Medicine and Health Sciences Commons^™

Tissue Engineered Micro And Macrovasculature Utilizing Stromal Vascular Fraction., Joseph Samir Zakhari

Electronic Theses and Dissertations

This dissertation describes the use of stromal vascular fraction to tissue engineer 3D microvasculature and macrovasculature. Stromal vascular fraction is an easily isolatable cell source from adipose tissue depots. It has demonstrated remarkable potential both in vitro and in vivo for forming microcirculation capable of perfusion upon implantation. SVF is clinically utilized as a therapeutic cell source for anti-inflammation for osteoarthritis and is being studied for ischemic tissue application to stimulate revascularization. The work described herein is divided within four chapters. Chapter I provides an introductory overview and lists the aims and hypothesis for the dissertation. Chapter II describes experiments …

Optimizing High-Speed Exercise Performance : Effect Of Load., Ling Bai

Electronic Theses and Dissertations

The purpose of this study was to identify an optimal load for the knee extension exercise done with Impulse (Newnan, GA). Forty-one women and twenty-nine men made six laboratory visits, including two familiarization sessions of the knee extension exercise and four real workout sessions which entailed four 30-second exercise sets, separated by 120-second rests, against four different loads (0Kg, 3.41Kg, 5.68Kg, 7.95Kg). A Latin Squares design was used to counterbalance the sequence of the sets. Average force (AF), peak force (PF), total work (TW), Impulse value, and the number of knee extension repetitions were each analyzed with a 2 (gender) …

An Assessment Of The Disaster Preparedness Knowledge Of Emergency Medical Services Providers In Hajj Of 2016., Ahmed Meaiwedh Al-Otaibi

Electronic Theses and Dissertations

Objectives: 1) Assess knowledge regarding disaster preparedness for mass gathering among SRC-EMS providers during the Hajj 2016 2) Explore the relationship between the demographic variables and knowledge about disaster preparedness among SRC-EMS providers during the Hajj 2016 3) Explore the sources of knowledge for SRC-EMS providers about disaster preparedness. Method: The data collection for this study was a cross-sectional survey using an online Qualtrics survey. It was convenience sample of 1650 respondents. For the analyses descriptive statistics was used, one-way ANOVA and Bonferroni correction for multiple comparisons tests, multiple regression analyses, and Pearson’s product coefficients. Results: The main findings in …

Effect Of Porcelain Thickness And Translucency On The Final Shade Of Ips E.Max Cad Overlaying A Dark Substrate., Peter F. Alena

Electronic Theses and Dissertations

IPS e.max is a very esthetic lithium disilicate used in dental ceramics. Unfortunately, it can unintentionally change color after cementation with resin cements. The purpose of this study is to better understand how combining thickness and translucency affects the post-cementation shade of IPS e.max CAD overlaying a dark substrate, thereby enabling clinicians to choose more appropriate techniques and materials. IPS e.max CADs (A1 shade) had either a low translucency (LT) or high translucency (HT), and cut with 0.3mm, 0.5mm, and 1.0mm thicknesses. Each sample overlaid a resin cement and dark substrate, a spectrophotometer helped derive the color difference (ΔE*ab), and …

Perceptions Of Pediatric Nurses And Parents Of Hospitalized Children Engaged In Shared Decision Making., Lisa English Long

Electronic Theses and Dissertations

Achievement of optimal quality in today’s healthcare environment practices means that clinical practices must be based on evidence. Evidence-based practice (EBP) is the integration of research findings, clinician expertise, and patient-centeredness that includes a focus on preferences and values (Melnyk & Fineout-Overholt, 2015). An area within EBP needing increased attention is the aspect of patient preferences and values. The process of Shared Decision Making (SDM) incorporates assessment of preferences and values within a process in which where patients, families and healthcare professionals collaborate to make decisions regarding patient care. The purpose of this study was to describe perceptions of parents …

Maturation Of Human Induced Pluripotent Stem Cell Derived Engineered Cardiac Tissues Using Chief Transfection And Chronic Optical Pacing., Marc M. Dwenger

Electronic Theses and Dissertations

The immaturity of engineered cardiac tissues (ECTs) limits their ability to regenerate damaged myocardium and to serve as in vitro disease models and surrogates for drug toxicity testing. Several chronic biomimetic conditioning protocols, including mechanical stretch, perfusion, and electrical stimulation promote ECT maturation but have significant technical limitations. Non-contacting chronic light stimulation using heterologously expressed light-sensitive ChIEF ion channels, termed optogenetics, may be an advantageous alternative to chronic electrical stimulation. As a proof of principle, we transfected ECTs using an AAV packaged ChIEF and then verified acute optical pacing (OP) by patch clamp. We then chronically OP ECTs for 7 …

Long-Term Dental Outcomes Of The Professional Education Preparation Program., Samuel D. Petersen

Electronic Theses and Dissertations

Introduction: The Professional Education Preparation Program (PEPP) is a health careers pipeline program for Kentucky pre-health students from Health Professional Shortage Area counties and/or racial/ethnic groups underrepresented in the health professions. The purpose of this study was to determine the demographics of the dental PEPP participants and if, post dental school graduation, they were providing care for underserved patient populations Methods: PEPP dental graduates (n=114) had been previously identified. Participants were contacted by phone, asked to participate and then mailed a survey. Survey questions covered personal, practice and patient characteristics, procedures performed, insurance accepted and community outreach. Logistic regression analysis …

Intraoral Imaging At Insertion Of Implant Supported Restorations At An Academic Institution : Conformity To Established Guidelines., J. Alec Power

Electronic Theses and Dissertations

The objective of this study was to establish the frequency of intraoral imaging at the time of insertion of implant supported restorations at University of Louisville School of Dentistry (ULSD). After IRB approval (14.1215), patients on whom an implant-supported single unit fixed restoration was placed were identified from the electronic health record over a 4-year period. Type of prosthesis retention (cement vs. screw) and discipline responsible for crown placement was recorded. Bitewing (BWx) or periapical (pa) images taken at the time of prosthesis placement were accessed and reviewed. Overall radiographic frequency according to modality was tallied and compared using Chi-square …

Feeding Behaviors And The Child With Posterior Tongue-Tie : Comparison To Norms., Mckenzie Sexton

Electronic Theses and Dissertations

The tongue is an important muscle used in speech, mastication, swallowing, and breastfeeding. It plays an important role in facial development, dentition, and periodontal status. Posterior ankyloglossia, also known as posterior tongue-tie (PTT), is characterized by a tether beneath the lingual mucosa. Upon visual inspection, the frenulum is non-prominent but with the use of a grooved director it may appear abnormally prominent, short, thick, or cord-like. Palpation of the frenulum may reveal tightness. There is a lack of empirical data about PTT and the impact on feeding beyond early infancy. PTT is not well recognized and can be missed resulting …

Development Of Blended Polymeric Fibers To Alter The Release Of Peptide Targeting Porphyromonas Gingivalis., Sonali Suresh Sapare

Electronic Theses and Dissertations

Periodontitis is a chronic inflammatory disease that infects the tissues of the periodontium. It is estimated that 47.2% or 67.2 million American adults suffer from mild, moderate and severe periodontitis. Globally, 30-50% of the adult population is afflicted with periodontal disease, making it one of the most prevalent infectious diseases in the world. Therapeutics targeting P. gingivalis may be effective to alter periodontitis progression. However, the current treatment modalities that target critical pathogens to maintain host-biofilm homeostasis are limited, urging the development of specifically targeted therapeutics to limit P. gingivalis recolonization of the oral cavity after periodontal treatment and healing. …

Therapeutic Potential Of A Plant-Made Cholera Toxin B Subunit Variant For The Treatment Of Ulcerative Colitis., Joshua Mark Royal

Electronic Theses and Dissertations

Cholera toxin B subunit (CTB) is a mucosal immunomodulatory protein that induces robust mucosal and systemic antibody responses. This well-known biological activity has been exploited in cholera prevention (as a component of Dukoral® vaccine) and vaccine development for decades. On the other hand, several studies have investigated CTB’s immunotherapeutic potential in the treatment of inflammatory diseases such as Crohn’s disease and asthma. Furthermore, we recently found that a plant-made variant of CTB (CTBp) could induce colon epithelial wound healing in mouse colitis models. In this thesis, it is revealed that the wound healing effects are unique to the plant-made variant, …

A Study Of Gpr3, Gpr6, Of Gpr12 As Novel Molecular Targets For Cannabidiol., Alyssa S. Laun

Electronic Theses and Dissertations

The G protein-coupled receptors 3, 6, and 12 (GPR3, GPR6, and GPR12) comprise a family of closely related orphan receptors with no confirmed endogenous ligands. These receptors are constitutively active, capable of signaling through G protein and non-G protein mediated mechanisms. These orphan receptors have previously been reported to play important roles in many normal physiological functions and to be involved in a variety of pathological conditions. Although they are orphans, GPR3, GPR6, and GPR12 are phylogenetically most closely related to the cannabinoid receptors. Using β-arrestin2 recruitment and cAMP accumulation assays, we have recently found that the non-psychoactive phytocannabinoid cannabidiol …

The Effects Of Polychlorinated Biphenyls Exposure On Non-Alcoholic Fatty Liver Disease : Role Of Aryl Hydrocarbon Receptor., Hongxue Shi

Electronic Theses and Dissertations

Polychlorinated biphenyls (PCBs) are detectable in serum of 100% of adults in US, and has been associated with fatty liver disease in epidemiological studies. PCBs are classified as either dioxin-like (DL) or non-dioxin-like (NDL) PCB based on their ability to activate the aryl hydrocarbon receptor (AhR). We used exposures that reflect human bioaccumulation patterns, which resembles Aroclor 1260 with a low level of the DL-PCB, PCB 126. Our aim was to determine if this exposure will activate the human and mouse AhR and examine if receptor activation influences these steatotic responses due to PCB exposures. DL-PCBs exposure-induced AhR activation in …

Inflammasome Independent Leukotriene-B4 Production Drives Crystalline Silica Induced Sterile Inflammation., Bindu Hegde

Electronic Theses and Dissertations

Silicosis is an irreversible lung inflammatory disease caused by chronic exposure to crystalline silica (CS) and is one of the most prevalent occupational diseases worldwide. Lipid chemoattractant Leukotriene B₄ (LTB₄) plays an important role in neutrophilic inflammation that drives silicosis and promotes lung cancer. Previous studies in our laboratory have demonstrated that CS-induced neutrophilic inflammation and lung tumor burden in K-ras^LA1 mice is abrogated in the LTB₄-receptor deficient mice. Another pathway whose importance is well studied in the progression of silicosis is the Nalp3 inflammasome pathway. Studies have shown inflammasome- dependent IL-1b to be …

Nutritional Virulence Of Legionella Pneumophila., Ashley M. Best

Electronic Theses and Dissertations

Legionella pneumophila is an environment organism that parasitizes a wide range of protozoa. Growth within the environmental host primes L. pneumophila for infection of human alveolar macrophages when contaminated aerosols are inhaled. Intracellular replication within either host requires the establishment a replicative niche, known as the Legionella-containing vacuole (LCV). Biogenesis of the LCV depends on the type IVb translocation system, the Dot/Icm, to translocation >320 effectors into the host cytosol. Effectors are responsible for preventing lysosome fusion to the LCV, recruitment of ER-derived vesicles to the LCV, and modulation of a plethora of host processes to promote the intracellular …

Functional And Structural Impact Of The Loss Of The Leucine-Rich Repeat Protein Lrit1 In The Mouse Retina., Catherine Ann Cobb

Electronic Theses and Dissertations

Mutations in genes encoding the leucine-rich repeat (LRR) proteins nyctalopin and LRIT3 lead to complete congenital stationary night blindness because they are critical to depolarizing bipolar cell function in the retina. LRIT3 has two closely related family members, LRIT1 and LRIT2. In silico analyses of publicly available RNA-Seq data showed that Lrit1 was highly expressed in the retina. Here I describe the expression pattern and impact of loss of LRIT1 on retinal function. To enable these studies, we used CRISPR/Cas9 technology to create an Lrit1^-/- mouse line. Retinal morphology and morphometry analyses showed no gross changes in retinal structure …

Divergent Evolution Of Di-Lysine Er Retention Vs. Farnesylation Motif-Mediated Anchoring Of The Ankb Virulence Effector., John David Perpich

Electronic Theses and Dissertations

Legionella pneumophila is an aquatic organism capable of intracellular replication within a wide range of protozoan hosts and within human macrophages where it causes Legionnaires’ Disease. L. pneumophila manipulates a variety of host cell processes by translocating, into the host cell cytosol, more than 300 effector proteins via the type IVB secretion system (T4SS). The AnkB effector from the AA100/130b strain (AnkB-AA100) contains a C-terminal CaaX motif that rapidly becomes farnesylated upon translocation into the host cell and anchored to the cytosolic face of the Legionella-containing vacuole (LCV) membrane, which is essential for intracellular replication. We show that a …

A New Surgical Approach For O-C2 Fusion, Solving The Problem Of Dysphagia., M. Kathryn Mcclure

Electronic Theses and Dissertations

The fusion of the second cervical vertebrae to the occipital bone (O-C2 fusion) for head stabilization can result in postoperative dysphagia and dyspnea, negatively impacting the patient’s quality of life. Currently, the O-C2 angle is used for head placement, which may not place the head neutrally. We hypothesize that aligning the external auditory meatus with midline of the C2 will reduce oropharyngeal stenosis, reducing dysphagia. One male patient with poor swallow quality of life who required a revision of a previous O-C2 surgery was evaluated via videofluoroscopy and completed the standard swallow quality of life questionnaire (SWAL-QOL) before and after …

Designing Interactive Virtual Environments With Feedback In Health Applications., Yi Li

Electronic Theses and Dissertations

One of the most important factors to influence user experience in human-computer interaction is the user emotional reaction. Interactive environments including serious games that are responsive to user emotions improve their effectiveness and user satisfactions. Testing and training for user emotional competence is meaningful in healthcare field, which has motivated us to analyze immersive affective games using emotional feedbacks. In this dissertation, a systematic model of designing interactive environment is presented, which consists of three essential modules: affect modeling, affect recognition, and affect control. In order to collect data for analysis and construct these modules, a series of experiments were …

Swallow And Breathing Coordination Following Suprahyoid Muscle Injury., Bradley Kimbel

Electronic Theses and Dissertations

Swallowing motility disorders (dysphagia) are a major complication following radiation treatment for head and neck cancer, affecting ~50% of those treated. One reason for this is that radiation causes muscle damage, provoking sensorimotor pathologies. Previous work has suggested that injury may cause discoordination between breathing and swallowing behaviors. We sought to determine if muscle injury provokes changes in this behavior. We hypothesized that acute suprahyoid muscle damage would alter cross-behavior excitability, causing destabilization of the respiratory-swallow pattern. Swallowing was evoked in anesthetized spontaneously breathing cats via injection of a 3cc bolus of water into the oropharyngeal cavity. A suprahyoid injury …

Traumatic Brain Injury : Investigating Misconceptions Among Graduate Students In Physical Therapy, Occupational Therapy, And Speech-Language Pathology., Michael Frazure

Electronic Theses and Dissertations

This study utilized a convenience sample (n = 510) to investigate misconceptions of traumatic brain injury (TBI) among first and second year graduate students in physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) training programs. Eighty-six-point-seven percent of participants were female, and 87.70% were white. All participants completed a survey comprised of items relating to general information about TBI, coma and unconsciousness, memory loss, recovery, and concussion. Descriptive and summary statistics indicated the persistence of misconceptions regarding coma and unconsciousness, memory loss, recovery, and concussion among graduate students in PT, OT, and SLP training programs. Group comparisons …

Autism Spectrum Disorder : Investigating Predictive Diagnostic Relationships In Children Three Years-Of-Age And Younger., Kaitlin Juergensen

Electronic Theses and Dissertations

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder whose symptoms may involve deficits across three domains: communication, socialization, and atypical behaviors or interests. With a high prevalence across populations and a tendency to impact males more so than females, early and accurate diagnosis appears critical. The most current literature on ASD provides a myriad of difficulties associated with diagnosis under the age of three years. The purpose of this study was to determine if a predictive relationship exists between a child’s individual developmental domain standard deviation (SD) subscale scores (motor, language, cognitive, social-emotional, and adaptive skills) on the Bayley …

Patients’ Perceptions Of Patient-Centered Care And The Hospital Experience Pre- And Post-Discharge, Cheryl Smith

Electronic Theses and Dissertations

Florence Nightingale used the principles of patient-centered care as the foundation for nursing practice. Today, patient-centered care delivery is part of the healthcare reform process that extends interprofessionally throughout all settings of healthcare in the United States (U.S.). Patient satisfaction measurement is one primary determinant of effective patient-centered care. The standardized Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and methods is a nation-wide tool used to measure patient satisfaction. However, this method of patient satisfaction assessment relies on recollections of patients’ hospital experiences and requires accurate memory and recall. This study sought to examine the effect of …

Vocal Health: Awareness And Perceptions In Undergraduate Vocal Music And Theatre Majors, Heather Smith

Electronic Theses and Dissertations

Objective: The purpose of this study was to identify the perceptions of students majoring in vocal music and theatre regarding the instruction they receive in their undergraduate curricula on voice health education.

Methods: A survey was adapted from a previous study, Beeman (2016), with permission by the author. The survey was disseminated to undergraduate vocal music and theatre majors across the United States via SurveyMonkey®, an online survey tool.

Results: Students perceived receiving knowledge on vocal health from their voice teachers, however they reported low levels of vocal hygiene compliance. Additionally, students recognized the connection between the singing and speaking …

Evaluating Socially Determined Health In Rural Appalachia: Use Of The Social Quality Theory, Paula Masters

Electronic Theses and Dissertations

People living in rural America face unique social circumstances that can prevent them from reaching optimal health status. This fact holds especially true in the rural Appalachian region of the United States where income, education, living circumstances, and lack of resources create an environment that has some of the highest rates of morbidity and mortality in the country. While the rest of the country has seen improvement in many health behaviors and health outcomes, rural Appalachian communities remain unchanged and further behind other regions. In many cases, programming and policy have failed to create a culture of health in Appalachia. …

Loss Of The Na+/H+ Exchange Regulatory Factor 1 Results In Increased Susceptibility To Cisplatin-Induced Acute Kidney Injury., Adrienne M. Bushau-Sprinkle

Electronic Theses and Dissertations

Background. Acute kidney injury (AKI), an abrupt loss of kidney function which carries a high mortality and confers an increased risk of chronic kidney disease, develops in 30% of patients who receive cisplatin, a widely used chemotherapeutic agent [1], [2], [3]. The sodium hydrogen exchange regulatory factor isoform 1 (NHERF1) is a scaffolding protein that anchors multiple membrane proteins, in renal proximal tubules [4]. NHERF-1 deficient mice have aberrant localization of BBM proteins in intracellular compartments [5]. The investigators have recently demonstrated NHERF1 deficient proximal tubule cells have an underlying …

A Survey Of The Implementation And Usage Of Electronic Dental Records And Digital Radiographs In Private Dental Practices In Mississippi, Barbara K. Brent

Electronic Theses and Dissertations

Implementation of electronic health records by the Health Information Technology for Economic and Clinical Health has led to the implementation of electronic dental records (EDRs) and digital radiography in dental offices. The purpose of this study was to determine the state of the implementation and usage of EDRs and digital radiographs by the private general and pediatric dental practices in Mississippi as well as reasons why the dental practices are not moving forward with the advanced technology.

A survey was emailed to 712 dental practices: 116 responded (16% response rate), and 104 consented to participate (89.66%). Results indicated dental practices …

Hiv-Related Knowledge, Attitudes, And Behaviors In Two Low Resource Settings, Candice Lynn Collins

Electronic Theses and Dissertations

Two Human Immunodeficiency Virus (HIV) outbreaks occurred almost simultaneously in the United States (US) (2014-2015) and in Cambodia (2015). Information is lacking on HIV-related knowledge, stigmatizing attitudes, and high-risk behaviors (KAB) among the general population, which may affect the transmission of HIV and lead to outbreaks. The current study aimed to: 1) assess KAB among the general population in a high-risk county in the US, 2) analyze KAB among the general population of Cambodia, and 3) compare KAB across samples from a high-risk county in Northeast Tennessee and a province in Cambodia. Tennessee data were collected in 2017 and Cambodian …

Success Rates Of Second Semester Anatomy Students In Online And On-Ground Classes At A Community College In East Tennessee, William Sproat

Electronic Theses and Dissertations

Educators expect the number of institutions offering online courses and the number of students enrolling in these courses to increase as many students, particularly nontraditional students, discover the advantages of online content delivery. Online courses require new methods of communication between students and faculty as well as discovering new ways to build relationships, earn student trust, conduct appropriate assessment, and deliver useful course content. Many institutions—public, private, and for-profit—offer a wide variety of online coursework but faculty, employers, and the public have expressed concerns about the quality of online course content. In particular, online delivery of coursework in the natural …

Exploration Of Rape Myths Among Former Military Professionals, Gabrielle Caldara

Electronic Theses and Dissertations

Sexual violence is sometimes considered a taboo topic for discussion, but it gained widespread attention in the media in late 2017 due to the social movements addressing the sexual assault of women. However, sexual violence perpetrated against men lacks publicity in America, and highlights a similar situation in the Armed Forces. A discussion of sexually violent acts committed against men is sometimes impeded by cultural norms. This discrepancy associated with civilian and military communities inspired this exploratory study.

A convenience sample of 520 former American military professionals completed an anonymous online survey to describe their attitudes and beliefs regarding rape …