Online Group Neurobehavioral Therapy (Nbt) For Veterans With Epilepsy And Major Depressive Disorder (Mdd), Melissa F. Fadipe

Dissertations and Theses (Open Access)

Background: Veterans with epilepsy experience high rates of psychiatric comorbidity, most commonly major depressive disorder (MDD). Barriers to accessing mental health care—including geographic distance, transportation limitations related to seizure-related driving restrictions, and fragmented care between neurology and psychiatry, contribute to the underdiagnosis and undertreatment of MDD in this population. Neurobehavioral Therapy (NBT), a Cognitive Behavioral Therapy (CBT)-informed psychotherapy developed for individuals with seizures, has demonstrated benefits for psychological distress and quality of life. Internet-based interventions and short message service (SMS) text messaging offer promising strategies to address access barriers; however, limited research has examined the feasibility and acceptability of delivering …

Agent-Based Modeling Of Cellular Dynamics In Adoptive Cell Therapies, Yujia Wang

Dissertations and Theses (Open Access)

Adoptive cell therapies (ACT) have shown promising progress in combating cancer, but clinical responses remain heterogeneous. Key determinants, including the functional states of infused cells, tumor–immune interactions, and dosing strategies, are difficult to resolve experimentally in the dynamic and heterogeneous tumor microenvironment, limiting optimization of ACT products and treatment regimens. To address the gap, we developed ABMACT (Agent-Based Model for Adoptive Cell Therapies), a computational framework that reconstruct key cellular functions, interactions, and molecular signatures to recapitulate cell population dynamics associated with differential treatment responses. ABMACT encodes autonomous “virtual cells” using literature-informed rules calibrated with experimental data, enabling simulation of …

Ai-Driven Segmentation And Volumetric Response Modeling Of Liver Regions To Radiotherapy, Aashish Chandra Gupta

Dissertations and Theses (Open Access)

In liver-directed radiotherapy (RT), liver regions receiving higher doses typically undergo atrophy while contralateral/adjacent lower-dose regions may exhibit compensatory hypertrophy through regeneration of healthy tissue. Optimizing the RT plan to promote regional hypertrophy while minimizing the risk of developing atrophy has the potential to enhance post-RT liver function and long-term survivorship. However, current clinical practice largely relies on global liver dose-volume metrics during RT-planning, which may obscure favorable dose-response correlation and limit actionable guidance for clinicians. Therefore, we hypothesized that post-RT regional liver response is governed by a combination of region-specific dose-volume and patient clinical features, and that these responses …

Regulation Of Müllerian Duct Mesenchyme Transcription During Mammalian Sex Differentiation, Haowen Li, Richard R Behringer, Rachel D Mullen

Dissertations and Theses (Open Access)

Sp7/Osterix (Osx) encodes a zinc-finger transcription factor of the Specificity-protein family discovered by Nakashima et al. at the MD Anderson Cancer Center. While primarily recognized for its role in osteogenesis, Osx has also been implicated in mammalian reproductive development, particularly in male sex differentiation, where Müllerian Duct (MD) regression occurs, mediated by anti-Müllerian hormone (AMH) signaling. AMH-induced regression signals are transduced by the mesenchymal tissue surrounding the ductal structure, known as the Müllerian Duct mesenchyme (MDM). It was discovered that AMH signaling is necessary and sufficient for driving Osx expression in MDM. A previous transgenic mouse reporter …

Newly Registered Nurses With Neurodiversities: A Qualitative Study Of Their Experiences During Transition To Professional Practice, Heather Wallace

Dissertations and Theses (Open Access)

Abstract Introduction: Transition-to-practice (TTP) programs play a crucial role in bridging the academic-to-practice gap for newly licensed Registered Nurses (NLRNs) and improving first-year retention rates. However, these programs may fall short in addressing the specific needs of NLRNs with neurodiversities (NLRN-ND). Neurodiversity (ND) encompasses Autistic Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Tourette Syndrome, and the 3 Ds – Dyslexia, Dyscalculia, and Dysgraphia. Unsupportive environments for disclosing neurodiversity and requesting accommodations may contribute to the 10-25% NLRNs leaving their jobs within the first year, with 1-3% exiting the nursing profession altogether. Objectives: This study aimed to (1) explore NLRN-ND …

Exploring Teamwork Between Virtual And Bedside Nurses, Caitlin Weinheimer

Dissertations and Theses (Open Access)

Background: Advancing technologies and the use of telehealth have expanded in hospitals to include telenursing. Telenursing introduces a unique dynamic where virtual and bedside nurses work together as a remote team to provide patient care. Published literature reports that teamwork among nurses and healthcare professionals impacts patient and workforce outcomes. However, there is a gap in exploring teamwork between virtual and bedside nurses. Addressing this knowledge gap is critical to ensure positive patient and nursing workforce outcomes in hospital-based telenursing settings.

Objective: To generate a grounded theory that explains teamwork between virtual and bedside nurses in the hospital setting. A …

Breastfeeding Education Preferences Of Pregnant People With Low Incomes, Megan Kindred

Dissertations and Theses (Open Access)

Background: The proportion of infants breastfed at 1 year in the United States remains below the Healthy People 2030 goal. Longer breastfeeding durations are important due to dose-response benefits, but disparities are greater among those with low incomes. Prenatal breastfeeding education (PBE) interventions can increase breastfeeding duration. Additionally, incentivization and gamification can be used to increase use of educational technology but are underexplored in this domain. Prior studies examining PBE format preferences do not reflect currently available technology. PBE format preferences of childbearing people should be reexamined.

Purpose: This purpose of this study is to: (1) identify PBE format preference …

Pattern Dynamics And Stochasticity Of Brain Rhythms And Spike Trains In A Tauopathy Mouse Model Of Alzheimer’S Disease, Clarissa M. Hoffman

Dissertations and Theses (Open Access)

Systems neuroscience posits that every aspect of perceived physical reality, every aspect of animal and human behavior, and every cognitive phenomenon emerges from patterns of neuronal activity. While most researchers embrace this idea, there are major difficulties in describing and analyzing these complex neuronal dynamics—spike flows produced by cells ensembles, synchronized extracellular field oscillations, and other patterns—which limits our understanding of how the activity of individual neurons and the whole-animal cognition and behavior might be connected. In particular, we lack the approaches and even the semantics for connecting the individual cell outputs and the integrated results of their activity. Current …

Technical Development, Optimization, And Clinical Implementation Of Quantitative Magnetic Resonance Imaging Methods For Radiation Oncology, Lucas Mccullum

Dissertations and Theses (Open Access)

Magnetic resonance imaging (MRI) has gradually grown more important in the field of radiation oncology. This paradigm shift has grown from initial experiments with MRI of cancerous lesions in the early 1970s, to the integration of MRI images for radiation therapy treatment planning (i.e., MRI-Simulation) in the early 1980s, to the combined MRI linear accelerator (MR-Linac) becoming commercially available in 2018 which can simultaneously image a tumor and treat it with radiation. However, due to its novelty in radiation oncology, its full potential for the integration of quantitative MRI-based biomarkers has yet to be fully realized.

Therefore, this dissertation will …

Platelet Gαz Regulates Ovarian Tumor Growth And Mediates The Effects Of Chronic Stress, María G. Torres Carrizalez

Dissertations and Theses (Open Access)

Ovarian cancer is the most aggressive gynecologic cancer, with 12,450 estimated deaths in 2026. Elevated platelet counts are commonly observed in patients with ovarian cancer and are associated with enhanced tumor growth and poor prognosis. Patients with ovarian cancer are frequently exposed to elevated levels of stress, which has been correlated with accelerated disease progression and increased mortality. Interestingly, the platelet Gαz protein is activated by epinephrine through the α2A-adrenergic receptor, suggesting a potential mechanistic link between stress signaling and platelet-driven tumor progression. To investigate this, I evaluated the role of platelet Gαz in ovarian cancer using control (Gz^{fl/fl …}

In-Vitro Testing Of Light Wavelength To Detect Clots In Neonatal Extracorporeal Membrane Oxygenation Circuitry, Amanda Holmes

Dissertations and Theses (Open Access)

Background: Neonates requiring extracorporeal membrane oxygenation (ECMO) are at high risk for thrombotic complications, which contribute substantially to morbidity and mortality. Current circuit surveillance methods rely on intermittent visual inspection and indirect laboratory markers, both of which often detect thrombosis only after clinically significant progression. Optical approaches offer a non-invasive alternative for earlier clot visualization, yet the influence of illumination wavelength on detection performance under realistic ECMO conditions remains incompletely characterized.

Methods: This study evaluated wavelength-dependent clot detection performance in a controlled in-vitro neonatal ECMO circuit model using a portable imaging prototype designed to emulate bedside workflow. Twelve independent ECMO …

A Patient-Centric Chatbot For Improving Clinical Trial Accessibility, Yumeng Yang

Dissertations and Theses (Open Access)

Clinical trial enrollment remains a major challenge, and low accrual continues to delay study completion, increase research costs, and slow the development of new therapies. A barrier is the scale of the trial-matching problem: patients and clinicians must search through a large and growing number of studies, while each trial contains complex eligibility criteria that may overlap only partially with other trials. Although public registries such as ClinicalTrials.gov make trial information available, they do not adequately help patients identify which studies are most relevant to their clinical profile. This dissertation addresses that information problem by developing and evaluating a patient-centric …

A Computational Framework For Quantifying Dysregulation And Mapping Pathways Using Transcriptomic And Molecular Data And Its Application In O-Glcnacylation, Rastko Stojsin

Dissertations and Theses (Open Access)

Post-translational modifications (PTMs) are chemical modifications that occur on proteins after synthesis and play an essential role in regulating protein function. Dysregulation of biologically critical PTMs has been widely implicated in many disease phenotypes primarily through effects on complex downstream protein networks. Measurement of PTMs—particularly abundant and rapidly cycling modifications—is often limited to technically challenging and low-throughput biochemical assays. As a result, large-scale clinical datasets rarely contain direct measurements of PTM activity. These limitations restrict current research to expensive, small-scale, hypothesis-driven laboratory studies often focused on an individual disease and pathway. This dissertation presents a data-driven biomedical informatics framework for …

Graph And Language Models For Biomedical Inference Across Networks And Text, Evan Yu

Dissertations and Theses (Open Access)

Biomedical research increasingly relies on large and heterogeneous data sources to support scientific inference. However, relevant evidence is often distributed across environments that differ substantially in structure, reliability, and scale. Biomedical evidence may be represented in relational networks that encode interactions among entities and in large-scale text corpora that contain unstructured knowledge and discourse. Developing computational approaches capable of extracting reliable and interpretable signals from these diverse data environments remains a central challenge. This dissertation investigates how graph and language models can support robust biomedical inference across three evidence environments: relational epidemiologic networks, large-scale social media discourse, and biomedical scientific …

Translating Evidence Into Action: Understanding How Community- Based Practitioners Make Intervention Implementation Decisions In Practice, Kristin C. Bennett

Dissertations and Theses (Open Access)

This study examined how community-based practitioners implement public health interventions in practice settings to identify gaps between existing implementation frameworks and real-world practice. Six farmers' markets in Southeast Texas served as cases to understand implementation decision-making by community-based practitioners addressing food access challenges. A qualitative case study approach was employed, using semi-structured interviews with program adopters and key stakeholders to examine how practitioners addressed food access problems, selected interventions, and navigated implementation decisions. This methodology captured the contextual nature of implementation decision-making in community settings. The findings revealed that program adopters recognized health problems through lived experience rather than formal …

Parental Experiences With Financial Toxicity In The Pediatric Intensive Care Unit: A Phenomenological Research, Sohrab Alexander Sardual

Dissertations and Theses (Open Access)

Background: Parents of children admitted to the pediatric intensive care unit (PICU) encounter multiple stressors; however, there is a need to further understand their experiences with financial toxicity. Understanding parents’ experiences and perspectives on how they can be assisted is a critical first step to formulating interventions to help parents deal with financial toxicity.

Aims: The aims of this study are (a) to describe the experiences with financial toxicity of parents with critically ill children admitted to the PICU and (b) to explore parents’ perspectives on how they can be assisted in dealing with financial toxicity.

Methods: A phenomenological qualitative …

Sik2 Inhibitor Grn-300 Enhances Sensitivity To Paclitaxel Treatment In Triple-Negative Breast Cancer, Marc A. Pina

Dissertations and Theses (Open Access)

Breast cancer is one of the most frequently diagnosed cancers worldwide, with approximately 15% classified as Triple-Negative Breast Cancer (TNBC). TNBC lacks expression of estrogen (ER) and progesterone (PR), and does not overexpress HER-2, leaving patients without effective targeted therapies. As a result, treatment primarily relies on chemotherapy, most commonly paclitaxel, a taxane that stabilize microtubules, disrupts chromosome separation and induces apoptosis. However, TNBCs are an aggressive cancer subtype, and patients often will develop resistance after a few rounds of chemotherapy. This study addresses a critical unmet need for more effective TNBC therapies by targeting Salt-Inducible Kinase 2 (SIK2), which …

Host-Intrinsic Factors Determine Anti-Tumor Efficacy Of Exercise In Pancreatic Ductal Adenocarcinoma, Sumedha Pareek

Dissertations and Theses (Open Access)

Pancreatic Ductal Adenocarcinoma (PDAC) is the third leading cause of cancer-related deaths with a low 5-year relative survival rate of approximately 13.3% for all stages combined. We have previously shown that exercise can improve quality of life and enhance functional capacity among patients with PDAC. Exercise induces a variety of changes in the tumor microenvironment with beneficial effects in several tumor types. However, our understanding of the clinical effects of exercise and the mechanisms that mediate anti-tumor effects are limited in pancreatic cancer.

In this project, using C57BL/6 mice from Taconic Biosciences (Tac) and Jackson Laboratories (Jax), we established a …

Capsinoids, Non-Pungent Trpv1 Agonists, Induce A Mild Hypothermia That Provides Short- And Long-Term Neuroprotection After Ischemic Stroke, Alexander Andersohn, Alexander Andersohn

Dissertations and Theses (Open Access)

Therapeutic hypothermia (TH) has demonstrated neuroprotection in instances of cardiac arrest and neonatal hypoxia/ischemia but faces different challenges in application to stroke due to the activation of cold defense mechanisms in conscious patients. This dissertation examines the efficacy and specificity of capsinoids (a purified mixture of capsiate and dihydrocapsiate) to induce a sustained mild hypothermia in conscious mice that is neuroprotective after stroke. Capsinoids function as TRPV1 agonists. However, unlike capsaicin, capsinoids are vulnerable to esterase-mediated breakdown, thus significantly restricting their action to the site of delivery. We showed that capsinoids delivered intraperitoneally (IP) to mice induced a TRPV1-dependent drop …

Orthogonal Comparison Of Nuclear And Mitochondrial Clonal Architectures In Hematologic Malignancies, Nehali Shah

Dissertations and Theses (Open Access)

Acute myeloid leukemia (AML) is a hematologic malignancy characterized by accumulation of mutations that disrupt hematopoietic differentiation and promote clonal expansion. Understanding how these mutations arise and evolve is essential for improving diagnosis, prognosis, and treatment stratification. Current methods are limited by either restricted genomic coverage (targeted panels) or low throughput and high cost (in single-cell whole genome sequencing, scWGS). An emerging alternative is the use of mitochondrial DNA (mtDNA) mutations as clonal markers.

This study aims to determine whether mitochondrial-derived clonal architectures correlate with nuclear-derived clonal architectures in AML, thereby evaluating mtDNA as a scalable orthogonal tool for lineage …

Deep Learning Frameworks For Disease Detection And Outcome Prediction Using Sequential Biomedical Data, Xiaotian Ma

Dissertations and Theses (Open Access)

Biomedical sequential data, including longitudinal clinical trial data, 3D imaging, and surgical videos, are essential for disease detection and outcome prediction. Since manual review of such data is time-consuming and requires significant domain expertise, deep learning approaches are widely adopted to facilitate clinical decision-making. However, it remains challenging to interpret model predictions by identifying informative, localized features from a large volume of sequences, such as small blood clots in a large 3D CT scans or specific disease-relevant frames in a long surgical video. This dissertation presents a comprehensive investigation into using deep learning for multiple modalities of biomedical sequential data. …

Establishing A Translational Research Framework For Optimizing Clinical Workflows And Care Pathways Across The Continuum Of Stroke Care: Evaluation Of Time Series Derived Patterns In Adverse Health Trajectories Among Acute Ischemic Stroke Survivors Using Clinical And Medical Claims Linked Data, Alan Pan

Dissertations and Theses (Open Access)

The post-stroke journey is highly variable. Upon hospitalization for a primary acute ischemic stroke (AIS), patients encounter a multitude of clinical decisions that ultimately influence the trajectory of their health recovery and outcomes. The overarching scope of our work is centered around leveraging routinely captured sources of health information – such as electronic medical records (EMR) and administrative medical claims – to assess how patterns in clinical workflows and care pathways can be extracted and transformed to generate insights from observational data repositories. Within this framework, we utilized a suite of computational methods to evaluate predictors of adverse health outcomes …

From Latent Patterns To Interpretable Subtypes: Machine Learning Driven Subtyping In Alzheimer’S Clinical Trials, Dulin Wang

Dissertations and Theses (Open Access)

Randomized controlled trials (RCTs) in neurodegenerative diseases often fail to show treatment benefits due to underlying patient variability. To overcome this challenge and improve clinical trial design, it is essential to identify responsive patient subgroups and understand distinct patterns of disease progression. This dissertation addresses these challenges by applying and developing advanced AI methodologies to Alzheimer’s Disease (AD) clinical trials. The first study investigates heterogeneous treatment effects (HTEs) across ten AD RCTs to identify responsive and non-responsive patient subgroups within trials previously considered negative or neutral. By implementing causal forests in ten AD clinical trials, this work reveals the HTEs …

Deciphering Medical Imaging From Genetic Data: Integrative Modelling Across Genetics And Imaging Modalities, Wentao Li

Dissertations and Theses (Open Access)

Integrating genetic data with medical imaging offers powerful opportunities to uncover biological mechanisms and clinical insights, yet linking genetic variation to diverse physical and molecular changes remains challenging. This dissertation introduces computational approaches that bridge this gap across neuroimaging and spatial omics. The first study develops a mixed-effects framework to identify genetic signatures of neuroimaging phenotypes in bipolar disorder. By modelling subject-specific brain region interactions, the method improves detection of significant variants in large-scale datasets such as the ABCD study and UK Biobank, with downstream analyses confirming biological relevance. The second study presents a cross-modal fusion strategy for spatial transcriptomics, …

The Association Of Adult Medicaid Beneficiaries’ Characteristics And Their Experience During The Covid-19 Pandemic, Frank R. Tortorella

Dissertations and Theses (Open Access)

Background: The COVID-19 pandemic disrupted the United States’ safety net program, Medicaid, for low-income individuals affecting access to care, increasing enrollment, and requiring new approaches to care delivery. The literature shows that beneficiaries’ personal characteristics influence their healthcare experience. This study investigated the association between Medicaid beneficiary characteristics and experience with their Medicaid health plan, examined if COVID-19 negatively impacted experience, and tested if COVID-19 moderated the relationship between beneficiary characteristics and experience.

Methods: The research sample was 76,976 adult Medicaid beneficiaries who voluntarily completed the annual Consumer Assessment of Healthcare Providers and Systems (CAHPS) health plan surveys in 2018 …

Dissecting The Heterogeneous Effects Of Opioid Prescribing Limit Laws On Pediatric Mortality: A Multidimensional And Negative Binomial Modeling Approach, Francine R. Vega

Dissertations and Theses (Open Access)

Opioid prescribing for children and adolescents continues to be a significant health crisis in the United States. Early naïve exposure to opioid prescriptions has been linked to later misuse, opioid use disorder, and death. In response to the crisis, many states have implemented opioid prescribing limit laws (OPLLs) aimed at reducing exposure to opioids. These laws vary widely in their approach, including differences in dosage restrictions, prescription duration limits, informed consent requirements, educational provisions, and whether they offer explicit protections specifically for minors. Despite their widespread adoption, there is limited understanding of how heterogeneity in legal regulations affects outcomes for …

Rethinking Health Systems Responsiveness In Low–And Middle-Income Countries, Meesha Iqbal

Dissertations and Theses (Open Access)

Health systems responsiveness (HSR) refers to a health system’s ability to meet legitimate non-health expectations of the population. Traditionally, HSR has been conceptualized across eight domains: respect for dignity, autonomy, confidentiality, prompt attention to health needs, availability of basic amenities, choice of provider, access to social support networks, and clarity of communication. However, as the expectations of populations in high-income countries (HICs) and low- and middle-income countries (L&MICs) differ significantly due to diverse social and cultural contexts, the conceptualization of HSR also varies. We conducted a systematic review of literature to adapt and contextualize the HSR framework for L&MICs based …

Anxiety During Perimenopause: A Narrative Qualitative Study Of The Women’S Lived Experiences, Kayla Mcelhany

Dissertations and Theses (Open Access)

Abstract

Objectives: Perimenopause has been associated with increased anxiety symptoms. However, data is lacking regarding the experiences of women with perimenopausal anxiety and the contributing factors to worsening anxiety symptoms. We explored the experiences of women with self-reported new onset or worsening of anxiety symptoms during perimenopause to better understand contributing factors.

Study design: Twenty women participated in one-on-one interviews to explore experiences of perimenopausal anxiety in the context of their daily lives and perimenopausal physical changes. Inductive thematic analysis was used to develop codes and themes from the transcribed interview data. Analysis was done using MAXQDA software.

Main …

Integrating Bulk And Single-Cell Transcriptomics To Investigate Intratumor Heterogeneity, Shuai Guo

Dissertations and Theses (Open Access)

Cancers are heterogeneous mixtures of tumor and surrounding cells, where each component comprises multiple distinct sub-types and/or states. Understanding the cell-type-specific contributions is critical for advancing cancer biology, yet high-throughput expression profiles from tumor tissues only represent combined signals from all diverse cellular sources. Bulk deconvolution with single-cell/nucleus (sc/sn) RNA-seq data has emerged as a powerful approach to dissect both cellular composition and cell-type-specific expression patterns, yet the technological discrepancy across sequencing platforms limits accuracy.

To systematically evaluate the impact of platform discrepancies on bulk deconvolution, we first generated a benchmark dataset of 24 healthy retinas with paired bulk and …

Effects Of Sex And Aging In The Response To Global Cerebral Hypoperfusion, Alexis Mcalister

Dissertations and Theses (Open Access)

Introduction

The prevalence of dementia worldwide is projected to double by the year 2030 and triple by 2050. Vascular cognitive impairment and dementia (VCID) encompasses diseases that lead to cognitive decline and dementia due to cerebrovascular disease. VCID is the second most common form of dementia after Alzheimer’s disease, accounting for approximately 15- 40% of all dementia cases. Reductions in cerebral blood flow from intracranial and extracranial atherosclerosis increase VCID risk, even in the absence of overt clinical or imaging evidence of stroke/embolization. The pathology seen in patients with chronic cerebral hypoperfusion, such as inflammation, neuronal loss, white matter abnormalities, …