Medicine and Health Sciences Commons^™

Medication Adherence Between Long-Acting Injectable And Oral Antipsychotic Medications In South Carolina Medicaid Beneficiaries With Schizophrenia, Pujing Zhao

Theses and Dissertations

Background: Schizophrenia is a chronic and serious mental disorder that affects millions of individuals worldwide. A recent study shows the prevalence of schizophrenia globally is about 1%. The primary schizophrenia treatment goal is to effectively manage symptoms and prevent relapses. Antipsychotic medications are very important for the treatment of schizophrenia. However, the prevalence of nonadherence to antipsychotic medication is high, with mean rates reaching 41.2%. In the realm of schizophrenia treatment, two primary categories of medications are utilized: long-acting injectable antipsychotics (LAI) and oral antipsychotic agents (OAP).LAI are administered at intervals spanning from two weeks to several months and have …

Assessing The Effects Of Repetitive Mild Traumatic Brain Injury On Risk/Reward Decision Making And Catecholamine Associated Proteins, Christopher Knapp

Theses and Dissertations

Mild traumatic brain injury (mTBI) disrupts cognitive processes that influence risk taking behavior; however, the effects of repetitive mild injury (rmTBI) or whether these outcomes are sex specific are unknown. Risk/reward decision making is mediated by the prefrontal cortex (PFC), which is densely innervated by catecholaminergic fibers. Aberrant PFC catecholamine activity has been documented following TBI and may underlie TBI-induced risky behavior. Here, we exposed rats to sham (no injury), single, or three closed-head controlled cortical impact (CH-CCI) injuries to characterize the effects of rmTBI on 1) risk/reward decision making behavior using a probabilistic discounting task (PDT) and 2) levels …

Manufacturing Of Aligned Electrospun Nanofiber Yarns For Their Enhanced Mechanical And Piezoelectric Properties, Adaugo Mary-Frances Enuka

Theses and Dissertations

Electrospinning is a widely used technique for producing nanofibers with diverse applications. This method uses polymer solutions and strong electric fields to generate nano-sized fibers with unique properties. This study presents a novel manufacturing approach that enables the production of electrospun poly(vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) nanofiber yarns using an automated parallel track system and an adjustable roll-to-roll collector. This research examines the impact of an automated post-drawing system on the polymer chain orientation, crystallinity, tensile strength, morphology, and piezoelectric properties of PVDF-HFP nanofiber yarn. The results reveal that the post-drawing process significantly improves molecular alignment, increases tensile strength, and enhances the …

Chemotherapy Drug Release From Hollow Core Polyethyleneimine Nanoparticles, Brian Boyle

Theses and Dissertations

Novel anticancer delivery vehicles are arising from engineered nanostructured materials. This work involved the synthesis, characterization, and release of novel hollow core polymeric nanoparticles (HCPNPs) for controlled drug delivery. Polyethyleneimine (PEI) was bound to AuNPs, forming polymer-shell nanoparticles with dissolution of the gold core via iodine forming HCPNPs with drug intercalated DNA bound to the surface. A high density (85 molecules/particle) of DNA intercalated with daunorubicin was conjugated. Particles were spherical with an average diameter of 105.7 ± 17.3 nm and zeta potential of 20.4 ± 3.54 mV. We hypothesize the DNA backbone electrostatically condensed to the primary amines on …

Potent And Selective Small Molecule Mcl-1 Inhibitor Demonstrates Anti-Myeloma Activity And Overcomes Chemotherapy Resistance, Omar Sami Faleh Al-Odat

Theses and Dissertations

Despite a record number of clinical studies investigating various anti-myeloma treatments, the 5-year survival rate for multiple myeloma (MM) patients in the US is only 55%, and nearly all patients relapse. Poor patient outcomes demonstrate that myeloma cells are "born to survive” which means they can adapt and evolve following treatment. Thus, new therapeutic approaches to combat survival mechanisms and target treatment resistance are required. Importantly, Mcl-1, anti-apoptotic protein, is required for the development of MM and treatment resistance. This study looks at the possibility of KS18, a selective Mcl-1 inhibitor, to treat MM and overcome resistance. Our investigation demonstrates …

Deciphering The Microbial Fingerprint Of Covid-19: A Multi-Layered Exploration Of The Oral And Gut Microbiome Dysbiosis, Iman Mostafa Sultan

Theses and Dissertations

The impact of SARS-CoV-2 infection on the human microbiome remains a dynamic and intricate puzzle. This study delves deeper into this mystery by revisiting the oral and gut microbial compositions of 53 COVID-19 patients before and after viral clearance, alongside comparisons to 76 healthy individuals. Through a comparative lens, we have emploed two distinct differential abundance methods – DeSeq2 and ANCOM – while drawing upon the thorough SILVA database encompassing the full-length 16S rRNA gene. The analysis underscores the crucial role of a diverse methodological choir in microbiome research. In certain instances, the congruence between DeSeq2 and ANCOM may exhibit …

Effect Of Plumbagin On Chemo-Resistant Metastatic Retinoblastoma, John J. Soto

Theses and Dissertations

Retinoblastoma, which is an ocular malignancy, usually results in poor prognoses in pediatric patients worldwide. Retinoblastoma in some events, can develop metastatic phenotypes which can lead to secondary tumor formation, furthering deleterious patient outcomes. It is of paramount importance to identify and research potent novel compounds that can be used to increase the likelihood of remission. Plumbagin (PLB) is a plant-derived, neuroprotective agent, which exhibits significant anticancer activities during in vitro study. PLB has been shown to have a high therapeutic efficacy against chemoresistant sublines as well as their normal counterparts. We attempted to show that the chemoresistant ABCC1 could …

Integrated Computational Approaches: Elucidating Molecular Mechanisms Of Pathogenic Proteins And Designing Novel Inhibitors Against Mycobacterium Tuberculosis And Sars-Cov-2, Justin David Carbone

Theses and Dissertations

Chapter 1 introduces computational strategies in computer aided drug design (CADD), focusing on physics-based methodologies to enhance drug discovery. This chapter also discusses the theoretical foundations and practical applications of molecular dynamics (MD) simulations including free energy and stochastic kinetic analysis. In Chapter 2, CADD methods lead to development of inhibitors targeting the RNA Dependent RNA Polymerase (RdRP) of SARS-CoV-2. Inspired by the nucleotide inhibitor Molnupiravir, we aim to design a combinatorial library of 72 novel inhibitors capable of impeding a dual threat inhibition mechanism inducing lethal mutations along with stalling viral replication with specific selectivity to RdRp over Human …

The Inflammatory Exposome Of Major Depressive Disorder In An Egyptian Sample, Reem Deif

Theses and Dissertations

Major depressive disorder (MDD) has been recognized as a global public health concern affect-ing the lives of 264 million people with increasing prevalence worldwide. Inspired by the expo-somic research, this study aims to investigate the dynamic and complex interplay between dif-ferent demographic, lifestyle, environmental factors and bimolecular factors that are potentially involved in the pathology of MDD in a sample of Egyptian adults living in Cairo. This is in an attempt to acknowledge the biological underpinnings of MDD without underestimating the role of environmental influences. The context of Egypt provides richness to the current study given the national transition from …

Validation Of Harmonized Cognitive Assessment Protocol (Hcap) In Egypt: A Sub Study Of The Egyptian Longitudinal Study Of Aging (Al-Seha), Sara Ayman Moustafa

Theses and Dissertations

Abstract Building upon the insights gained from the AL-SEHA pilot study, which underscored the pressing need for comprehensive cognitive assessment tools in Egypt, a subsequent research initiative was launched. This initiative sought to address the escalating burden of dementia and Alzheimer's Disease Related Dementias (ADRD) by adapting and validating the Harmonized Cognitive Assessment Protocol (HCAP) for the Egyptian context. The validation study, conducted with 300 participants aged 55 and over, drawn from diverse backgrounds and healthcare settings in Cairo, Mansoura, and Beni Suef, demonstrated the HCAP's effectiveness across different age and education levels within the Egyptian population. The tool exhibited …

Effect Of Cystic Fibrosis Transmembrane Conductance Regulator (Cftr) Loss In Lung Adenocarcinoma (Luad), Marilyn G. Vallejo Alvarez

Theses and Dissertations

Lung adenocarcinoma (LUAD) is the most common form of non-small cell lung cancer in the United States and is a major cause of cancer-related mortality. Patients with LUAD experience severe pulmonary symptoms and often progress to metastatic disease. Our previous work has shown that LUAD cells downregulate lung cell identity programs across cancer progression such as genes involved in the maintenance of epithelial barrier integrity. For example, CFTR (Cystic Fibrosis Transmembrane Conductance Regulator), a water and bicarbonate channel, is expressed in normal alveolar type 2 (AT2) cells and is downregulated in cells that give rise to LUAD. Although the loss …

Using Rapid Protein Degradation To Determine The Effect Of Runx1 Loss-Of- Function On Dna Damage Accumulation And Repair., Jackriel Pina Morales

Theses and Dissertations

Germline mutations in RUNX1 are associated with familial platelet disorder with a predisposition to myeloid malignancy (RUNX1-FPDMM), in which patients present with low platelet counts,excessive bleeding and bruising, and an increased risk of Acute Myeloid Leukemia (AML)/Myelodysplastic Syndrome (MDS) development throughout their lifetime. To understand how these loss-of-function mutations in RUNX1 drive predispose to malignancy, it is important to develop a detailed understanding of the molecular basis of RUNX1 function. While RUNX1 is a transcription factor, preliminary data from our group and work from others suggests that RUNX1 also interacts with proteins that are critical for DNA damage …

Exploring Caregiver Support For Advanced Practice Nurses Following An Error, Sunnie Lee Nield

Theses and Dissertations

Advanced Practice Registered Nurses (APRN) are a growing population of employed individuals within the healthcare system, working in outpatient and inpatient settings. Like other healthcare professionals, nurse practitioners can and do make errors while practicing. Nevertheless, little to no research has focused on them. This research aimed to better understand nurse practitioners' attitudes towards error approach, perception, and cause using the Medical Error Attitude Scale (MEAS). Additional purposes included the further exploration of APRNs' experiences following an error and support they may or may not receive. A convenience sample of ARPNs licensed in Utah was sent an electronic survey via …

Psychological Safety Of Pre-Licensure Nursing Students: A Longitudinal, Qualitative Study, Laura Butler

Theses and Dissertations

Background: Previous studies have explored the concept of psychological safety among pre-licensure nursing students; however, the literature is notably sparse on personal descriptions of pre-licensure nursing students' experiences of psychological safety in clinical settings. Individual descriptions of psychological safety will provide added insight and understanding about the elements that shape psychological safety in pre-licensure nursing students. Objectives: This research aimed to longitudinally explore pre-licensure nursing students' experiences of psychological safety during clinical rotations and how their experiences of psychological safety change over time. Methods: This study used a longitudinal, qualitative, descriptive approach. Participants were recruited from a nursing program in …

Evaluating On-Screen Edit Checks For Improving The Quality Of Healthcare Data, Emel Seker

Theses and Dissertations

This study investigates the impact of on-screen edit checks (OSECs) on reducing data entry errors in Electronic Data Capture (EDC) systems, addressing a gap in existing literature on the efficacy of OSECs. Employing a crossover experimental design, the research utilizes deidentified neonatal opioid withdrawal data from the ACT NOW CE study. Twenty participants were divided into two arms to enter data into an electronic case report form (eCRF): one arm began with OSECs enabled and the other without and transitioned to the opposite halfway through. Each participant processed 20 cases, yielding a total of 130,815 data points across 285 questions …

From Crisis To Aftermath: The Role Of Nursing Professional Development Educators During The Covid-19 Pandemic: A Realist Case Study, Kimberly Kanner

Theses and Dissertations

The purpose of this qualitative, realistic inquiry case study was to examine and understand the experiences of NPD educators as they assisted new graduate nurses transitioning into clinical nursing practice during the COVID-19 pandemic in acute care hospitals in the state of New York. Moreover, this research study sought to understand how the COVID-19 pandemic brought about changes to the NPD educator's role and their ability to assist new graduate nurses transitioning into clinical practice post-pandemic. The sample included NPD educators from acute care hospitals in the state of New York. Data collection included semi-structured interviews and document collection. The …

Pricks And Pills, Anna A. Charles

Theses and Dissertations

"Pricks and Pills" is a collection of audio pieces designed for an online platform where individuals with diabetes can listen to and find emotional support from others who share their experiences. This audio project provides an intimate look into the lives of people navigating the challenges of diabetes. Through heartfelt interviews with individuals and their families, the podcast highlights their journeys, showcasing both their struggles and triumphs.

Bayesian Estimation Of Reproduction Numbers From Distributions Of Outbreaks Sizes: Branching Process Approach, Alberta Araba Johnson

Theses and Dissertations

The Generalized Poisson distribution is useful in modeling epidemiological processes as a branching stochastic processes problem. Our goal is to construct accurate and reliable estimators for the reproduction number (R0) (i.e., the number of secondary infections), particularly in the context of disease outbreaks modeled by a Galton-Watson process. Towards this goal, we construct the classical Bayes estimator, the Maximum Likelihood estimator, and the Empirical Bayes (EB) estimator under the Square Error Loss function in Chapter II. We prove that the Empirical Bayes estimator is asymptotically optimal and estimate the rate of convergence. We then proceed to monotonize the Empirical Bayes …

Representation Learning For Generative Models With Applications To Healthcare, Astronautics, And Aviation, Van Minh Nguyen

Theses and Dissertations

This dissertation explores applications of representation learning and generative models to challenges in healthcare, astronautics, and aviation.

The first part investigates the use of Generative Adversarial Networks (GANs) to synthesize realistic electronic health record (EHR) data. An initial attempt at training a GAN on the MIMIC-IV dataset encountered stability and convergence issues, motivating a deeper study of 1-Lipschitz regularization techniques for Auxiliary Classifier GANs (AC-GANs). An extensive ablation study on the CIFAR-10 dataset found that Spectral Normalization is key for AC-GAN stability and performance, while Weight Clipping fails to converge without Spectral Normalization. Analysis of the training dynamics provided further …

Examining Time Spent On Social Media And Its Effects On Mental Health In Terms Of Body Image Concerns, Self Esteem And Overall Quality Of Life Among U.S. Adults, Rigel Macarena Pinon

Theses and Dissertations

Daily exposure and dependence on computer-based technologies (smartphones) allows for 24/7 constant access to social media (i.e., Facebook, Instagram, Twitter, YouTube, TikTok, and other sites) and has empirically shown to have a positive and negative impact on the mental health of individuals across cultures in our society. Depending on user intent, exposure, and interests, social media platforms can create a sense of community; however, some of the platforms and what users post about themselves has led to cyberbullying, low self-esteem, user addiction, suicide, self-harm behaviors such as eating disorders, sexual dysfunction, and other mental health issues such as depression and …

To Decipher Genomic Evolution Of Dengue Virus And To Probe The Activation Mechanism Of A Her2 Directed Chimeric Antigen Receptor Toward Computer Aided Drug Design (Cadd), Mariya Hryb

Theses and Dissertations

This study encompasses three significant chapters focusing on diverse yet interconnected aspects of pharmaceutical research. Chapter 1 delves into the complexities of drug development, emphasizing the challenges and the pressing need for advanced technologies to streamline the process. Computational methods like Computer-Aided Drug Design (CADD) extend their scope beyond small molecules, aiding in the design of intricate biomolecules vital for biomedical advancements, especially in immunotherapy. Chapter 2 introduces the Near-Neutral Balanced Selectionist Theory (NNBST) validated through analysis of Dengue virus evolution. The unique features observed align with NNBST, surpassing existing theories. This approach offers a deeper understanding of viral evolution …

Tunable Dual-Phase Dual-Drug Delivery System Using A Plga Microparticle/Pva Hydrogel Composite, Timothy John Eck

Theses and Dissertations

Current drug-eluting coatings have demonstrated controlled long-term, sustained release but have only tried to mitigate short-term burst release as a negative side effect. For applications like wound healing, there is a need for a drug-eluting coating which is adjustable in both short- and long-term release, independent of each other. We present a tunable dual-phase dual-drug delivery coating composed of drug-loaded polymer microparticles and drug-loaded hydrogel which can control short term and long term release individually in this study. This coating was created using lidocaine and dexamethasone encapsulated in poly(D,L-lactide-co-glycolide) particles combined with lidocaine- and dexamethasone-loaded poly(vinyl alcohol) hydrogel. Hydrogel drug …

Association Between Direct Access Laws And Physical Therapy Use And The Effect Of Change In Physical Therapy Use On Subsequent Healthcare Spending, Utilization, And Opioid Use, Dakshu Jindal

Theses and Dissertations

Background

Physical therapy (PT) has been recommended as the first-line treatment for patients with incident musculoskeletal conditions without severe trauma. Initial or early use of PT may help address some of the nation’s most pressing health policy challenges, including escalating healthcare spending and an ongoing opioid epidemic, by encouraging the use of physical therapy as a substitute for expensive surgeries and the use of opioids. Yet, state scope of practice laws have historically restricted the diagnosis and treatment of medical conditions to physicians. Traditionally, patients seeking care from a physical therapist had to obtain a referral from a physician first. …

Personal Dosimeter Testing For High Altitude Air Crew, Seth D. Bacon

Theses and Dissertations

In 2014 the Thermo Scientific N2 electronic personal dosimeter became the aircrews’ sole means to record ionizing radiation dose. The production of this dosimeter was discontinued in July of 2021, motivating the Air Force to seek a flight-certifiable replacement. The Thermo Scientific Trudose NG, Mirion DMC 3000, and Fuji NRF-51 electronic personal dosimeters, as well as the Landauer InLight optically stimulated luminescent dosimeter, were subjected to mixed gamma and fast neutron fields simulating a high-altitude flight environment. Dosimeters are evaluated on their consistency and accuracy in reporting dose and compared to the current N2 dosimeter’s reported dose.

Utilization Of The System Engineering Design Process To Design And Test A Low-Cost Infectious Aerosol Control Mechanism For Patient Aeromedical Evacuation, Sara Shaghaghi

Theses and Dissertations

The aeromedical evacuation of military patients is a critical component of care for Armed Forces members. The Air Force’s ability to transport patients relies on the technology and systems available. A vital transport responsibility is keeping the patient and medical personnel safe during transport. The historical and legacy systems provide reliable transport mechanisms for the Armed Forces’ patients infected with high-level biological agents, but drawbacks must be considered. This dissertation will discuss the development, conceptual design, and initial evaluation of a new low-cost, litter-mounted patient transport system, Biological-Mitigation in Patient Transport (B-MIPT), using the “V” model of the system engineering …

Radiological Decontamination Methodologies On Litter-Bound Patients In Arctic Environments, And The Associated Airborne Risks Posed To First Responders, Juan S. Alb

Theses and Dissertations

This study was conducted to determine if air-based decontamination (decon) methods would be effective at both treating patients exposed to dry, radiological contamination as well as reducing its re-aerosolization during the disrobing process, such that these methods could be applied on litter-bound patients in extreme cold environments. A litter-bound, full-size mannequin dressed in a set of standard military issue extreme cold weather jacket and pants coated in 27 g (1 Tbs) of Copper Oxide (density 6.315 g/cm³ ) was given one of three treatments for dry aerosol decon. The three cleaning treatments included high-efficiency particulate air (HEPA) vacuum, a …

Retrospective Cohort Study Of Pure Tone Audiometry Hearing Changes From Ototoxic Metalsand Solvents, Continuous Noise, And Impulse Noise Exposures At Hill Air Force Base From 2005 To 2019, Zachary I. Johnson

Theses and Dissertations

This retrospective cohort epidemiological study investigated the relative risks of hearing loss associated with ototoxicants in combination with noise exposure. Utilizing Department of Defense (DoD) industrial hygiene and hearing conservation data, this research expanded on a 2020 thesis conducted on Tinker Air Force Base (AFB), applying a similar methodology to Hill AFB, adding 893 evaluated individuals. Grouped into twelve exposure combinations with a minimum of three years of exposure duration, the study assessed various hearing loss indicators, including DoD Standard Threshold Shift (STS) and NIOSH STS. Ototoxic substances consistently elevated relative risk (RR) compared to noise-only exposure groups, but none …

Measuring The Comparative Performance Of Usaf Behavioral Health Clinic Operations: Emphasis On Capacity, Daniel L. Straw

Theses and Dissertations

This research examines the operations of behavioral health clinics in Air Force Continental United States facilities, with a focus on operational efficiency and capacity through Data Envelopment Analysis. Most facilities operate near capacity, demonstrating efficient resource usage, but concerns arise with the potential of increased demand. Days-to-care and leakage are identified as major sources of inefficiency, suggesting that addressing these issues can enhance operations and reduce costs. The study also explores the impact of COVID-19 on care delivery.

An Investigation Of Torso Muscle Fatigue And Its Relation To Discomfort During Vertical Vibration Exposure, Nathan H. Hodges

Theses and Dissertations

Military and civilian helicopter pilots often experience back pain attributed to vibration exposure during flight and sustained poor posture, known as the "helicopter hunch." This study investigated torso muscle activation using surface electromyography (EMG) to assess the relationship between discomfort and muscle fatigue. Eight subjects were exposed to different vibration frequencies over two-hour periods, with EMG data collected every five minutes. Significant differences in muscle activation were observed before and after vibration exposure, suggesting increased muscle activation during vibration compared to prolonged seating alone. Discomfort surveys indicated higher discomfort during vibration.

" Does Educational Level Affect The Outcome Of Myocardial Infarction? ", Ahmed Magdy Ahmed Elsayed

Theses and Dissertations

Background: Heath awareness plays a major role in determining the outcomes of serious medical conditions specially when response time is crucial. STEMI patients are prone to serious compilations if they didn’t receive the appropriate treatment on time. Raising the health awareness of the community would result in seeking medical help at earlier stage of the disease. Earlier presentation to the medical center would result in better health outcomes. Certain factors form the health awareness of the community. This includes educational level, previous exposure to similar situations, and exposure to health awareness materials.

Methods: This is a cohort study in …