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Articles 1531 - 1560 of 4194
Full-Text Articles in Medicine and Health Sciences
The Moderating Effect Of Employee Bottom-Line Mentality On The Relation Between Personality And Unethical Pro-Organizational Behaviors, Jordan Thomas
The Moderating Effect Of Employee Bottom-Line Mentality On The Relation Between Personality And Unethical Pro-Organizational Behaviors, Jordan Thomas
Theses and Dissertations
Unethical pro-organizational behavior (UPB) refers to unethical actions that employees engage in to benefit the company they work for. The issue of employees engaging in UPB has been high-lighted in various high-profile scandals, such as the Volkswagen emissions scandal. The current study examined the interaction between employees’ personality traits, perceptions of bottom-line mentality (BLM), and UPB. The results suggested that when employees who are low on trait conscientiousness and honesty-humility are placed in an environment in which they perceive to have high levels of BLM, they are more likely to engage in UPB than those individuals who had higher levels …
Nurse Practitioner And Pharmacist Collaboration In Rural Congregate Housing Facility, Kendra Babcock Pharmd
Nurse Practitioner And Pharmacist Collaboration In Rural Congregate Housing Facility, Kendra Babcock Pharmd
Theses and Dissertations
A Certified Nurse Practitioner (CNP) expanded her clinical services to include a project called Senior Transitions (ST). The CNP visited assisted living facilities in the area and conducted rounds on each of the facility’s patients participating in the ST program. The CNP had collaborated with pharmacists in her prior practice setting and wanted to continue doing so in her new practice setting. A pharmacy resident was assigned to participate in co-visits with the CNP at a local assisted-living facility and consulted on any medication-related questions regarding long-term care facility patients which were followed by the practitioner. While conducting co-visits and …
Social Emotional Learning Through Depression Education In A High School Setting, Antonette Minniti
Social Emotional Learning Through Depression Education In A High School Setting, Antonette Minniti
Theses and Dissertations
Education on depression is an important part of social emotional learning. Lacking emotion regulation skills tend to lead to larger problems, such as academic struggles, disconnect from peers, strife at home and trouble in interpersonal relationships. Research in depression education or educational programs connected to mental health literacy are minimal, especially at the high school level. The purpose of this research will focus on examining the impact of one depression education program, John Hopkins Hospital’s Adolescent Depression Awareness Program (ADAP). ADAP is a three-day program that informs students about the facts of depression, how it is treated, and what to …
Deciphering The Consequences Of Yolk Testosterone Metabolism In Birds, Nicole A. Campbell
Deciphering The Consequences Of Yolk Testosterone Metabolism In Birds, Nicole A. Campbell
Theses and Dissertations
Maternal steroids transferred to eggs can elicit permanent effects on various aspects of offspring phenotype. Although, testosterone was thought to be a key mediator of maternal effects in birds, we now know that vertebrate embryos actively regulate their exposure to maternal testosterone through steroid metabolism, suggesting testosterone metabolites may elicit the observed phenotypic effects. To address the role steroid metabolism plays in mediating yolk testosterone effects, we used European starling (Sturnus vulgaris) eggs to characterize the timing of testosterone metabolism and determine whether etiocholanolone, a prominent testosterone metabolite in avian embryos, is capable of influencing early embryonic development. Tritiated testosterone …
Improving Narrative And Expository Language: A Comparison Of Narrative Intervention To Shared Storybook Reading, Karee Douglas
Improving Narrative And Expository Language: A Comparison Of Narrative Intervention To Shared Storybook Reading, Karee Douglas
Theses and Dissertations
The purpose of this study was to explore the impact of oral narrative intervention delivered in a multi-tiered system of support format on proximal narrative retell outcomes, and more distal personal story generation and expository language outcomes of preschool and kindergarten students. Participants included 241 preschool and kindergarten students. Students were divided into 3 different groups (treatment, alternate treatment, and no-treatment control). The treatment group received Story Champs Tier 1 oral narrative language intervention from their classroom teacher twice a week for 15-20 minutes over 14 weeks. A sub-sample of students from the Story Champs group who did not meet …
Impact Of A Single Injury Prevention Instructional Session On The Incidence Of Injury Among U.S. Army Rotc Cadets, Joshua Wooldridge
Impact Of A Single Injury Prevention Instructional Session On The Incidence Of Injury Among U.S. Army Rotc Cadets, Joshua Wooldridge
Theses and Dissertations
Background: Musculoskeletal injuries are the leading health concern for the United States Army. These injuries are the third leading cause of hospitalizations for Army service members and the primary cause for the majority of service-connect disability discharges. Over 80% of musculoskeletal injuries are overuse injuries caused by physical training. The Joint Services Physical Training Injury Prevention Work Group considers education to be a mandatory component of all injury prevention efforts; however, little military research has investigated the impact of education as a primary intervention. Objective: To examine the effect of an injury prevention education class on the incidence of injuries …
Synthesis Of Novel Library Of Cyanopyrrolidinyl Beta-Amino Alcohols And Matrine Alkaloids, Xiaotian Chen
Synthesis Of Novel Library Of Cyanopyrrolidinyl Beta-Amino Alcohols And Matrine Alkaloids, Xiaotian Chen
Theses and Dissertations
Cyanopyrrolidines and beta-Amino alcohols are molecular scaffolds that are highly found in commercially available drugs. We developed a multi-step synthetic method to form a novel library of compounds as inhibitors that share both scaffolds toward potent and selective diabetes therapeutics. Despite the ease for the synthesis of Cyanopyrrolidines, the difficulty of forming high selective beta-Amino alcohols is challenging. We successfully find the best condition for the preference of highly selective mono-alkylation and double-alkylation products and produce them with high yield.
Matrine is an alkaloid found in plants from the genus Sophora and can produce some pharmacological effects such as anti-cancer …
Project Palmms (Physical Activity Levels And Family Medical Histories): An Undergraduate Sample, Pierre Alexander Leon
Project Palmms (Physical Activity Levels And Family Medical Histories): An Undergraduate Sample, Pierre Alexander Leon
Theses and Dissertations
Background: Physical inactivity has garnered significant attention as it is considered an emerging worldwide young adult problem. There is empirical evidence on predictors of low levels of physical activity (PA), such as an individual’s sex and/or socio-economic status. There are also other possible reasons for the decline in PA, such as an individual’s motivations and/or barriers for participation in physical activity and an individual’s understanding of their predisposition to chronic illnesses. This study seeks to identify perceptions of benefits/barriers to PA and motivating factors needed to increase physical activity in college populations. Methods: A survey gathering information on demographics, PA, …
Mining For Specialized Metabolism Genes In Red Sea Brine Pool Prokaryotic Metagenomes For Antibacterial And Anticancer Activities, Laila Ziko
Theses and Dissertations
Antibiotic and anticancer drug resistance are current global health threats, thus new antibiotics and anticancer agents are required to treat the strains and cancers that are currently untreatable with the available drug spectrum. One way to search for new chemotherapeutics is to search nature, particularly metagenomes of un-cultured microbial communities. A subset of specialized metabolites (SMs) produced by microbes confer activities of pharmaceutical importance, such as antibacterial and anticancer effects, and are coded by specialized metabolism gene clusters (SMGCs) in the organisms’ genomes. We aimed to search for SMGCs in the metagenomes of Red Sea brine microbial communities by employing …
Effects Of Type I Diabetes On Labor Force Participation: A Propensity Score Match, Ore Aina-Badejo
Effects Of Type I Diabetes On Labor Force Participation: A Propensity Score Match, Ore Aina-Badejo
Theses and Dissertations
Type I Diabetes (T1D) is a chronic autoimmune mediated form of insulin resistance that has lasting socioeconomic effects from childhood through old age that may impact labor force participation. Examining this relationship will enhance our understanding of life-long chronic illness beyond individual medical/financial impact by establishing broader socioeconomic implications. This study utilized data from the 2008-2015 data set of the Medical Expenditure Panel Survey (MEPS), to explore the effects of T1D on labor force participation. It was hypothesized that having T1D would decrease both employability and contribution to the labor force. Utilizing methods of propensity score matching and entropy balancing, …
Intranasal Delivery Of Insulin By Nanoemulsion System, Darshana Mahendrakumar Shah
Intranasal Delivery Of Insulin By Nanoemulsion System, Darshana Mahendrakumar Shah
Theses and Dissertations
The main objective of this research was to develop an o/w nanoemulsion dosage form of insulin for intranasal delivery where insulin is loaded into the oil phase of the nanoemulsion for enhanced absorption. When loaded into the lipid droplets (oil phase), insulin can be protected from enzymatic degradation, can permeate through the mucus gel barrier in a comparatively efficient manner and can be absorbed through transcellular permeation along with paracellular route. To incorporate lipophilicity to insulin molecule, several complexes of insulin with various amphiphiles were developed to load it into the oil phase. The cytotoxicity of these amphiphiles and the …
Stresi Dhe Niveli I Burn-Out (Shterrimit) Tek Profesionistet E Shëndetit Mendor Në Prizren, Herolind Fanaj
Stresi Dhe Niveli I Burn-Out (Shterrimit) Tek Profesionistet E Shëndetit Mendor Në Prizren, Herolind Fanaj
Theses and Dissertations
Stresi në punë si dhe djegia janë gjetur në profesione të ndryshme në nivele të ndryshme. Me qëllim të hulumtimit të nivelit të stresit dhe të djegies (burn-outit) tek punëtorët profesional të shëndetit mendor në Prizren si dhe të njejtën kohë edhe shkaktarët e mundshëm të tyre janë përdorur pyetësorët Maslach Burnout Inventory dhe Forma vetë-raportuese e kënaqësisë në punë dhe shkaktarëve të mundshëm të stresit dhe të djegies (burn-out). Pjesëmarrës në hulumtim ishin (N=24, Mmes=41.19, DS=8.03), respodent të dy gjinive, ka dominuar gjinia femrore me 16 respodent apo 66.7%. Ka rezultuar nivel i lartë i stresit tek 66.7 % …
Understanding Structure-Activity Relationship Of Synthetic Cathinones (Bath Salts) Utilizing Methylphenidate, Barkha J. Yadav
Understanding Structure-Activity Relationship Of Synthetic Cathinones (Bath Salts) Utilizing Methylphenidate, Barkha J. Yadav
Theses and Dissertations
Synthetic cathinones are stimulant drugs of abuse that act at monoamine transporters e.g. the dopamine transporter (DAT) as releasing agents or as reuptake inhibitors. More than >150 new synthetic cathinones have emerged on the clandestine market and have attracted considerable attention from the medical and law enforcement communities.
threo-Methylphenidate (tMP) is an FDA approved drug for the treatment of ADHD and narcolepsy, which also acts as a DAT reuptake inhibitor and is widely abused. tMP and synthetic cathinones share some structural similarities and extensive structure-activity relationship (SAR) studies on tMP have been conducted. However, much less is known about the …
Factors Associated With Hospital Readmissions Among United States Dialysis Facilities, Amber B. Paulus
Factors Associated With Hospital Readmissions Among United States Dialysis Facilities, Amber B. Paulus
Theses and Dissertations
Hospital readmissions are a major burden for patients with end stage renal disease (ESRD). On average, one in three hospital discharges among patients with ESRD are followed by a readmission within 30 days. Currently, dialysis facilities are held accountable for readmissions via the ESRD Quality Incentive Program standardized readmission ratio (SRR) clinical measure. However, little is known about facility-level factors associated with readmission. Additionally, unlike other standardized measures of quality in the dialysis setting, incident patients within their first 90-days of dialysis are included in the performance calculation. This study analyzed CMS Dialysis Facility Report data from 2013 to 2016 …
Regorafenib Enhances Lethality Of Sildenafil And Curcumin In Colorectal Cancer Cells, Kervin Benjamin Owusu
Regorafenib Enhances Lethality Of Sildenafil And Curcumin In Colorectal Cancer Cells, Kervin Benjamin Owusu
Theses and Dissertations
In the United States, more than 130,000 people will be diagnosed with colorectal cancer (CRC) each year and an estimated 50,000 people will die from the disease. Standard of care (SOC) therapies for CRC combine multiple cytotoxic chemotherapeutic drugs. These combinations have varying degrees of effectiveness and can often result in significant patient morbidity. For second recurrence patients, the multi-kinase inhibitor, regorafenib, is an approved agent, but is often poorly tolerated at current doses. In the current study, we propose to develop therapeutic regime of combining agents with modest toxicity profiles: curcumin and sildenafil with regorafenib. Using clinically achievable enterohepatic …
Pharmacologic Profiling Of Novel Compounds Via Fluorometric Analyses Of Monoamine Transporter Responses, Ashkhan Hojati
Pharmacologic Profiling Of Novel Compounds Via Fluorometric Analyses Of Monoamine Transporter Responses, Ashkhan Hojati
Theses and Dissertations
In humans and other organisms, monoaminergic systems are crucial in neuronal function and behavior. The monoamine transporters (MATs), which can be found on the presynaptic plasma membrane of neurons in the central nervous system (CNS), are crucial in the regulation of neurotransmitter concentration in the synaptic cleft. As the duration and concentration of neurotransmitters in the cleft affect further downstream signaling responses, these proteins are important targets for both understanding neuronal physiology and compounds of interest. Multiple theories exist proponing the contribution of MATs to a variety of mental and neurological disorders, including depression. This theory establishes that depression is …
Examining Biobehavioral Variables And Predictors Associated With Type 2 Diabetes Self- Management, Karin A. Emery
Examining Biobehavioral Variables And Predictors Associated With Type 2 Diabetes Self- Management, Karin A. Emery
Theses and Dissertations
Type 2 diabetes mellitus self-management is a challenging process that brings forward a variety of emotional responses. The purpose of this work was to explore relationships between diabetes distress, self-efficacy and resilience and outcomes of glycosylated hemoglobin, quality of life and health status. A cross sectional descriptive design was used for this pilot study of 78 individuals enrolled from an Endocrine clinic in the Midwest United States and a Primary Care clinic in the southeast United States.
Data were analyzed using descriptive statistics to characterize the sample and model variables. Spearman’s correlation was completed to identify relationships among variables. A …
Inhibition Of Cancer Stem Cells By Glycosaminoglycan Mimetics, Connor P. O'Hara
Inhibition Of Cancer Stem Cells By Glycosaminoglycan Mimetics, Connor P. O'Hara
Theses and Dissertations
Connor O’Hara July 29, 2019
Inhibition of Cancer Stem Cells by Glycosaminoglycan Mimetics
In the United States cancer is the second leading cause of death, with colorectal cancer (CRC) being the third deadliest cancer and expected to cause over 51,000 fatalities in 2019 alone.1 The current standard of care for CRC depends largely on the staging, location, and presence of metastasis.2 As the tumor grows and invades nearby lymph tissue and blood vessels, CRC has the opportunity to invade not only nearby tissue but also metastasize into the liver and lung (most commonly).3 The 5-year survival rate …
The Role Of Psychosocial And Health Behavioral Factors In Pregnancy Induced Hypertension, Sylvia Sreeparna Rozario
The Role Of Psychosocial And Health Behavioral Factors In Pregnancy Induced Hypertension, Sylvia Sreeparna Rozario
Theses and Dissertations
Background: Pregnancy induced hypertension (PIH) is the leading cause of maternal mortality and a major contributor to preterm birth and neonatal mortality. Literature suggests that several modifiable psychosocial and health behavioral factors may play significant roles in the development of PIH. However, interrelationships among these factors and their collective impact on PIH are not well understood.
Objectives: This study aims to: 1) Examine the relationship between pre-pregnancy physical activity and risk of PIH, 2) Determine the association between prepregnancy depression and PIH and the role of race/ethnicity in this association, 3) Evaluate the association between intimate partner violence (IPV) in …
The Effects Of Long-Term Deafness On Density And Diameter Of Dendritic Spines On Pyramidal Neurons In The Dorsal Zone Of The Feline Auditory Cortex, Rachel J. Bauer
The Effects Of Long-Term Deafness On Density And Diameter Of Dendritic Spines On Pyramidal Neurons In The Dorsal Zone Of The Feline Auditory Cortex, Rachel J. Bauer
Theses and Dissertations
Neuroplasticity has been researched in many different ways, from the growing neonatal brain to neural responses to trauma and injury. According to recent research, neuroplasticity is also prevalent in the ability of the brain to repurpose areas that are not of use, like in the case of a loss of a sense. Specifically, behavioral studies have shown that deaf humans (Bavalier and Neville, 2002) and cats have increased visual ability, and that different areas of the auditory cortex enhance specific kinds of sight. One such behavioral test demonstrated that the dorsal zone (DZ) of the auditory cortex enhances sensitivity to …
Incidence And Predictor Variables Of Pressure Injuries In Patients Undergoing Ventricular Assist Device And Total Artificial Heart Surgeries: An Eight-Year Retrospective Review, Christopher T. Brindle
Incidence And Predictor Variables Of Pressure Injuries In Patients Undergoing Ventricular Assist Device And Total Artificial Heart Surgeries: An Eight-Year Retrospective Review, Christopher T. Brindle
Theses and Dissertations
BACKGROUND
Cardiac surgery patients have some of the highest reported incidence and prevalence of pressure injuries (PI). A growing subset of cardiac surgery include patients with end-stage heart failure who undergo ventricular assist device (VAD) or total artificial heart (TAH) surgery. The risk of PI and their natural history of development in this population are unknown and the specific risk factors for PI development remain unexplored.
OBJECTIVES
To perform a systematic review of the literature to identify the incidence and risk factors of PI development in patients undergoing VAD-TAH surgery and thereby inform study design and variables in an eight-year …
Chemical Characterization Of Pseudognaphalium Obtusifolium By Gas Chromatography - Mass Spectrometry (Gc-Ms) To Assess Potential Therapeutic Phytochemicals And Toxicological Concerns Using Simulated Use Conditions, Regina Ballentine
Theses and Dissertations
Chemical Characterization of Pseudognaphalium obtusifolium by Gas Chromatography – Mass Spectrometry (GC-MS) to Assess Potential Therapeutic Phytochemicals and Toxicological Concerns Using Simulated Use Conditions
By Regina Ballentine
Virginia Commonwealth University, 2019
Director: Sarah C. Rutan, Professor, Department of Chemistry
Currently, there is an increasing demand for natural therapies and herbal products to treat various ailments. It is generally believed that natural therapies have fewer side-effects than traditional western medicine; however, they are often used in different strengths and formulations without consistency of the levels of target compounds or knowledge about toxicity. Due to this growing trend, a comprehensive chemical evaluation …
Adaptation And Validation Of The Situation Awareness Global Assessment Technique For Student Registered Nurse Anesthetists, Deniz Dishman
Adaptation And Validation Of The Situation Awareness Global Assessment Technique For Student Registered Nurse Anesthetists, Deniz Dishman
Theses and Dissertations
Anesthesia is a health care specialty fraught with high workload demands, stressful work environments, increased production pressure, work areas with many distractions, an increasing use of advanced technology, and the constant need to prioritize work actions. Effective clinical judgment in this dynamic environment necessitates that the provider demonstrate the ability to project what may occur secondary to actual or potential condition changes. These key elements operationalize situation awareness (SA).
High level SA is an important characteristic for the successful development of student registered nurse anesthetists (SRNAs). With Endsley’s “Theory of Situation Awareness” as the foundation, the goal of this study …
Development Of Bivalent Ligands Targeting The Putative Mu Opioid Receptor And Chemokine Receptor Cxcr4 Heterodimer, Bethany A. Reinecke
Development Of Bivalent Ligands Targeting The Putative Mu Opioid Receptor And Chemokine Receptor Cxcr4 Heterodimer, Bethany A. Reinecke
Theses and Dissertations
Human immunodeficiency virus (HIV) and opioid abuse have been described as synergistic epidemics. Pharmacologically, it has been found that opioids have the capacity to enhance HIV infection and replication. Research has shown that activation of the mu-opioid receptor (MOR) elevates the expression of the HIV-1 entry co-receptor CXCR4 on T-lymphocytes in the peripheral nervous system, thus allowing for enhanced viral entry and invasion. Although the exact mechanism for opioid modulation of CXCR4 expression and subsequent exacerbation of HIV is unknown, several hypotheses exist. One hypothesis is that MOR and CXCR4 are functionally interacting through the formation of a heterodimer. This …
Use Of Emoji In Pain Level Assessment In Pediatric Dental Patients, Manpreet K. Dhillon
Use Of Emoji In Pain Level Assessment In Pediatric Dental Patients, Manpreet K. Dhillon
Theses and Dissertations
USE OF EMOJI IN PAIN LEVEL ASSESSMENT IN PEDIATRIC DENTAL PATIENTS
Purpose: The purpose of this study is to determine the efficacy of a pain scale with Emoji images in comparison to the commonly used Wong-Baker FACES® pain scale. Methods: Healthy, English-speaking patients aged 4-17 presenting to the VCU Pediatric Dental clinic and the operating room and presenting to the MCV Pediatric Emergency Room were asked to rate their pain using the Wong-Baker FACES® and Emoji scales. These patients were then asked to select which pain scale they preferred. Results: A total of 151 children were enrolled in the study. …
Comparison Of Triple Combination Oral Sedation Regimens For Pediatric Dental Treatment, Brett H. Henderson
Comparison Of Triple Combination Oral Sedation Regimens For Pediatric Dental Treatment, Brett H. Henderson
Theses and Dissertations
Purpose: Compare the efficacy of two benzodiazepines (diazepam or midazolam) in combination with meperidine and hydroxyzine for pediatric dental sedation. Methods: A randomized, double blind observation study of behaviors and outcomes related to two sedation groups. Frankl and Houpt behavior scores were recorded at three time points: injection time, initiation of treatment and at the end of treatment. Postoperative phone call surveys were conducted within eight hours of discharge to assess sleep, activity, and behavior. Results: A total of 40 sedation subjects were included in the study, of which 20 were treated with diazepam triple Combination (Di+M+H) and 20 with …
Therapeutic Targeting Of Relaxin Signaling In Ischemic Heart Disease, Siva Teja Vk Devarakonda
Therapeutic Targeting Of Relaxin Signaling In Ischemic Heart Disease, Siva Teja Vk Devarakonda
Theses and Dissertations
Ischemic heart disease is characterized by reduced perfusion of oxygenated blood to the myocardium, potentially resulting in infarction upon occlusion of coronary arteries. While prompt reperfusion and advances in in-hospital care have led to a decline in short term mortality, sustained damage to the ventricle, along with reperfusion injury, can lead to progressive deterioration in cardiac function. Limiting the extent of this initial ischemia-reperfusion injury and combating the course of adverse remodeling remains the scope of several preclinical studies geared towards improving cardiac health after MI. To this, relaxin-2 – the peptide hormone that regulates maternal hemodynamic function during pregnancy …
Glycosaminoglycan Mimetics For The Treatment Of Cancer And Lung Inflammation, Shravan Morla
Glycosaminoglycan Mimetics For The Treatment Of Cancer And Lung Inflammation, Shravan Morla
Theses and Dissertations
Glycosaminoglycans (GAGs) are linear polysaccharides whose disaccharide building blocks consist of an amino sugar and either uronic acid or galactose. They are expressed on virtually all mammalian cells, usually covalently attached to proteins, forming proteoglycans. GAGs are highly negatively charged due to an abundance of sulfate and carboxylic acid groups, and are structurally very diverse, with differences arising from chain length, the type of monomeric units, the linkages between each monomeric unit, the position of sulfate groups, and the degree of sulfation. GAGs are known to interact with a multitude of proteins, impacting diverse physiological and pathological processes. In addition, …
Antibiotics And Antimicrobial Resistance: An Evaluation Of The Knowledge, Attitude And Perception Among Dental Students And Academic Deans And Department Chairs Within U.S. Dental Schools, Magdalena S. Holz
Theses and Dissertations
Purpose: This study aimed to survey current 3rd and 4th year dental students, academic deans, and department chairs within U.S. dental schools to analyze the level of understanding; education; guidelines; and overall awareness regarding antibiotic use within dentistry and antimicrobial resistance.
Methods: A 25-question survey intended for 3rd and 4th year dental students and a 20-question survey intended for academic deans and various department chairs of U.S dental schools were each developed utilizing REDCap. The survey invitations were sent via e-mail to the current academic dean of each U.S. dental school for distribution.
Results: There were …
Designing Biomimetic Implant Surfaces To Promote Osseointegration Under Osteoporotic Conditions By Revitalizing Mechanisms Coupling Bone Resorption To Formation, Ethan M. Lotz
Theses and Dissertations
In cases of compromised bone remodeling like osteoporosis, insufficient osseointegration occurs and results in implant failure. Implant retention relies on proper secondary fixation, which is developed during bone remodeling. This process is disrupted in metastatic bone diseases like osteoporosis. Osteoporosis is characterized low bone mass and bone strength resulting from either accelerated osteoclast-mediated bone resorption or impaired osteoblast-mediated bone formation. These two processes are not independent phenomena. In fact, osteoporosis can be viewed as a breakdown of the cellular communication connecting bone resorption to bone formation. Because bone remodeling occurs at temporally generated specific anatomical sites and at different times, …