Medicine and Health Sciences Commons^™

The Prevalence, Predictive Factors, And Classification Of Intrapulpal Cracks In Maxillary Molars Requiring Endodontic Treatment, Husain Karashi

Theses and Dissertations

Diagnosis and treatment of teeth with longitudinal fractures is challenging. Cracks are usually not visible radiographically; they require a thorough evaluation to aid in diagnosis. Patients may be asymptomatic, demanding the dentist rely on clinical findings to make a diagnosis. Early diagnosis of the presence and extent of a crack is essential for the successful management of a cracked tooth. There is limited information in the literature regarding the prevalence or predictive factors of cracks extending into the pulp chamber of teeth. The purpose of this study was to determine the prevalence of intrapulpal cracks in maxillary molars and to …

The Impact Of Perceived Mental Illness Stigma On Caregivers’ Desire To Relinquish Care, Tyler R. Corson

Theses and Dissertations

Caregiving can be stressful, and older adults’ health and well-being may be impacted by the roles and responsibilities they assume as caregivers for persons with serious mental illness (SMI). This study is the first to apply the Stress Process Model of Caregiving (SPM) in an attempt to understand how mental illness stigma influences caregiver outcomes, specifically their desire to relinquish care. The intent of this study was to call attention to care relinquishment as an under-studied stress process outcome and to explore stress factors, with a focus on mental illness stigma, that contribute to SMI caregivers’ desire to relinquish care. …

The Influence Of Genetic And Environmental Factors On Quit Attempt In Adolescent And Young Adult Twins, Gladys Langi

Theses and Dissertations

The purpose of this study was to examine the genetic and environmental influences on lifetime quit attempt in three US adolescent and young adult twin samples (N total = 6,322). The study utilized a common-contingent-causal (CCC) model to estimate these factors for lifetime quit attempts, after accounting for the factors for lifetime cigarette use and cigarettes per day. The study also examined age and sex differences, as well as the degree of relationship between these smoking phenotypes. The results demonstrated significant genetic influences for lifetime quit attempts in adolescents and young adults. No sex differences were observed for the contributions …

Profiling Precursor Lipids For Specialized Pro-Resolution Molecules In Platelet-Rich Fibrin Following Fish Oil And Aspirin Intake, Danielle M. Mccormack

Theses and Dissertations

Background: Current research has demonstrated that aspirin and fish oil (EFA) increase plasma levels of specialized pro-resolution molecules (SPMs). This study investigates their effects on SPM precursor pools in platelet rich fibrin (PRF). Methods: Twenty healthy volunteers were randomly assigned to take aspirin; EFA or aspirin and EFA. Four hours later, SPM precursor levels were quantified using combined Liquid Chromatography tandem mass spectrometry. The differences between the groups: Aspirin (yes or no), EFA (yes or no), were analyzed by ANCOVA, testing for group differences after covarying out the baseline value. Results: There were 4 significant interactions, 1 with an aspirin …

Profiling Precursor Lipids For Specialized Pro-Resolution Molecules In Platelet-Rich Plasma Following Fish Oil And Aspirin Intake, Lisa A. Turner

Theses and Dissertations

Background: Unfavorable outcomes following periodontal surgeries can be attributed to impaired resolution mechanisms likely due to decreased levels of specialized pro-resolution molecules (SPM). The current study investigates if SPM substrate pools in platelet-rich plasma preparations (PRP) can be increased by essential fatty acid (EFA) and / or aspirin supplementation. Methods: Nineteen healthy volunteers were randomly assigned to take i) aspirin; ii) EFA; iii) aspirin and EFA. Four hours after intake, the lipid precursor pools in PRP were quantified using combined Liquid Chromatography tandem mass spectrometry (LC-MS/MS) and the data statistically analyzed using ANCOVA. Results: Of the 77 metabolites screened, only …

Weighted Quantile Sum Regression For Analyzing Correlated Predictors Acting Through A Mediation Pathway On A Biological Outcome, Bhanu M. Evani

Theses and Dissertations

Abstract

Weighted Quantile Sum Regression for Analyzing Correlated Predictors Acting Through a Mediation Pathway on a Biological Outcome

By

Bhanu M. Evani, Ph.D.

A thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2017.

Major Director: Robert A. Perera, Asst. Professor, Department of Biostatistics

This work examines mediated effects of a set of correlated predictors using the recently developed Weighted Quantile Sum (WQS) regression method. Traditionally, mediation analysis has been conducted using the multiple regression method, first proposed by Baron and Kenny (1986), which has since …

An Investigation Of Surface Characteristics Of Enamel Treated With Infiltrative Resin: A Scanning Electron Microscopy Study, Danielle E. Easterly

Theses and Dissertations

AN INVESTIGATION OF SURFACE CHARACTERISTICS OF ENAMEL TREATED WITH INFILTRATIVE RESIN: A SCANNING ELECTRON MICROSCOPY STUDY

Danielle E. Easterly, Doctorate of Dental Surgery.

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University.

Virginia Commonwealth University. 2017.

Director: Dr. Eser Tüfekçi

D.D.S., M.S., Ph.D., M.S.H.A.

Objective: To evaluate the microstructural changes of a resin infiltrant (ICON®, DMG America LLC, Englewood, NJ) after six months of simulated toothbrushing.

Materials and Methods: Ten extracted third molars (n=10) were collected. Artificial white spot lesions were created and resin applied. Environmental SEM …

Work-Related Musculoskeletal Disorders Among Dentists And Orthodontists, Natalie R. La Rochelle

Theses and Dissertations

WORK-RELATED MUSCULOSKELETAL DISORDERS AMONG DENTISTS AND ORTHODONTISTS

A thesis submitted in partial fulfillment of the requirements for the degree of

Master of Science in Dentistry at Virginia Commonwealth University.

by

Natalie R. La Rochelle

Thesis Director: Dr. Eser Tüfekçi, D.D.S., M.S., Ph.D., M.S.H.A.

Professor, Department of Orthodontics

Virginia Commonwealth University

Richmond, Virginia

May 2017

The practice of dentistry is physically demanding due to static and dynamic postures sustained daily throughout careers. Previous literature suggests that work-related musculoskeletal disorders (WMSD) are not solely the result of work habits, but also due to the individual, his or her physical makeup, genetics, and …

Design, Synthesis, And Biological Screening Of Selective Mu Opioid Receptor Ligands As Potential Treatments For Opioid Addiction, Samuel Obeng

Theses and Dissertations

Today, more Americans die each year because of drug overdoses than are killed in motor vehicle accidents. In fact, in 2015, more than 33,000 individuals died due to an overdose of heroin or prescription opioids. Sadly, 40-60 % of patients on current opioid addiction treatment medications relapse. Studies have shown that the addiction/abuse liability of opioids are abolished in mu opioid receptor (MOR) knock-out mice; this indicates that the addiction and abuse liability of opioids are mainly mediated through MOR. Utilizing the “message-address concept”, the our laboratory reported a novel non-peptide, reversible MOR selective ligand 17-cyclopropylmethyl-3,14β-dihydroxy-4,5α-epoxy-6α (isoquinoline-3-carboxamido)morphinan (NAQ). Molecular modeling …

Walking In Beauty: Responsive And Responsible Health And Healing Among Virginia American Indian People, Amy J. Prorock-Ernest

Theses and Dissertations

Little is systematically known about the collective health and well-being of Virginia American Indian people. This study sought to explore the meaning of health and healing among Virginia American Indian people in the context of a reservation-based, non-federally funded health clinic. Using an emergent approach to qualitative research grounded in a constructivist inquiry paradigm and guided by Indigenous research principles, a total of 24 in-depth, semi-structured interviews were conducted with 17 American Indian service-users of the Clinic. Through an inductive thematic analysis of participant stories, a framework for understanding responsive and responsible health and healing was derived. The framework includes …

Lung Disposition Model-Based Analyses Of Clinical Pharmacokinetic Profiles For Inhaled Drugs, Anuja Raut

Theses and Dissertations

There has been a desire to accurately interpret the inhaled pharmacokinetic (PK) profiles of drugs in humans to aid successful inhaled drug and product developments. However, challenges are layered, as 1) the drug dose delivered to the lung (DTL) from inhalers is a portion of the formulated dose but rarely determined; 2) lung delivery and regional deposition differ, depending on drug, formulation and inhaler; 3) drugs are not only absorbed from the lung but may also be from the gastrointestinal (GI) tract; and 4) in addition to absorption into the systemic circulation, multiple non-absorptive processes also eliminate drugs from the …

Short And Long Chain Free Fatty Acids Differentially Regulate Glucagon-Like Peptide-1 And Peptide Yy Transcript Levels In Enteroendocrine Cells (Stc-1), Colin M. Catherman

Theses and Dissertations

The regulation of glucagon-like peptide-1 and peptide YY hormone levels are regulated based on different influential factors, but primarily levels are dependent upon ingested food content. As meals today become more fat-enriched, there is greater requirement for evaluation of these hormones that regulate insulin and satiety levels within the body. We have shown that the gene expression transcript production of glucagon-like peptide-1 and peptide YY are modulated by different concentrations, and times of short-chain fatty acids and long-chain fatty acids. Although the peptide hormone levels have the influential physiological role on effector tissue, the regulation of these hormones begins at …

A Targeted Approach To Increasing The African American Blood Donor Pool, Arnethea L. Sutton

Theses and Dissertations

A continuous need for blood products, specifically for those who require frequent transfusions, such as individuals with sickle cell disease, warrants the need for targeted interventions to increase blood donations from underrepresented populations. One population in particular, African Americans, only account for 1% of blood donors in the United States. Literature indicates numerous reasons why this population is underrepresented amongst donors, including fear, lack of knowledge about the blood donation, and specific to this population, lack of trust in the medical community. This study involves the development, implementation, and assessment of a targeted educational approach, incorporating the Theory of Planned …

Socioecological Aspects Of Tobacco Use In College Populations, Michael D. Sawdey

Theses and Dissertations

Background: Although cigarette smoking is decreasing in the US and among college students, tobacco use remains a major public health problem. Specific socioecological gaps in the literature related to college tobacco use exist including: trends of tobacco use, combinations of polysubstance use, and availability of tobacco products around college campuses.

Objectives: The main goal of this research was the understand interrelationships that exist within a socioecological framework of college tobacco use. Specifically, this project aims to: 1) examine trends of tobacco and polytobacco use by gender and associations of polytobacco use and perceived peer tobacco use, 2) examine …

The Dual Faces Of Misery, Arden Moscati

Theses and Dissertations

Major Depression (MD) and Generalized Anxiety Disorder (GAD) are psychiatric disorders that arise from dysfunction of the core human capacities for emotion. Sapience is inextricably bound up with the potential for feelings of regret, worry and concern. When these emotions lead to clinically significant impairment or distress, they may result in one or both of the disorders of MD and GAD. The occurrence of MD and GAD in the same person, known as comorbidity, is remarkably high; substantially higher than would be expected by chance.

MD and GAD have been studied since the mid-20^th century, resulting in a substantial …

Altering A Runner’S Foot Strike Using A Modified Elliptical Trainer, Daniel Shull

Theses and Dissertations

One possible solution to common running related injuries is to transition runners from a rearfoot strike during initial contact to a midfoot strike. Natural rearfoot strike runners were studied to see if a modified elliptical trainer could be used to alter their running pattern to that of a midfoot strike runner. Their results were compared to subjects who ran on a non-modified elliptical trainer. After training on the modified elliptical trainer, subjects demonstrated a decrease in foot angle at initial contact when attempting to run with a midfoot strike. Training did not affect all kinetic metrics or stride frequency. However, …

Sustainable Adapted Treatments For Eating Disorders: The Role Of Cultural Adaptation In Prevention, Sarah J. Javier

Theses and Dissertations

Despite demonstrating eating disorder rates equivalent to White women, African American and Asian American women are less likely to seek treatment and are more likely to terminate treatment prematurely. One of the most successful programs for eating disorder prevention has only focused on surface-level cultural adaptations. Prevention literature maintains that deep-structure cultural adaptation (e.g., integrating cultural values and beliefs) can enhance outcomes for ethnic minorities. This dissertation examined the feasibility of Sustainable Adapted Treatments for Eating Disorders (SATED), a pilot intervention that included a culturally- targeted pre-treatment to an eating disorder dissonance-based intervention. A sample of 72 women (ages 18-30) …

Tissue Factor Expression, Regulation, And Signaling In Human Airway Cells, Michael D. Davis

Theses and Dissertations

Rationale: Tissue Factor (TF) is a transmembrane glycoprotein that canonically functions as the initiator of the coagulation cascade. Increased levels of TF have been associated with inflammatory airway diseases. Since lipopolysaccharide (LPS) is known to elicit and inflammatory response in airway epithelium, we hypothesized that airway epithelial cells release TF when exposed to LPS. Since TF aids in local wound healing, we also hypothesized that inhibition of TF would decrease NHBE growth. The specific aim of this work was to evaluate the effects of LPS exposure on TF production and release from airway epithelia and determine the signaling pathways involved. …

Sleep Disturbances And Depression: The Role Of Genes And Trauma, Mackenzie J. Lind

Theses and Dissertations

Sleep disturbances and insomnia are prevalent, with around 33% of adults indicating that they experience at least one main symptom of insomnia, and bidirectional relationships exist with common psychopathology, particularly major depressive disorder (MDD). However, genetic and environmental (e.g., traumatic event exposure) contributions to the etiology of these phenotypes are not yet well understood. A genetically informative sample of approximately 12,000 Han Chinese women aged 30-60 (50% with recurrent MDD) was used to address several gaps within the sleep literature. Sleep disturbances were assessed in all individuals using a general item addressing sleeplessness (GS). A sleep within depression sum score …

Comparison Of Intraoral And Extraoral Scanners On The Accuracy Of Digital Model Articulation, Jason L. Porter

Theses and Dissertations

Introduction: Orthodontists increasingly rely on digital models in clinical practice. The ability of modern scanners to articulate digital models must be scientifically evaluated. Methods:Twenty five digital articulated models were produced from four digital scanners in five experimental groups. The resulting inter-arch measurements were compared to the gold standard. An acceptable range of 0.5mm more or less than the gold standard was used for evaluation. Results: iTero® and iTero® Element yielded all acceptable inter-arch measurements. The 3M™ True Definition and Ortho Insight 3D® with Regisil® bite registration produced four of six acceptable inter-arch measurements. The Ortho Insight 3D® with Coprwax ™ …

Chemical Probes For Protein Α-N-Terminal Methylation, Brianna D. Mackie

Theses and Dissertations

While protein α-N-terminal methylation has been known for nearly four decades since it was first uncovered on bacteria ribosomal proteins L33, the function of this modification is still not entirely understood. Recent discoveries have demonstrated α-N-terminal methylation is essential to stabilize the interactions between regulator of chromosome condensation 1 (RCC1) and chromatin during mitosis, to localize and enhance the interaction of centromere proteins (CENPs) with chromatin, and to facilitate the recruitment of DNA damage-binding protein 2 (DDB2) to DNA damage foci. Identification of N-terminal methyltransferase 1 (NTMT1) unveiled the eukaryotic methylation writer for protein α-N-termini. In addition, NTMT2 that shares …

Examining The Reversal Of Vocal Fold Dehydration Using Aerosolized Saline In An Excised Larynx Model, Maya Elena Stevens

Theses and Dissertations

Previous studies have found vocal fold hydration to be crucial for healthy function of the vocal mechanism. Surface tissue hydration facilitates efficient vocal fold oscillation. The composition of vocal fold surface fluid includes protective water and mucus layers, similar to the fluid that covers the mucosa and epithelia of the upper airway. Laryngeal dehydration has been linked to several factors such as mouth breathing, obstructive sleep apnea, dry air exposure, upper airway hypersensitivity, and certain diseases or behavioral voice use factors. Laryngeal dehydration affects phonation threshold pressure (PTP) and phonation threshold flow (PTF), defined as the pressure and flow observed …

Cause For Question: Risk And Postmodern Panic In The Vaccine Safety Debate, Marygrace Trifilio

Theses and Dissertations

This thesis analyzes the thoughts and feelings of non-vaccinating parents in America and argues that contemporary vaccine refusal results from overwhelming information saturation in the Internet age. Non-vaccinating parents express distrust of competing scientific research and call for a return to a more natural, toxin-free lifestyle.

Development Of Psychometrically Equivalent Speech Recognition Threshold Materials For Native Cebuano Speakers, Melissa Dawn Anderson

Theses and Dissertations

While there is a clear and immediate need for reliable speech audiometry materials to evaluate the speech recognition threshold (SRT), these recorded materials are not available in Cebuano, a language of the Philippines with 15.8 million speakers. The purpose of this study was to develop, digitally record, evaluate, and psychometrically equate a set of Cebuano trisyllabic words for use in measuring the SRT. To create the SRT materials, common Cebuano trisyllabic words were digitally recorded by a male talker of Cebuano and presented for evaluation to 20 native speakers of Cebuano with normal hearing. Based on psychometric performance, a set …

The Ability Of Six Children With Language Impairment To Generate Stories From Pictured Stimuli: A Pilot Study, Molly Roxanne Alldredge

Theses and Dissertations

Narrative production and comprehension is a difficult task for children with language impairment (LI). Their stories are typically shorter and contain more grammatical errors than the stories of typically developing age-matched peers. This pilot study describes the abilities of six children with LI to produce stories from pictured stimuli. Stories were elicited from each child during a 10-week period. Stimulus pictures and coding procedures from the Edmonton Narrative Norms Instrument were employed to analyze the participants' story grammar (SG). Eight SG elements were assessed including character introduction, setting, initiating event (IE), internal response (IR), internal plan (IP), attempt, and outcome. …

Topic Manipulation In Five Children With Language Impairment In Response To Topic Probes, Kimberly Kasey Baker

Theses and Dissertations

This study describes a series of case studies on topic management patterns of five children (ages 5 to 10 years) with language impairment. The children participated in semi-structured topic tasks that assessed conversational abilities on topics that were verbally introduced and topics that were introduced both verbally and with an object. Although there was considerable variability among participants, the children generally responded to most introductions by acknowledging and maintaining the topic. With the exception of one child, however, the children in this study demonstrated immature topic manipulation patterns that could be expected to have negative social ramifications.

Evaluating Practicum Student's' Therapeutic Effectiveness Using Solution Focused Brief Therapy With Mexican American Clients: A Single Case Design, Krystle L. Ortega

Theses and Dissertations

The purpose of this study is to examine the effectiveness of a practicum counseling experience on client therapeutic outcomes using Solution Focused Brief Therapy with Mexican American clients. We implemented a small series (N = 3) single-case research design to assess the effectiveness of SFBT for increasing hope and decreasing clinical symptoms. Clients’ clinical areas of functioning and clinically significant change will be evaluated using the Outcome Questionnaire -45.2 whereas hope will be assessed using The Trait Hope Scale. The results of this study will ultimately help researchers in counseling education, counselors, supervisors, and students by providing an outcome …

False Positives On Neuropsychological Measures Of Effort Among Bilingual Neurologically Intact Mexican Americans, Arnoldo Amador Jr.

Theses and Dissertations

The present study examines the performance of bilingual Mexican Americans on neuropsychological measures of effort in language and visual-perceptual formats. Optimal/suboptimal effort cutoff scores derived from monolingual English Speakers were used to test participants divided by language of administration and bilingual groupings based upon Spanish-English difference scores on the Woodcock Munoz Language Survey-Revised Picture Vocabulary subtest. Participants produced more false positives (misidentification of suboptimal effort) on the Reliable Digit Span, a language formatted measure, and similar rates of false positives on visual-perceptual effort measures: Test of Memory Malingering and the Dot Counting Test as compared to established rates using monolingual …

The Meaning Of Nursing Education As Described By Students With Learning Disabilities, Jacqueline Lee Reep-Jarmin

Theses and Dissertations

The numbers of students with learning disabilities (LD) in post-secondary education settings is rising (National Center for Education Statistics (NCES), 2016). The Americans with Disabilities Act, Amendments Act was passed in 2008, since that time little research has been done to reflect any impact of the original ADA (1990) being amended. Research is needed about the experiences of students with learning disabilities in higher education, and more specifically nursing education. The purpose of this study was to develop an understanding of the lived experience of nursing education from the perspective of students with learning disabilities, and delineate the essence of …

Preventing Vocal Fold Dehydration Using Aerosolized Salinein An Excised Porcine Model, Mallory Lynn Hansen

Theses and Dissertations

Vocal fold hydration is important for efficient oscillation during voice production. Dehydration of the vocal fold surface is believed to produce adverse effects on the voice. Specifically, low environmental humidity, mouth breathing, and certain medical conditions may contribute to laryngeal and vocal fold dehydration. This dehydration effect may be quantified using the observed pressure and flow at the onset of phonation, operationally defined as phonation threshold pressure (PTP) and phonation threshold flow (PTF), respectively. Previous research has documented that nebulized isotonic saline (0.9% Na+Cl-) can reduce PTP. Additionally, the topical application of liquid saline increases vocal fold hydration in excised …