Medicine and Health Sciences Commons^™

Outcomes Of Anterior Crossbite Correction On Alveolar Bone Morphology In Patients With Cleft Lip And Palate, Katherine J. Hayes

Theses and Dissertations

Objective: To determine if patients with cleft lip and/or cleft palate (CLP) with dental correction of the anterior crossbite during growth display differences in alveolar bone thickness around the maxillary central incisors compared to patients without crossbite correction.

Methods: This retrospective study evaluated post-treatment cone beam computed tomography (CBCT) images of growing patients with CLP with anterior crossbites who underwent Phase I orthodontic treatment (n=32). CBCTs were sorted by whether the crossbite was corrected (n=16) or not corrected (n=16) during Phase I. Alveolar bone thickness was measured on the buccal and palatal aspects of the central incisors at 3 mm, …

The Effect Of Experienced Compassion At Work On Nursing Home Certified Nursing Assistants' Well-Being And Turnover Intentions, Kristin M. Macdonald

Theses and Dissertations

Statement of problem and objectives: Could experienced compassion at work alleviate nursing home certified nursing assistant (CNA) burnout? This study investigates whether experienced compassion at work predicts higher well-being (meaningfulness of work, psychological vitality, and resilience) for CNAs, and if well-being predicts lower turnover intentions.

Procedure followed: This is a prospective, observational, survey-based study with three timepoint data collection. Convenience sampling of Kansas and Virginia NHs was conducted (n=13). All CNAs working at the NHs were study eligible. CNAs received gift cards with laddered incentives for ongoing participation. There was in-person administration of a CNA survey at each timepoint. …

Role Of Human Intermediate Form Prl Receptor I-Tail In The Pathogenesis Of Breast Cancer, Shanwei Shen

Theses and Dissertations

Breast cancer continues to be the second most common cancer in women in the United States. The neuroendocrine hormone human prolactin (hPRL) plays an important role in normal mammary gland development and growth, stimulating normal breast tissue proliferation and differentiation. Considerable evidence has shown that hPRL is involved in the malignant transformation of human breast tissue. hPRL enhances viability, invasiveness, and proliferation of breast cancer cells in vitro. Evidence from epidemiologic and genetic studies also implicates role of hPRL in the pathogenesis of breast cancer. Its cognate receptor the human prolactin receptor (hPRLr) is required for the action of hPRL. …

Opioid System's Potential Involvement In Ketamine's Cognitive And Antidepressant-Like Effects In Rats, Fan Zhang

Theses and Dissertations

Depression stands as one of the most pervasive mental health challenges worldwide, including the United States. Conventional antidepressants typically display a delayed onset of therapeutic action (4-8 weeks) and lack efficacy in a substantial portion of patients (over 40% of depressed patients are treatment-resistant). The dissociative anesthetic ketamine, which is a glutamatergic N-methyl-D-aspartate (NMDA) antagonist, has emerged as a promising novel treatment due to its rapid and prolonged antidepressant effects, and it is especially beneficial for treatment-resistant depression. Nevertheless, the precise neurochemical mechanisms underlying ketamine’s antidepressant properties remain elusive, hampering the development of safer and more efficacious treatments. The present …

Burnout In Forensic Psychology Related To Personal Traits And Vicarious Trauma, Olivia Shae Bruno

Theses and Dissertations

Burnout is described as having three components: emotional exhaustion, depersonalization, and feelings of ineffectiveness (Maslach et al., 1997). Burnout is considered a major occupational hazard due to the consequences for the afflicted and the population they work with (Leka & Jain, 2012) including low quality care, job dissatisfaction, absenteeism, and high turnover rates (Maslach et al., 2001). Previous research has identified some occupations and settings which are linked to high rates of burnout, including psychologists (Rodriguez & Carlotta, 2017) and those working in a high stress field, such as police officers (Vazquez et al., 2021), corrections officers (Herlickson, 2010) or …

Addressing Inappropriate Polypharmacy: Investigating Perceived Facilitators And Barriers To U.S. Pharmacists' Ability To Recommend Deprescribing, Susanne Steiner

Theses and Dissertations

While the concurrent use of multiple prescriptions (polypharmacy) is common for those with chronic conditions, professional ownership is lacking when it comes to tapering or discontinuing potentially inappropriate medications. Our growing elderly population is especially vulnerable to negative risks associated with polypharmacy. Pharmacists are highly educated and skilled healthcare professionals working as critical touchpoints with patients; yet they are not empowered to deprescribe potentially inappropriate medications directly. This qualitative research study examined the perceived barriers and facilitators pharmacists encounter when pursuing deprescribing recommendations and initiatives with prescribers, healthcare staff, patients, and caregivers. Findings from this study revealed three key implications …

Frozen By Worry And Fatigue? A Mixed Methods Approach To Understanding The Lived Experiences Of Freezing Of Gait, Sarah M. Ghose

Theses and Dissertations

This study utilized a mixed methods emergent, phenomenological approach to (1) understanding the lived experience of freezing of gait for individuals diagnosed with Parkinson’s Disease and (2) determining the role of anxiety and sleep in freezing of gait outcomes. Participants included 13 adults diagnosed with Parkinson’s Disease (N=14 for qualitative data, N=13 for quantitative data; 23.1% female-identifying, 76.9% male-identifying) who were predominantly white (92.3%) with an average age of 69 years (SD = 6.73 years). Data collection consisted of semi-structured interviews, self-report measures, actigraphic sleep data, and salivary alpha amylase biomarker collection. Results are organized into …

From Suicidal Ideation To Suicide Attempt: Clarifying The Role Of Painful And Provocative Events, Mallory Stephenson

Theses and Dissertations

The Interpersonal-Psychological Theory of Suicide hypothesizes that capability for suicide is acquired in part through exposure to physically painful and/or fear-inducing experiences, referred to as painful and provocative events (PPEs). Studies of PPE exposure offer an opportunity to characterize potential targets for suicide prevention and inform efforts to identify individuals at elevated suicide risk. However, the literature on PPE exposure and risk for suicidality has been limited by a reliance on cross-sectional designs, lack of genetically informed research, inclusion of risk-taking behaviors as potential PPEs, and focus on risk over resilience. In this dissertation, we aimed to address these knowledge …

The Influence Of Flavor On The Abuse Liability Of A Heated Tobacco Product And Its Feasibility As A Menthol Cigarette Substitute, Augustus White

Theses and Dissertations

Heated Tobacco Products (HTPs) purport to expose people that use cigarettes to fewer of the harmful or potentially harmful constituents of tobacco while still delivering reinforcing amounts of nicotine (Auer, Concha-Lozano et al., 2017). An exemplar of the HTP class, IQOS, and its three varieties of “HeatSticks” have been authorized by the Food and Drug Administration (FDA) as “Modified Risk Tobacco Products” (MRTP). However, as the FDA is planning to ban menthol as a characterizing flavor in cigarettes, questions remain regarding whether characterizing flavors should be permitted in HTPs (FDA, 2022e). New evidence regarding HTP abuse liability (i.e., the likelihood …

Validation Of A Screening Tool For Sleep Apnea In Children, Brandon Khor

Theses and Dissertations

Objective: The aims of this study were to (1) determine the ability of a pediatric obstructive sleep apnea (POSA) questionnaire to identify high-risk patients through confirmation with an at-home sleep apnea test (HSAT) and (2) to evaluate the correlation between high-risk patients as identified by the questionnaire (PM-STOP-Bang) and an already validated POSA screening tool.

Methods: Orthodontic patients aged 12-17 who met the inclusion criteria were consecutively enrolled in the study (n=16). At the initial orthodontic appointment, the clinician filled out the PM-STOP-Bang questionnaire. Subsequently, participants were invited to complete a one-night HSAT (WatchPat, WP-Itamar-Medical, Caesarea, Israel), which recorded diagnostic …

Factors Important To Underrepresented Minority Applicants In Ranking Orthodontic Programs, Alyssa Patterson

Theses and Dissertations

Purpose: To determine if there was a difference in desirability of various factors used by applicants ranking orthodontic programs depending on their racial or ethnic background.

Method: A survey was distributed to orthodontic residents to assess overall preferences, and differences in desirability of various factors between underrepresented minority (URM) and non-URM applicants.

Results: For applicants overall, “clear aligner therapy training”, “good quality of clinical faculty” and “high number of cases started” had the highest mean desirability. “Racial and ethnic diversity among current and former residents”, “racial and ethnic diversity among faculty” and “participation in care of Medicaid patients” were significantly …

A Radiographic Analysis Of Teeth With Carrier-Based Obturation Requiring Retreatment, Robert W. Rudnicki

Theses and Dissertations

Objective: The purpose of this study was to determine observer accuracy and agreement in detecting carriers using preoperative radiographs, as well as to identify potential radiographic indicators for the presence of carriers.

Methods: A chart review was conducted for patients seen at the VCU graduate endodontic clinic. Eligible cases included previously treated teeth that were nonsurgically retreated, with and without identified carriers. 100 cases were identified, including 61 carrier and 39 non-carrier cases. Preoperative radiographs were randomized, and evaluators assessed each case for the presence of carrier-based obturation. Evaluators included three endodontists, one general dentist, and four endodontic residents. Statistical …

Characteristics Of Permanent Teeth Diagnosed With Pulpal Necrosis: A Retrospective Study, William Lee

Theses and Dissertations

Objective: To determine associations of pulpally necrotic teeth with demographics, clinical findings, radiographic presentation, and periapical status.

Methods: Virginia Commonwealth University uses AxiUm software to record dental treatment and treatment notes. The current study involves a keyword search using the term “pulpal necrosis”. Factors compiled and evaluated included but not limited to patient demographics, location in the dental arch, clinical findings, radiographic presentation, and periapical status.

Results: Data has revealed that teeth with pulpal necrosis can present with a variety of different clinical findings. All of the following were observations of teeth with pulpal necrosis. A total of 325 teeth …

Chronobiology Of Meal Timing In Early-Stage Hypertension: Effects On Renal And Vascular Function, Natalie J. Bohmke

Theses and Dissertations

Introduction: Previous research determined that a Western-style meal acts as a stressor to the kidney and contributed to impaired blood pressure and vascular function. Despite an understanding of acute postprandial physiology in humans, studies have not investigated the impact of the time of day of meal consumption on physiology. Methods: Ten participants with elevated or stage-one hypertension underwent a randomized crossover trial with a controlled feeding intervention of a Western-style meal in the morning or the evening. Participants completed a run-in day to standardize diet followed by the experimental day. On day 2, participants completed ambulatory blood pressure, core temperature, …

Investigating Black Emerging Adult Health And Model Of Care Choices, Alexandra Wynn

Theses and Dissertations

This mixed methods study aimed to analyze the health profiles of Black emerging adults (who do not seek medical care for chronic condition management) college students to identify factors influencing their use of preventive services and their choices in healthcare plans. The study revealed distinct profiles of Black emerging adults based on patterns of factors related to their engagement with healthcare, such as barriers to care, insurance access, usual source of care, self-rated health, intention to seek care, discrimination, trust in physician, medical mistrust, and sex-assigned at birth. Interviews were conducted to investigate the similarities and differences among all participants …

Associations Between Childhood Trauma And Tobacco Dependence Among Latine Adults: Testing The Protective Effects Of Compassion For Self And Others, Camila Tirado

Theses and Dissertations

Tobacco dependence has posed a significant public health challenge in the United States and disproportionately affects Latine adults' risk of developing a variety of adverse health conditions. Childhood trauma is a recognized risk factor for dependence, overall health, and mental health concerns. Still, the influence of compassion for self or compassion for others in this context remains unclear. This cross-sectional study investigated the moderating effects of self-compassion and compassion for others on the relationship between childhood trauma and cigarette dependence among Latine adults. Data was collected through questionnaires assessing childhood trauma, self-compassion, cultural values and factors, compassion for others, and …

Exploring The Relationship Of Intact Limb Knee Joint Loading With Step Lengths And Step Length Symmetry In Individuals With Lower Limb Amputation, Edward D. Syrett

Theses and Dissertations

Individuals with unilateral lower limb amputation (LLA) frequently experience intact limb knee pain, dysfunction, and osteoarthritis. These problems can worsen pre-existing reductions in mobility and quality of life that this population regularly experiences. It is widely accepted that knee joint loading is implicated in the development of knee joint issues, and intact limb knee joint load alterations are thought to be widespread in individuals with LLA. Prior work suggests that gait deviations frequently present in this population may be a contributory cause of these altered forces. These deviations can take many forms, but individuals with LLA commonly demonstrate alterations in …

Levofloxacin Incorporated Extracellular Matrix Nanoparticles For Pulmonary Cystic Fibrosis Infections, Raahi Patel

Theses and Dissertations

Cystic fibrosis (CF) is a progressive genetic disorder that affects around 40,000 people in the United States. CF is characterized by a mutation in the CFTR protein that causes dysregulated ion transport across epithelial cells, producing viscous mucus in the lung that increases bacterial invasion, causing persistent infections and subsequent inflammation. Pseudomonas aeruginosa and Staphylococcus aureus are two of the most common infections in CF patients that are resistant to antibiotics. One antibiotic approved to treat these infections is levofloxacin (LVX) that functions to inhibit bacterial replication, but can be further developed into tailorable particles. Nanoparticles are an emerging inhaled …

Drugging The Histone Acetyltransferase Ep300 Modulates Alternative Splicing At Schizophrenia Risk Genes, Shravani Malay

Theses and Dissertations

Purpose. We will evaluate the effects of drugging the epigenetic histone acetyltransferase (HAT) enzyme p300, encoded by the schizophrenia risk gene EP300, on genome-wide gene expression in neural cells. We hypothesize that drugging p300 will affect gene expression and alternative splicing of other schizophrenia risk genes. Our motivation is to identify potential new epigenetic treatment avenues for schizophrenia.

Methods. Prior to my joining the lab, an experiment was conducted using the novel p300 HAT inhibitor, A-485, to modulate genomic regulation in a neural cell line (SH-SY5Y). SH-SY5Y cells were exposed to 10μM of A-485 or vehicle (DMSO) for 24 …

Revealing The Elusive Mechanism Of Action Of The Lipid Chaperone Fatty Acid Binding Protein 4, Abdul J. Castillo Ibanez

Theses and Dissertations

Fatty acid binding proteins (FABPs) are pivotal in orchestrating lipid trafficking within cells. This dissertation aims to reveal the mechanism of action of adipocyte FABP (FABP4) by meticulously detailing steps for producing uniformly isotopically labeled protein, understanding dynamics and structural changes in aqueous conditions, analyzing protein-membrane interaction with membrane mimicking models, and revealing its membrane-bound state through novel NMR structural elucidation. Chapter 1 provides an overview of FABP4's indispensable role in lipid trafficking, emphasizing its significance in maintaining cellular homeostasis and metabolic regulation. Chapter 2 delves into the optimization of FABP4 protein expression and proposes a high yield recovery and …

Age Of First Dental Visit And Early Childhood Oral Health Quality Of Life, Richard Greene

Theses and Dissertations

Objective: This project aims to examine the association between the age of a child's first dental visit and their Early Childhood Oral Health Impact Scale (ECOHIS) score.

Methods: A 22-item cross-sectional survey was distributed to caregivers of healthy children aged 5 years and younger with an American Society of Anesthesiology (ASA) I and II status who presented for new patient exams.

Results: In total, 117 caregivers participated in the survey. The ECOHIS was assessed on a 5-point Likert scale and scores ranged from 0-52; higher values indicate poor oral health having a greater impact on the child and family. Those …

Assessment Of Maxillary Sinus Pneumatization In Dentate And Edentulous Areas Using Cone Beam Computed Tomography, Catherine Ramundo

Theses and Dissertations

Objectives: The primary goal of this retrospective analysis is to analyze the morphologic changes that occur following extraction in regards to sinus pneumatization.

Methods: The patient population was selected from the VCU School of Dentistry Graduate Periodontics Department. Cone Beam Computed Tomography scans (CBCT) was obtained from patients that had a posterior tooth extracted. A horizontal tangent line was drawn to the inferior border of the nasal cavity, acting as a constant reference point for measuring the extent of maxillary sinus pneumatization. Radiographic measurements were performed from a horizontal line at this fixed anatomical marker to the deepest level of …

The Value Of Educating Teachers, Coaches, And Athletic Trainers On The Management Of Dental Trauma., Darlene W. Jean

Theses and Dissertations

Purpose: To investigate the benefit of educating teachers, coaches, and athletic trainers about dental trauma to prevent incidents and improve the management of students/athletes with dental trauma.

Methods: Teachers, coaches, and athletic trainers throughout the greater Richmond metro area were recruited via email. Participants answered a pre-seminar survey to evaluate their baseline knowledge and determine whether they have experienced dental trauma with their students/athletes previously. The participants were given the option to attend an in-person or virtual seminar educating them on the basic management of traumatic dental injuries and how to guide affected students/athletes and their families to obtain optimal …

Clinical Outcomes Of Primary Anterior Esthetic Crowns In Pediatric Dentistry, Jenan Alahmad

Theses and Dissertations

Clinical Outcomes of Primary Anterior Esthetic Crowns in Pediatric Dentistry - A Prospective Cohort Study

By: Jenan Alahmad, BDS

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, 2024

Thesis Advisor: Parthasarathy Madurantakam, DDS, MDS, PhD

Department of Pediatric Dentistry

BODY

Purpose: This prospective cohort study aimed to compare the effectiveness of restoring maxillary anterior teeth in children (aged 3-6 years) with three different materials: Zirconia Crowns (ZC), Resin Composite Crowns (RC), and Pre-veneered Stainless-Steel Crowns (PVSSC). The study aims to assess the Oral …

A Preliminary Report Of A Randomized Controlled Clinical Trial Comparing Ferric Sulfate With Zin Oxide Eugenol And Non-Eugenol Based Material For Pulpotomy In Primary Molar Teeth, Sarah Balal

Theses and Dissertations

Purpose: This study aimed to evaluate the effect of eugenol and non-eugenol-based Zinc Oxide Eugenol (ZOE) cements on primary tooth pulpotomies where Ferric Sulfate (FS) is used as a medicament.

Methods: Children aged 3-7 years with dental caries in their primary molars that have clinical and radiographic diagnosis of reversible pulpitis and undergoing dental treatment under Oral Conscious Sedation (OCS) or General Anesthesia (GA) were recruited. Children were randomly assigned to receive either FS and ZOE (IRM) or FS and non-eugenol based (CAVIT). The outcomes were assessed based on failure rates of the materials separately for clinical or radiographic evidence …

Established Colonization Of Sneathia Vaginalis In A Mouse Model, Kailyn E. Turcios-Gonzalez

Theses and Dissertations

Sneathia vaginalis (Sv) is a gram-negative anaerobic bacterium associated with adverse reproductive outcomes. Sv can traverse the fetal membrane and damage epithelial cells in vitro by producing a pore-forming cytotoxin, cytopathogenic toxin A (CptA). To further understand the transition of Sv from normal flora to a pathogen, an animal in vivo model needs to be created to observe the preliminary ascending infection before we begin to study the effects on pregnancy. Experimentation was conducted to optimize mouse breed, bacteria administration methods, and other variables that arise when working in vivo. The C57BL/6 mouse strain displayed the most consistent …

Acute Effects Of An Oral Nicotine Pouch In People Who Use Smokeless Tobacco, Alisha Eversole

Theses and Dissertations

People who use smokeless tobacco (SLT) are exposed to a variety of carcinogenic toxicants, yet, despite health risks, nearly 6 million people in the US use SLT. SLT contains and delivers nicotine, a psychostimulant that causes dependence and hinders cessation efforts. An orally-administered nicotine pouch marketed as “tobacco-free” recently has become available for purchase in the US. However, there are very few non-industry-sponsored studies regarding the effects of these oral nicotine pouches.

The current study used clinical laboratory methods to determine the acute effects of an oral nicotine pouch in people who use SLT. Participants completed four sessions (within subjects, …

Mental Health Help-Seeking Behaviors And Service Utilization Of Black College Students, Troy J. Keys

Theses and Dissertations

Black college students are less likely to seek mental health services compared to other students. While previous research has identified barriers and facilitators contributing to Black college students’ help-seeking behaviors, the current political and social climate and pandemic have negatively impacted their mental health thus warranting the exploration of these factors again. This study aimed to identify the mental health help-seeking behaviors and attitudes of Black college students, the barriers and supports for help-seeking behaviors, their preferred service utilization providers, and their thoughts about promoting mental health help-seeking among their peers. Black college students (n = 21) enrolled at an …

Assessing Providers’ Readiness To Integrate Mat Services In A Primary Care Setting, Carmen Ingram-Thorpe

Theses and Dissertations

Opioid use disorder is a growing concern in the United States. Despite medication-assisted treatment (MAT) being a more effective treatment option than behavioral treatment alone, primary care providers’ rate of adoption and utilization of MAT has not matched the demand of the opioid crisis. The largest barrier facing our local community is the availability of organizations and providers that can and will actually provide MAT services. The purpose of this study was to identify factors that impact primary care providers’ readiness to treat individuals with opioid use disorder (OUD) using MAT. This study used the ADKAR model as framework, which …

Memory Impairments Due To Binge Ethanol Are Impacted By Age And Sex, Maria Alexis M. Bent

Theses and Dissertations

Ethanol is the most consumed drug among adolescents, which can cause long-term effects on memory and changes in gene and protein expression. While both adolescents and adults engage in binge drinking, the neurological and behavioral effects differ, with adolescents showing fewer adverse physiological effects but greater memory deficits than adults. Sex differences related to ethanol occur with women showing higher BEC than men and similar cognitive deficits despite fewer years of ethanol consumption. During adolescence the mPFC and dHPC undergo maturation development with both brain regions playing a role in spatial and recognition memory. Proteins critically involved in memory and …