA) for 90 minutes. Nicotine quantification was performed by HPLC-PDA. For pH determination, ONP samples were prepared in water or artificial saliva (pH 6.8) with measurements for 30 minutes. BTA results were compared …

Analysis Of Differential Gene Expression In Androgen-Independent Clones Derived From The Mycap Pca Cell Line, Jessie L. Tignor, Melanie Sinanian, Richard Inho Joh, David Gewirtz, Jason Reed

Undergraduate Research Posters

Androgen deprivation therapy (ADT) is a primary treatment strategy for prostate cancer (PCa), yet many tumors eventually develop androgen independence, leading to treatment resistance. To investigate the molecular changes underlying this transition, we analyzed differential gene expression in four androgen-independent (AI) clones derived from the Myc-CaP prostate cancer cell line using RNA sequencing. Gene expression profiles were compared to the parental Myc-CaP line, and differentially expressed genes (DEGs) were identified using DESeq2 and edgeR. The AI clones exhibited significant downregulation of senescence-associated genes, including Ezh2 and lamin B1, suggesting a loss of senescence-related chromatin repression. Additionally, upregulation of Wnt pathway …

Still Faces, Different Places: An Assessment Of The Literature On The Face-To-Face Still Face Procedure For Cultural Congruence, Merilyn Arikkat, Leslie B. Lantz, Patricia Kinser

Undergraduate Research Posters

Cultural understanding is a factor that impacts reliability of research results for observational studies. It is important to include participants of minority groups in research, as many people of color face disproportionate challenges in terms of healthcare access and resources. Within the context of mother-infant attachment, a technique known as the Face-to-Face Still Face procedure can be utilized to observe attachment styles and the bond between a parent and their infant. In order to combat subjectivity within the coding process for this Face-to-Face Still Face procedure, cultural congruence between the participants being observed in the study and the coding researchers …

Department Of Medicinal Chemistry, Virginia Commonwealth University: Historical And Personal Reflections, Richard A. Glennon

VCU University History Books

This book presents a historical account of Virginia Commonwealth University's Department of Medicinal Chemistry, compiled and recollected in 2025 by Professor Emeritus Richard A. Glennon. Included are personal reflections alongside a historical overview of the department's origins and faculty, as well as newly developed programs and initiatives.

Comparative Evaluation Of Three Endodontic Rotary File Systems In S-Shaped Root Canals: An In-Depth Analysis, Mudher Bahar

Theses and Dissertations

Objective: This study compares three endodontic file systems—XP‐3D Shaper⁺, EdgeFile X7 and WaveOne Gold in S‐shaped simulated canals in resin blocks. It aimed to quantify canals volumetric changes post‐instrumentation to guide clinical selection of a system that preserves tooth structure while efficiently shaping root canals.

Methods: Thirty S‐shaped canals in resin blocks were divided into three groups (n=10) for instrumentation with XP‐3D Shaper⁺, EdgeFile X7 or WaveOne Gold using the crown‐down technique and manufacturers recommended settings. A no‐treatment control provided a baseline for volumetric changes measured via CBCT scans analyzed with ITK‐SNAP. Data were analyzed using ANOVA and Tukey’s test …

Subgingival Microbiomes Of Healthy And Periodontitis Subjects, Tareq Abdulrasoul

Theses and Dissertations

Background: Periodontitis is a common chronic inflammatory disease triggered by the dysbiosis of the subgingival microbiome. 16s rRNA sequencing has been used to profile the subgingival plaque samples in healthy and periodontitis subjects. Here, we have collected subgingival plaque samples from subjects and analyzed the microbiome profile from 16s rRNA sequencing. We hypothesized that periodontitis patients will have a different subgingival microbiome profile than that of healthy subjects.

Methods: Subgingival plaque samples were collected from periodontitis and healthy subjects who were indicated for periodontal surgeries (osseous resective and regenerative surgery for periodontitis patients or crown lengthening for healthy …

Development Of A Mediation Model Of Pain Cognition In Adult Patients With Sickle Cell Disease, Daniel M. Sop

Theses and Dissertations

Pain is a hallmark of Sickle Cell Disease (SCD), a genetic hemoglobinopathy characterized by chronic hemolytic anemia, vaso-occlusion, and organ damage. While acute vaso-occlusive crises (VOC) have been extensively studied, the mechanisms underlying chronic pain and its interplay with brain function remain unclear. This dissertation investigates the relationships between cerebral blood flow (CBF), fluid cognition, and pain sensitivity in adults with SCD, utilizing advanced imaging techniques and validated assessment tools.

Arterial spin labeling (ASL) and functional magnetic resonance imaging (fMRI) were employed to measure CBF and brain activity, respectively. Pain sensitivity was assessed using the Pain Sensitivity Questionnaire (PSQ), and …

Immersive Medical Practice And Clinical Training: Virtual And Mixed Reality In Pharmacy And Orthopedic Surgery, Silas Semprini De Toledo Contaifer

Theses and Dissertations

Extended‑reality (XR) technologies including virtual reality (VR) and mixed reality (MR) offer new ways to improve training and surgical precision. This thesis evaluates their educational and clinical impact through two complementary studies.

Specific Aim 1 compared an immersive 360° video VR module with conventional training for teaching USP < 797> sterile‑compounding skills to second‑year PharmD students (N = 36). VR trainees raised their knowledge from 6.14 ± 1.55 to 8.69 ± 1.07, yet the overall post‑test advantage versus control was not statistically significant (U = 71.50, p = 0.21). Item‑level McNemar testing showed significant VR‑exclusive gains on three critical questions (K5, K6, …

Hafnium Oxide-Based Nanoheterostructures For Catalytic Radiosensitization And Enhanced X-Ray Radiotherapy, Marlen Dariela Calix Quezada

Theses and Dissertations

Orthovoltage X-ray beams are attractive for surface and intra-operative radiotherapy. Yet, their clinical utility is constrained by rapid attenuation and the limited dose that can be delivered without harming healthy tissue. High-Z hafnium oxide (HfO₂) nanoparticles can boost local energy deposition through the photoelectric effect, while catalytic surface defects accelerate water radiolysis. Harnessing both mechanisms in a single nano-heterostructure could enable potent radiosensitization at diagnostic-range energies.

This thesis develops and evaluates HfO₂-based nanoheterostructures, both bare and Au-decorated, as catalytic radiosensitizers.

Two types of HfO₂ were evaluated, one was synthesized following a specific route and the …

Enhancing Clinical Trial Matching In Molecular Diagnostics: Using Natural Language Processing And Clustering Approaches In Hematological Malignancies, Gillian Fanning

Theses and Dissertations

Clinical trial matching is a critical component of personalized medicine, particularly in the management of hematologic malignancies. At Virginia Commonwealth University (VCU) Health, the Molecular Diagnostics (MDX) Lab produces somatic variant reports and recommends clinical trials based on the presence of clinically significant mutations. However, the current manual trial recommendation process is time-intensive and lacks scalability.

This study introduces a computational framework to streamline and standardize clinical trial matching using natural language processing (NLP) and unsupervised clustering. Trial brief descriptions were analyzed to extract frequent terms, and trials were grouped based on term similarity using joint dimensionality reduction and clustering. …

Rare Variant Analysis Of Electronic Health Record-Defined Major Depressive Disorder In The All Of Us Research Program, Stephen Emil Vieno

Theses and Dissertations

The underlying pathogenesis of MDD remains poorly understood, with multiple competing hypotheses regarding its exact etiology. As a heterogeneous disorder with relatively low heritability, large-scale genome-wide association studies of MDD have relied on increasingly large sample sizes to identify common genetic variants associated with the disorder. However, the rare variant genetic architecture of MDD is still largely unknown. The aim of the present analysis was to use the AoU—a United States-based biobank that integrates healthcare records from over 50 healthcare systems and possesses whole genome sequencing data for participants—to perform a gene set–based analysis of MDD. This analysis presented several …

Modeling Vaccination Strategies And Intervention Impacts On Infectious Disease Dynamics, Elizabeth B. Amona

Theses and Dissertations

This dissertation explores how mathematical and statistical modeling can inform vaccination strategies and evaluate the impact of interventions during infectious disease outbreaks. Motivated by the challenges observed during the COVID-19 pandemic, the research integrates compartmental modeling, Bayesian inference, and agent-based simulation to assess policy effectiveness and disease control across varying contexts. The first study develops a SEIRDV model that incorporates government interventions and vaccination rollout to examine COVID-19 dynamics in Qatar. A Bayesian approach is used to estimate parameters and compute time-varying transmission rates. The model captures shifts in transmission following policy changes and quantifies the reduction in deaths attributable …

Automated Treatment Planning Framework For Cervical Cancer In Brachytherapy, Suman Gautam

Theses and Dissertations

Brachytherapy (BT) is a critical treatment modality for cervical cancer that delivers ionizing radiation directly to the tumor using intracavitary (IC) and/or interstitial (IS) applicators. In high dose-rate (HDR) BT, a remote afterloader guides the radioactive source to specific dwell positions for defined durations, known as dwell times, allowing for a conformal dose to the tumor while minimizing exposure to surrounding organs at risk (OAR). However, due to the inherent nature of ionizing radiation, some dose to OARs is unavoidable, creating a fundamentally conflicting objective in treatment planning: maximizing tumor coverage while minimizing OAR dose. This characterizes the problem as …

Scopolamine-Induced Modulation Of Serotonin And Dopamine Transporters Activity: Behavioral And Molecular Insights Into Rapid Antidepressant Action, Deepak Karunakaran

Theses and Dissertations

Major depressive disorder (MDD) affects over 350 million individuals worldwide and is characterized by profound dysregulation of serotonin (5-HT) and dopamine (DA) systems that govern mood, reward processing, and motivation. The serotonin transporter (SERT) and dopamine transporter (DAT), both dynamically regulated through phosphorylation, serve as critical determinants of synaptic monoamine signaling. Despite decades of therapeutic development, current antidepressants require 4-6 weeks to achieve efficacy, and approximately one-third to half of patients develop treatment-resistant depression. The emergence of rapid-acting antidepressants like ketamine represents a paradigmatic shift, demonstrating symptom relief within hours; however, ketamine's therapeutic potential remains constrained by abuse liability, dissociative …

Therapy-Induced Senescence In Cancer: Developing Senolytic-Based Combination Strategies To Delay Re-Emergence Of Triple-Negative Breast Cancer, Eesha Chakraborty

Theses and Dissertations

Therapy-induce senescence (TIS) represents a major biological outcome of many anticancer treatments and is increasingly recognized as a strategic vulnerability in triple negative breast cancer, which is a highly aggressive subtype with limited therapeutic options and frequent relapse. Here, we probed TIS as a primary cellular response that may ultimately compromise long-term outcomes using standard chemotherapeutic agents in TNBC as well as the antibody-drug conjugate sacituzumab govitecan (SG). Both chemotherapy and SG reliably induced pronounced senescence across TNBC models, yielding durable growth arrest, however, also generating a persistent reservoir of viable tumor cells capable of eventual proliferative recovery, a hallmark …

Effectiveness Of Immersive Virtual Reality Combined With Task-Specific Training On Hemiplegic Arm Function Following Stroke: A Single Case Series Study, Rahsaan J. Holley

Theses and Dissertations

Motor recovery of the arm following a neurological injury is a common goal of the rehabilitation process for individuals impacted by the condition . Due to the long-term functional implications of impaired arm movement, individuals are often trained to use compensatory strategies to complete functional tasks without incorporating the weakened limb. While compensatory strategies offer stroke survivors the opportunity to regain a level of independence, such approaches fail to directly address the underlying causes of the disability (i.e., limited range of motion, decreased strength, poor coordination, motor planning difficulties) which can unfortunately result in long-term impairment and functional disability.

Motor …

Place, Culture, And Care: A Socioecological Examination Of Type 2 Diabetes Among Hispanics In The U.S., Danielle Montoya

Theses and Dissertations

Introduction: Type 2 diabetes (T2D) disproportionately affects U.S. Hispanic populations. This dissertation examined whether structural determinants fundamentally drive T2D disparities among Hispanics, with attention to within-group racial heterogeneity.

Methods: Three studies utilized nationally representative data. Study 1 examined neighborhood segregation and ethnic enclave residence associations with T2D using restricted NHANES data (2011-2018, n=5,056). Study 2 investigated acculturation and T2D associations using restricted NHANES data (2011-2018, n=4,540). Study 3 analyzed patient-provider racial/ethnic concordance and adequate diabetes care using MEPS data (2008-2021, n=17,138).

Results: Structural factors demonstrated primacy across all studies. Neighborhood segregation (aOR=1.17, p>0.05) and ethnic enclave residence showed no …

Opioid Tolerance And Withdrawal In The Mouse Colon, James Fune

Theses and Dissertations

Constipation is a major clinical obstacle associated with opioids, prompting patients to discontinue treatment due to pain, discomfort, and psychosocial stressors. Moreover, chronic users become tolerant to the analgesic effects of opioids, but not to their constipating effects. Upon cessation of long-term treatment, serious diarrhea–among other somatic signs of withdrawal–may ensue. These symptoms become a driving factor for relapse, causing patients to restart opioid treatment. In this study, we aim to understand mechanisms that contribute to opioid tolerance and withdrawal in the colon. Previous findings suggest that constipation occurs partly due to the colon’s lack of tolerance to opioids’ inhibitory …

Establishing A Conventional Linac-Based Electron Flash Beam, Justin Defrancisco

Theses and Dissertations

Problems: A rediscovered radiotherapy technique, FLASH, involves increasing the dose rate to >40 Gy/s. For a given dose, FLASH is shown to decrease the normal tissue complication probability without affecting the tumor control probability. More preclinical studies are necessary to confirm and enable these desirable properties on humans. Current preclinical investigations have diverse constraints, requiring FLASH apparatuses with flexible parameters and accurate control. However, there are limited FLASH platforms available, the existing ones are costly. Our institution is not in possession of any such infrastructure. Even if available, dosimetry and beam control in FLASH are extremely lacking. There is …

A Mathematical Modeling Study On Hdv Rna, Alt, And Hbsag Dynamics Reveals Dual Mechanisms Of Peginterferon-Lambda., Adquate Mhlanga, Ohad Etzion, Harel Dahari

Biology and Medicine Through Mathematics Conference

No abstract provided.

Modeling Of Intracellular Compartmentalized Gpcr Signaling, Léo Darrigade

Biology and Medicine Through Mathematics Conference

No abstract provided.