The Relationship Between Outcomes Associated With Patient Blood Management Programs And Transfusion Safety Officers, Gary Morral

Theses and Dissertations

BACKGROUND: Patient Blood Management (PBM) has become the standard of care for transfusion services in hospitals. Transfusion Safety Officers (TSOs) have been identified by some as being a crucial part of a successful PBM program; however, no studies have been done to show their effectiveness, or if there is even a relationship between having a TSO and outcomes associated with PBM programs. The purpose of this study was to describe and test the relationship between having a TSO and six outcomes associated with PBM programs including blood product wastage (red blood cells, plasma, and platelets), hospital lengths of stay, rates …

Behavioral Effects Of Adolescent Social Isolation Stress And/Or Binge Drinking And The Role Of The Vhip --> Mpfc Circuit, Jyoti Lodha

Theses and Dissertations

Adolescence is characterized by heightened social interaction and risk-taking behavior. Disruptions to cortical development by binge ethanol or social isolation can lead to attention, social, and cognitive deficits later in life, and increase risk for alcohol use disorders. During adolescence, proper development of a monosynaptic connection from the ventral hippocampus (vHip) to the medial prefrontal cortex (mPFC) is critical to proper social and working memory. We ask whether these factors affect neurobiological factors such as gene expression and the role of the vHipmPFC circuit in these behaviors. Social stress was modeled by social isolation (aSI) during adolescence. We expect aSI …

Transforming Children's Oral Health: The Impact Of Oral Healthcare Policies On Virginia Medicaid Dental Health Outcomes., Anita M. Kumar

Theses and Dissertations

Abstract: Transforming Children's Oral Health: The Impact of Oral Healthcare Policies on Virginia Medicaid Dental Health Outcomes.

Objectives: This dissertation uses Department of Medical Assistance Services (DMAS) administrative files at the individual and provider level from fiscal years (FY) 2011 to 2021 to systematically study the effect of recently implemented oral health policies (EBD guidelines on sealants, CMS updated quality measures, expansion of Medicaid oral healthcare for qualifying pregnant women) on oral health outcomes of Virginia Medicaid-enrolled children.

Methods: The studies employ a difference in differences regression methods (negative binomial, Poisson, and logistic) to examine the effects of oral health …

Exploration Of Dopaminergic And Serotonergic Pathways Utilizing Pleiotropic Agents, Charles B. Jones Iii

Theses and Dissertations

2-(Benzoyl)piperidines (BPs) are at a crossroads of therapy and abuse. These compounds are a hybrid between the ADHD medication methylphenidate and abused stimulant cathinones. Here we use computational molecular modeling, synthesis, mutagenesis, and epifluorescence microscopy to further improve the understanding of and potential treatments for several neuropsychiatric disorders. Utilizing the BP scaffold and controlling chirality and aryl substitution, these agents were examined at DAT and SERT. From these investigations it has now been established that R isomer BPs are favored for DAT while S isomer BPs are favored for SERT. Aryl-substitution can greatly affect the selectivity of these agents with …

Mild Traumatic Brain Injury In Yucatan Minipigs: Assessing Changes In Approachability And Mechanical Nociception Following Diffuse Central Fluid Percussion Injury, Mark D. Pavlichenko

Theses and Dissertations

Traumatic brain injury (TBI) is a major healthcare concern affecting millions. Symptoms of TBI include sensory sensitivity and social changes that may persist long-term. Due to similarities in cytoarchitecture, metabolism, and inflammation, higher order minipig models are advantageous for translational TBI research, however, there remains a shortage of information regarding their behavioral and sensory sequelae following injury. Therefore, in this study, we assessed changes in sociability and somatosensation in adult male and female Yucatan minipigs for up to one-week following a sham or central fluid percussion injury (cFPI). Specifically, the voluntary human approach task (VHAT) and the forced human approach …

Longitudinal Analysis Of Maternal Depression, Physical Work Demand, And Working Hours Before, During, And After Pregnancy On Offspring Blood Pressure Trajectories, Medhin Tsegaye Haile

Theses and Dissertations

Overall Abstract

Background: Pediatric high blood pressure (BP) is a growing global concern, with 1 in 7 adolescents in the U.S. experiencing elevated BP or hypertension. Maternal lifestyle factors, including depressive symptoms, physically demanding work, and work hours during pregnancy, may influence offspring BP trajectories. However, prior studies often focus on single time points or specific age groups, limiting understanding of long-term effects. This study investigates the associations between maternal depressive symptoms, physically demanding work-related factors, and work hours before, during, and after pregnancy with offspring systolic blood pressure (SBP) trajectories from early childhood to adolescence.

Methods: We utilized …

Cellular Metabolism Is A Viable Therapeutic Target For Radiation-Induced Pulmonary Fibrosis, Josly Pierre-Louis Odoom

Theses and Dissertations

Herein, we provide evidence for cellular metabolic reprogramming as a driver of radiation-induced pulmonary fibrosis (RIPF). We are the first to identify a distinct metabolic signature for RIPF in a cohort of patients with radiographic sequela. We also used a RIPF mouse model to detect the metabolic pathways that enrich during pathogenesis. Our previous work highlighted the importance of lactate, a derivative of the glycolysis end-product pyruvate. Consequently, we took a special interest in the effects of radiation on the glycolysis pathway. We learned that radiation accelerates and reprograms glycolysis to an anabolic state in a pyruvate kinase M2 (PKM2)-dependent …

Life After Discharge: Predicting Longitudinal Trajectories Of Community Integration And Global Functioning In Black Individual With Traumatic Brain Injury, Chimdindu Ohayagha

Theses and Dissertations

The onset of traumatic brain injury (TBI) begins a chronic health pathway that contributes to various impairments and comorbidities across the lifespan. Common consequences of TBI include mental health issues, cognitive impairments, and reduced functional independence, all of which impact how an individual integrates into their community. Community integration is a primary goal for rehabilitation after TBI. Studies show that racially/ethnically minoritized individuals have a higher incidence of TBI, higher rates of mortality, and report poorer functional and community integration outcomes. Limited studies have explored longitudinal outcomes of community integration in a Black-only sample of individuals with TBI. Additionally, no …

The Patient Experience Of Language Discordance And Interpreter Services In The Emergency Department, Keri L. Baker

Theses and Dissertations

Background: Clear communication is critical to the interaction of a patient and medical provider. For non-English speaking patients, language discordance, described as the lack of proficiency in a shared language, with the medical team results in a poor patient experience and poor patient outcomes. The predominant solution to language discordance is the use of interpreter services, however these services are underused in the emergency department (ED). Studies examining underuse of interpreter services have primarily focused on the clinician and little is known about the patient’s influence on the use of interpreter services.

Methods: Semi-structured interviews were conducted with 12 Spanish-speaking …

Continuous Flow As A Process Intensification Tool For The Preparation Of Pharmaceutically Relevant N-Heterocycles, John W. Tomlin Jr

Theses and Dissertations

Continuous flow as a process intensification tool for the preparation of pharmaceutically relevant N-heterocycles

John W. Tomlin

Thesis Defense: 17 January 2024

Committee: B. Frank Gupton, Ph.D. (Advisor), Suzanne M. Ruder, Ph.D. (Chair), Heather R. Lucas, Ph.D., James K. Ferri, Ph.D., Matthew C.T. Hartman, Ph.D.

A dissertation submitted in partial fulfillment of the requirements of Doctor of Philosophy at Virginia Commonwealth University

© 2024 John W. Tomlin Jr All Rights Reserved

Abstract

Essential medicines must be produced in large quantities to accommodate large global demand. The preparation of these active pharmaceutical ingredients (API) must therefore strive to be both cost-effective …

The Genetic Architecture Of Cervical Change During Pregnancy: From Modeling To Mechanism — Does The Cervix Mediate Maternal Risk For Spontaneous Preterm Birth?, Hope M. Wolf

Theses and Dissertations

This project leverages clinical data and biospecimens from a prospective longitudinal cohort of pregnant women to study the genetic and phenotypic relationships between cervical shortening and the duration of pregnancy. Sonographic cervical length (CL) was measured throughout pregnancy in a cohort of 5,160 Black/African American women in Detroit, Michigan. Maternal DNA samples were sequenced with a next-generation low-pass whole genome platform. The heritability of cervical change during pregnancy and its genetic correlation with gestational age at delivery (GAD) were estimated using Genome-Wide Complex Trait Analysis. These estimates suggest that cervical change is heritable (h²CL = 51%) and highly polygenic trait. …

Feasibility Of Using Somatosensory Input On Pediatric Patients Receiving Dental Treatment, Liara D. Vinson

Theses and Dissertations

Purpose: The aim of this randomized, cross-over designed feasibility study is to evaluate patient anxiety, patient cooperation, and patient acceptance of a vibrating weighted vest used during the restorative treatment compared to when no device is used.

Methods: Children aged 5 to 15 years, needing at least two appointments for restorative treatment requiring local anesthesia under basic behavior guidance techniques were recruited. Patients were randomly allocated to wearing a vibrating weighted vest at one of the appointments. At both appointments, behavior was evaluated using Frankl scores and anxiety was evaluated at the beginning and at the end of …

Social Networks As Predictors Of Musculoskeletal Injury In U.S. Army Soldiers (Snap-Mski), Kristen L. Zosel

Theses and Dissertations

INTRODUCTION: Musculoskeletal injuries (MSKIs) are the leading cause of medical non-readiness among U.S. Army Soldiers, costing the Military Health System an estimated $4.7 billion annually in direct and indirect costs. Current MSKI mitigation efforts focus on individual attributes such as body mass index and gender. However, emerging research highlights the significance of social ties on health outcomes and behaviors. This study examined the patterns of MSKI within military social networks and how social interactions, along with health behaviors such as sleep, physical activity (PA), and diet, co-occur in Soldiers with and without MSKI. METHODS: Phase 1 involved a cross-sectional sociocentric …

Opportunities For Mental Health Interventions In Rural Mississippi Communities During The Covid-19 Pandemic: A Quantitative Analysis, Brice Fortinberry

Theses and Dissertations

COVID-19 presented unique challenges for rural Mississippi communities including impacts on the mental health of rural individuals. This research study aimed to identify opportunities for mental health interventions to provide health promotion professionals with quantitative data on the accessibility and the likelihood of engagement with mental health-fostering behaviors. A secondary objective of this research was to categorize these behaviors within the constructs of the Social Ecological Model. Demographics for rural Mississippi communities were collected and displayed, and using multivariate analyses including Spearman’s correlation and a Mann-Whitney U test the correlation between mental health fostering behaviors and demographic factors was obtained. …

Increased Coding Potential Of Bovine Herpesvirus 1, Victoria Jefferson

Theses and Dissertations

Bovine respiratory disease (BRD) costs the cattle industry millions of dollars in costs in treatment and loss every year in the United States. A significant pathogen often contributes to BRD is Bovine Herpesvirus 1 (BoHV-1), a double stranded DNA virus with the ability to establish latency in the trigeminal ganglia and neurons. Primary infection with BoHV-1 results in immunosuppression that increases the risk of secondary bacterial infection and pneumonia. Because herpesviruses infect their hosts for life and can be reactivated in times of stress, BoHV-1 can present a recurring risk of BRD. The following research aims to expand the knowledge …

Does What Doesn’T Kill You Make You Stronger? Examining The Effects Of Resilience And Functional Outcomes On Post-Traumatic Growth In Adults With Acquired Disability, Dominique Renee Ghirardi M.S.

Theses and Dissertations

Disabilities acquired in adulthood are often unexpected and disruptive because a loss of functioning can affect one’s ability to maintain employment, pursue their interests, and participate in social activity without assistance or accommodation. This is especially true for those who experience a life-altering injury or develop a chronic health condition between the ages of 18 and 64, as they likely have not planned for the financial and social adjustments that life with a disability involves. However, factors such as post-traumatic growth can reveal the extent to which someone experiences personal growth and improvement in the wake of a traumatic and …

Reimagining Associate Degree Nursing Education: An Insider’S View, Ntiense E. Otu

Theses and Dissertations

The demographics of nursing students in the Associate Degree Nursing (ADN) program are diverse, hence the need for nurse educators to prepare and handle the challenges faculty face in the ADN program. Although many pieces of literature have addressed different modalities of instructional delivery and teaching methods in nursing education, transition experience of nurse educators, and teaching preparation and readiness, these are not evident in the ADN programs in the Rio Grande Valley (RGV). The teaching preparation of nurse educators and their utilization of instructional methods in the ADN program in the RGV is limited in the literature. This study …

Mathematical Evaluation Of Ulnar Nerve Somatosensory Evoked Potentials (Sseps), Maribel Carmen Gomez

Theses and Dissertations

As the number of individuals suffering with low back and neck pain rises, we find people undergoing spinal procedures more often. In means, of safeguarding the patient and their neurological structures during the procedure intraoperative neuro-physiological monitoring (I.O.M) has been more widely used amongst surgeons orthopedic and neuro alike. During these procedures, a modality widely used for both low back and neck surgery is somatosensory evoked potentials (SSEPs). The aim of neuro-technicians is to obtain a baseline waveform that can be considered present and reliable. When obtaining SSEPs the technician can encounter obstacles with ’noisy’ wave-forms due to …

The Impacts Of Caregiving And Social Support On Stress For Multiple Sclerosis: A Study On Informal Caregivers, Jacqueline Mercado

Theses and Dissertations

The purpose of the present quantitative study was to gain an increased understanding of the impacts of caregiving and social support on stress for unpaid informal caregivers of persons with Multiple Sclerosis. Caregiving for MS can be rewarding yet stressful. Informal caregivers are the primary source of ongoing home care for family members or friends with MS. Due to the complexity of care, caregivers are especially vulnerable to higher strain as they often feel unprepared for this role. This study examined perceived social support and demographic variables on caregivers' stress to gain insight into mediating caregiver psychosocial challenges. …

Student Perceptions Of The Effectiveness Of Collegiate Recovery Programs And Collegiate Recovery Communities, Michael Anthony Herold

Theses and Dissertations

Research on the objective effectiveness of Collegiate Recovery Programs and Collegiate Recovery Communities (CRPs / CRCs) has shown success in maintaining recovery and improving academic outcomes for college students in recovery, but research on the experiences of this population is starting to emerge. This study used a mixed-method design to investigate the perceptions of members of CRPs / CRCs regarding the impact of participation on their recovery from substance abuse and their overall quality of life. Thirty-one participants completed the Drug Avoidance Self-Efficacy Scale (DASES) and the Quality of Life Index – Generic Version iii (QLI). Paired samples t-tests were …

Age-Related Oligodendrocyte Lineage And Learning Abnormalities Driven By Nf1 Mutation In Mice, Saul Lopez

Theses and Dissertations

Neurofibromatosis Type 1 (NF1) is an autosomal dominant disease caused by mutations in the NF1 gene, on chromosome 17. NF1 patients suffer from a number of neurological issues including learning deficits and increased risk of age-related dementia. Additionally, NF1 patients present with multiple white matter and myelin abnormalities. Whether and how myelin abnormalities impact learning in NF1 is not known; therefore, we aimed to gain insights on potential links between Nf1 mutation and learning issues Unpublished data indicate that NF1 female-but not male- mice with Nf1+/- germline mutation show defects in a myelin-regulated learning/memory test (the complex wheel; CW) at …

Development Of A Physics-Informed Neural Network For Prediction Of Blood Flow, Marcello Vittorio Mattei Di Eugenio

Theses and Dissertations

Abstract—Objective: We propose a new neural network architecture that accepts point clouds and outputs 3D velocity profiles for aneurysm geometries. Methods: We generated a synthetic aneurysm 3D flow dataset using CFD and used it to train our model architecture and compare it with other popular architectures like U-net and PointNet. We incorporate tools for improving model performance such as incorporating a distance function, a physics-informed loss to enforce the law of mass conservation, and the Huber loss to learn patterns across heterogeneous velocity components of multiple dimensions. Results: The tools implemented together with our architecture achieved the best performance on …

Dynamic Regulation Of Store-Operated Calcium Entry By Protein S-Acylation, Goutham Kodakandla

Theses and Dissertations

Calcium plays a pivotal role in many physiological functions in cells. Cytosolic calcium levels are finely tuned by calcium ion channels, pumps, and intracellular organelles. Store-operated calcium entry (SOCE) is when depletion of endoplasmic reticulum (ER) calcium stores activates a calcium sensor known as stromal interaction molecule 1 (STIM1). Activation of STIM1 leads to a conformational change from a compact state to an extended state. This extended state of STIM1 allows it to bind to a calcium channel in the plasma membrane (PM) known as Orai1. The binding of Orai1 and STIM1 leads to opening of Orai1 channels and calcium …

Sun Protection Behaviors And Skin Cancer Risk Among Children Of Color, Williana Magloire

Theses and Dissertations

Sun protection is beneficial for children of color as it decreases the risk for sunburns, hyperpigmentation, and most importantly, skin cancer. Invasive melanoma is commonly seen in children of color due to inadequate sun protection. Parental and caregiver modeling of sun protection behaviors may decrease the likelihood of skin cancer among children of color. The American Academy of Pediatrics (AAP, 2011) has suggested that pediatricians adopt the role of informing parents about the benefits of using sun protection products for their young children. They recommended that providers discuss sun protection behaviors with both the parent/child beginning at the age of …

The Relationship Between Parental Trauma History And Perceptions Regarding Their Child’S Healthcare And Utilization Of Healthcare Services, Krishna Patel

Theses and Dissertations

Abstract

TITLE: The Relationship Between Parental Trauma History and Perceptions Regarding Their Child’s Healthcare and Utilization of Healthcare Services

Adverse child events (ACEs) have been associated with a number of physical and mental health problems and have also been linked to increased health care utilization. While parents who have an ACE history may tend to seek healthcare services for themselves, limited studies have examined the impact of their trauma history on seeking healthcare services for their child. Healthcare utilization may also depend on the parents’ level of health anxiety, as well as their anxiety about their child’s health status. This …

Can Physical Activity Help Fight Diabetes Incidence And What Is The Association Between Socioeconomic Status, Demographics, And Diabetes Mellitus In Arkansas In 2019?, Rahima Kerimovna Bay

Theses and Dissertations

One of the most prevalent health challenges among people of all ages in the United States is Diabetes Mellitus that affects 9.3% of the total population. In 2019 Arkansas entered the top 5 states with the highest diabetes death rates (1,144 deaths). Many researchers state that a sedentary lifestyle is considered one of the major risk factors for T2DM and its complications. Regular physical activity is an effective primary and secondary prevention strategy for at least 25 chronic diseases, including type 2 diabetes. Our study showed that the variable for physical activity is statistically significant and associated with the incidence …

Impact Of Steroid Receptor And Hormone Manipulation In Skeletal Muscle: Implications For Glucose Metabolism And Insulin Sensitivity In Male Mice, Christian Aaron Unger

Theses and Dissertations

This dissertation aimed to investigate the influence of modifying steroid receptor content and steroid production within skeletal muscle on glucose metabolism and insulin sensitivity within the context of diet-induced obesity. Specifically, our research focused on three key aspects:1) determining the role that skeletal muscle androgen receptor has on glucose metabolism and insulin action in male mice fed a high-fat diet and 2) determining if inducible skeletal muscle aromatase overexpression improves glucose intolerance and insulin action in male mice fed a high-fat diet and 3) determining if inducible skeletal muscle estrogen-receptor alpha (ER-α) overexpression improves glucose intolerance and insulin action in …

Dietary Inflammatory Index During Pregnancy And Changes Over Time: Associations With Post-Partum Sleep Duration And Quality And Depressive Symptoms., Nowrin Tamanna

Theses and Dissertations

STUDY OBJECTIVES: Sleep and mental health are two important factors for a new mother, as adequate sleep and a healthy mind help her prioritize self-care, seek support when needed, and create a nurturing environment for both her and her baby. Among various plausible theories exploring the etiology of sleep disturbances and depression, the concept of inflammation is gaining attention. This study examined the hypothesis that more pro-inflammatory diets during pregnancy are associated with a decrease in sleep quality and duration, abnormal sleep timing and higher Edinburg Postnatal depression score (EPDS) scores 6 months and 12 months post-partum.

METHODS: A secondary …

No More Loosies: A Mixed-Methods Study On The Implementation And Enforcement Of The Loose Cigarette And Bidi Sale Ban In India, Mayank Sakhuja

Theses and Dissertations

Background: Sale of loose cigarettes and bidis (loosies) is widely accepted as a key factor in promoting the tobacco epidemic in India. This mixed-methods study aimed to broaden understanding around the sale and purchase of loosies addressed three aims: 1) To determine the prevalence and correlates of loosies purchase in India; 2) To examine the association between purchase behavior and health warning labels (HWLs) exposure and responses, and 3) To conduct a stakeholder analysis regarding the ban on the sale of loosies in India. Methods: Data from the 2018-19 Tobacco Control Policy (TCP) India survey (643 current cigarette users and …

The Intersectionality Of Rurality And Race On Covid-19 Vaccination Among Adults In The United States, Shiba Simon Bailey

Theses and Dissertations

Background Vaccination remains a cornerstone of public health, significantly contributing to the prevention and control of infectious diseases. During the COVID-19 pandemic, vaccine development was critical to prevent new SARS-Cov-2 infections. However, COVID-19 vaccination uptake among racial and ethnic minority populations and rural residents in the United States (US) lags behind their urban non-Hispanic White counterparts. Underlying causes of these disparities are unclear, but vaccine hesitancy, access to care barriers, and structural racism may be to blame. Such barriers may vary by residential urbanicity, leading to different racial/ethnic disparities in rural and urban America. Understanding the variations in vaccine uptake …