Development Of A Qa Plan For A 3.0t Cannon Galan Mr-Sim, Nathaniel D. Teague

Theses and Dissertations

Purpose: To develop and incorporate a QA (quality assurance) program for a Canon Galan 3 tesla MR Simulator for applications in radiation therapy.

Methods and materials: The QA program was centered around tests performed with three separate levels of frequency. The daily QA procedure consisted of scanning a vendor provided daily QA cube phantom that measures basic performance parameters. Additionally, a series of basic safety check were performed. The monthly QA procedure consisted of several tests, including scanning the ACR MRI large accreditation phantom and manually performing its corresponding image quality tests. Scanning the MagPhan RT for its detailed geometric …

Prospective Investigation Of Insomnia Symptoms And Sleep Duration As Risk Factors For Stroke Incidence And All-Cause Mortality In U.S Adult, Wendemi Sawadogo

Theses and Dissertations

Background and Objectives: Stroke is the second leading cause of death in the world. In the United States, on average, someone has a stroke every 40 seconds and someone dies as a result of stroke every 3.5 minutes. Identifying modifiable risk factors of stroke is therefore a public health priority. The purpose of this study was to investigate the extent to which insomnia symptoms and sleep duration contribute to stroke incidence, all-cause mortality, and explore potential causal pathways.

Methods: The Health and Retirement Study (HRS) and the REasons for Geographic And Racial Differences in Stroke (REGARDS) study were …

Evaluating The Acute Effect Of Vaping On Food Intake, Gabrielle Maldonado

Theses and Dissertations

Background: Weight control is a common motive for continued cigarette smoking, and weight concerns pose a barrier to quitting. These effects are driven in part by nicotine’s ability to reduce overall appetite and ultimately body weight. Electronic nicotine delivery systems (ENDS) have been marketed and used for weight control, suggesting that the use of these products potentially may share similar effects as well as barriers to quitting as observed for cigarette smoking. However, little to no controlled clinical lab evidence exists supporting ENDS use for weight control. The present study tested the influence of an ENDS on acute eating behavior …

“It's Just Not Enough”: Examining The Experiences Of School-Based Sexual Health Education And Conversation Engagement With Trusted Adults Among Black Boys In Richmond, Va, Sharyn A. Dougherty

Theses and Dissertations

The Centers for Disease Control and Prevention estimate that youth make up a quarter of the sexually active population, yet account for half of the 20 million new sexually transmitted infections in the United States.In 2021, youth age 15-19 living in Virginia’s central region, which includes the Richmond Metropolitan area, had the second highest number of chlamydia cases and fourth highest number of gonorrhea cases among all age groups, with the highest rates among Black youth. The aim of this study is to explore the experiences of Black youth in Richmond, VA with school-based sexual health education (SHE) and their …

Evaluation Of Spliceai For Improved Genetic Variant Classification In Inherited Ophthalmic Disease Genes, Melissa Reeves

Theses and Dissertations

ABSTRACT

EVALUATION OF SPLICEAI FOR IMPROVED GENETIC VARIANT CLASSIFICATION IN INHERITED OPHTHALMIC DISEASE GENES

By Melissa Jean Reeves, Ph.D.

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

Virginia Commonwealth University, 2023

Major Director: Melissa Jamerson, PhD, MLS(ASCP)

Associate Professor, Department of Medical Laboratory Sciences

Inherited ophthalmic diseases impact individuals around the globe. Inherited retinal diseases (IRDs) are the leading cause of blindness in individuals aged 15 to 45. The personal, social, and economic impact of vision loss is profound. Due to individual differences, symptoms can be variable, and …

Role Of The Ormdls In Keratinocytes, Souad Hatmi

Theses and Dissertations

The epidermis, the outermost layer of the skin, serves as a vital barrier protecting the body from environmental stressors, pathogens, and dehydration. Keratinocytes, the predominant cell type in the epidermis, play a central role in maintaining skin integrity and barrier function. In normal human skin, keratinocytes move from the basal layer to the stratum corneum, the top layer of the epidermis. In their travel, keratinocytes undergo a process of terminal differentiation, loss their ability to proliferate, secrete sphingolipids into the extracellular space, and gradually loss their nucleus and organelles. Sphingolipids, particularly ceramides, are key components of the intercellular lipid lamellae …

Quantitative And Molecular Genetic Analyses Of Brain Structure, Substance Use, And Posttraumatic Stress Phenotypes: Data From Children, Adolescents And Adults, Daniel Bustamante

Theses and Dissertations

Abstract

QUANTITATIVE AND MOLECULAR GENETIC ANALYSES OF BRAIN-IMAGING, SUBSTANCE USE, AND POSTTRAUMATIC STRESS PHENOTYPES: DATA FROM CHILDREN, ADOLESCENTS AND ADULTS

By Daniel Bustamante, B.S., B.A.

Doctoral dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Integrative Life Sciences – Behavioral and Statistical Genetics at Virginia Commonwealth University.

Virginia Commonwealth University, 2023.

Dissertation directors: Michael C. Neale, Ph.D., Banks Distinguished Professor of Psychiatry & Human and Molecular Genetics; and, Ananda B. Amstadter, Ph.D., Professor of Psychiatry, Psychology, & Human and Molecular Genetics.

Substance use (SU) and posttraumatic stress disorder (PTSD) phenotypes are comorbid, share …

Interactions Between Hiv And Opioids On Antiretroviral Accumulation, The Blood Brain Barrier, And The Inflammatory Response In The Brain., Kara Rademeyer

Theses and Dissertations

The complex mechanisms related to HIV infection, neurodegeneration, and chronic neuroinflammation collectively describe neuroHIV (Hauser et al. 2007; Chang et al. 2014; Smith et al. 2014). Specifically, opioid abuse, poor penetration of antiretroviral (ARV) drugs, chronic inflammation and neuronal injury/degeneration are all implicated in neuroHIV (Fantuzzi et al. 2003; Letendre et al. 2004; Verani et al. 2005; Duncan and Sattentau 2011; Hong and Banks 2015; Simoes and Justino 2015; Olivier et al. 2018; Murphy et al. 2019; Osborne et al. 2020). For the first time, we demonstrate that morphine, fentanyl, and methadone in vivo alter the brain accumulation of ARVs, …

Successfully Transitioning Executives During Times Of Multidimensional Change: A Delphi Study Examining Organizational Practices In Large Hospital Systems, Lilicia Bailey

Theses and Dissertations

Healthcare is the fastest growing industry in the United States and globally. Economists forecast that as the population grows and life expectancy increases, the healthcare sector will continue expanding to meet consumer needs domestically and globally. Population aging and the emergence of global pandemics has substantially increased the demand for healthcare services and has created volatile, complex, uncertain, and ambiguous conditions that ignite social, economic, and workforce shifts within and outside the organization. While these factors require growth and agility within healthcare organizations, high turnover in the healthcare workforce threatens these organizations’ ability to effectively fulfill their mission. The high …

Lived Experiences Of College-Educated Black Women: Contextualizing Gendered Racial Health Disparities, Christiana L. Johnson

Theses and Dissertations

Black women are disproportionately affected by gendered racial health disparities. Public health research that seeks to unearth the root cause of these gendered racial health disparities is insufficient. More recently, researchers have turned their attention to structural inequities and their influence on the lived experiences of Black women. This study contributes to this body of work by using a theoretical concept derived from intersectionality⎯structural gendered racism⎯to identify key upstream social factors that shape nulliparous, college-educated Black women's lived experience and childbearing desires. Semi-structured, individual interviews were conducted with nulliparous, college-educated Black women (n=30), ages 25 to 35, living in the …

Probing The Porphyromonas Gingivalis Nitrosative Stress Response Network, Alexandra Galina

Theses and Dissertations

Objective: To persist in the oral cavity, the perio-pathogen Porphyromonas gingivalis must have an efficient nitrosative stress response mechanism. To better understand how P. gingivalis responds to nitrite (NO₂^-) we must determine what genes are involved in the nitrosative stress response network.

Methods: Through genomic screening, a list of genes was generated that were hypothesized to be part of the nitrosative stress response network and believed to be involved in nitrate/nitrite metabolism or redox state of the cells. Protein coding regions were replaced with the ermF sequence by allelic exchange mutagenesis. 15 mutants were created …

Sustaining Breaths For Restorative Rest: A Preliminary Evaluation Of Sleep, Mental Health, And Cognitive Function Following Hypoglossal Nerve Stimulation For Obstructive Sleep Apnea, Elliottnell Perez

Theses and Dissertations

Introduction: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that produces repetitive obstruction or collapse of the upper airway. Positive airway pressure (PAP) therapy is the gold standard treatment for OSA. Hypoglossal nerve stimulation (HNS) is considered an alternative treatment for patients who are unable to tolerate PAP therapy. The purpose of the study was to examine sleep, mental health, and cognitive health outcomes before and after HNS to determine its viability as an alternative treatment.

Methods: The study utilized a single-group, pretest-posttest design. Objective and subjective sleep was measured using actigraphy, sleep diary, and questionnaires. Objective and subjective …

The Promis Women Education Program: Promoting Cervical Cancer Prevention Methods Among Muslim Women In Virginia, Asmaa M. Namoos

Theses and Dissertations

Abstract

Purpose: US Muslim women have suboptimal participation in cervical cancer screening and prevention services. This is due in part to a lack of access to culturally relevant education programs. To address this issue three aims were identified: Aim 1. Adapt existing evidence- based educational materials for a religious and culturally appropriate intervention; Aim 2. Test the preliminary efficacy of the intervention and Aim 3. Assess the feasibility and acceptability of the intervention and materials.

Methods: The ORBIT model for developing behavioral interventions guided intervention design, refinement (Phase I), and preliminary testing (Phase II). Focus groups and interviews were conducted …

The Heads-Ed: A Psychosocial Screening For Pediatric Patients In Emergency Departments: A Systematic Review, Jessica Burns

Theses and Dissertations

The rates of mental health (MH) conditions among the pediatric population are rising steadily (Abramson, 2022; Clark et al., 2019). Given that MH symptoms and concerns frequently present in the emergency department (ED)-particularly since the onset of the COVID-19 pandemic-the ED setting may be a practical and effective setting to implement screening measures to identify youth at risk for mental illness and suicide (Leeb et al., 2020; Leff et al., 2021). This integrative systematic review examined the extent to which the HEADS-ED, one specific psychosocial screening measure, has been administered in the ED setting with youth and which healthcare professionals …

Black Midwives For Black Mothers: Ameliorating Racial Disparities In The Quality Of Maternal Healthcare, Kimberly Navarro

Theses and Dissertations

In the United States, maternal mortality represents a dire health crisis with a stark racial imbalance. Black women are two and a half to three times more likely to die from pregnancy and birth-related complications than their White counterparts. Racial disparities in maternal health can be explained by variations in the quality of maternal healthcare services that women tend to receive. Racial and ethnic minority women are more likely to receive inferior quality prenatal care (PNC), which brings to question the care model of traditional PNC and its adequacy in serving the healthcare needs of Black women. Since Black women …

Experiences And Perceptions Of Bilingual Spanish-English Latinx Clients And Bilingual Spanish-English Latinx Therapists In Psychotherapy: A Systematic Review, Irvin I. Navarrete

Theses and Dissertations

As the bilingual Spanish-English Latinx population in the United States increases, so will the need for culturally and linguistically competent mental health therapists. While past research has focused on providing culturally competent care, the role of language in the process of psychotherapy has received limited attention. This study aimed to comprehensively analyze the existing literature on bilingual Spanish-English Latinx clients’ and bilingual Spanish-English Latinx therapists’ experiences and perceptions within a bilingual psychotherapy setting and identify recommendations to enhance language proficiency. A systematic review was conducted and identified nine studies for inclusion. Results highlight seven themes focusing on bilingual Spanish-English Latinx …

Formation Of Vasculogenic Mimicry: Role Of Melanoma Differentiation Associated Gene-9 In Human Melanoma, Jinkal Shah

Theses and Dissertations

Malignant melanoma (MM) is the most aggressive skin cancer and the most frequent skin disorder in Caucasians. MM is associated with aggressive and progressive disease states, leading to major cancer-related morbidity and mortality. Recent investigations identify an alternative pathway -vasculogenic mimicry (VM), which is considered a cancer hallmark that can independently facilitate tumor neovascularization by the formation of fluid-conducting and vascular endothelial cells. MM cells undergoing VM can dedifferentiate into numerous cellular phenotypes and acquire endothelial-like features, resulting in the formation of the de novo matrix-rich vascular-like networks, such as plasma and red blood cells. The co-generation of endothelial cells, …

Exploring The Effect Of Early Motor Delay And Physical Therapy Interventions On The Parent-Child Relationship, Rebecca Molinini

Theses and Dissertations

Emotional availability (EA) or the ability of the parent-child dyad to engage emotionally and partake in congruent and mutually enjoyable interactions, is essential for familial health and well-being. EA is considered the “connective tissue” of healthy parent-child relationships and is associated with secure attachment, maternal mental health, and children’s adaptive development. Most evidence supporting the integral role of EA on healthy outcomes is supported by typically developing populations in which adults present with a social or biological risk factor such as experiencing past traumas of adversities with mental health. In line with the transactional model of development, children are equal …

Age-Associated Collagen Crosslinking And Its Role In Skeletal Muscle Regeneration, Lucas C. Olson

Theses and Dissertations

Advanced glycation end-products (AGEs) non-enzymatically accumulate on skeletal muscle collagen in old age via the Maillard reaction, causing an increase in intramuscular collagen and a stiffening of the muscle’s microenvironment. AGEs abrogate muscle regeneration through stiffening the muscle stem cell (MuSC) microenvironment and by binding to the receptor for advanced glycation end products (RAGE). Stiffer substrates promote MuSC proliferation at the expense of differentiation, and soluble AGEs are known to abrogate myogenic differentiation. Previously our group has demonstrated that decellularized muscle matrix (DMM), a type of extracellular matrix (ECM) scaffold extracted from skeletal muscle, encourages regeneration in a challenging rat …

Effectiveness Of Cognitive Behavioral Therapy Versus Therapeutic Play For Hospitalized Children Diagnosed With Cancer: An Integrative Systematic Review, Dianne Kong

Theses and Dissertations

Psychotherapy provides essential coping mechanisms and strategies for children who are diagnosed with cancer, as they experience the extraordinary burden of physical, emotional, and mental strains. While many medical advancements have been made within the past few decades, progress related to psychotherapy for pediatric cancer patients has not been commensurate, evidenced by the limited current literature. Given the sparsity of relevant research, it is presently difficult to compare and evaluate the various psychotherapeutic interventions available for pediatric oncology patients. Additionally, there are significant challenges in providing psychotherapeutic care for patients and their families, including lack of consistency, disruption of care, …

The Use Of Dance And Movement For The Embodied Healing Of Interpersonal Trauma In Women And Girls: A Systematic Review, Catherine Xinyu Liang

Theses and Dissertations

Interpersonal trauma is a serious and devastating problem for women and girls from all walks of life. Research has shown that there are physiological consequences for experiencing trauma, and as such, treatment for trauma may need to target the body. Dance/Movement Therapy (DMT) has been emerging in the current literature as one body-oriented treatment approach that is effective in helping women and girls heal from interpersonal trauma. This review examines how practitioners are currently using DMT for this population, what treatment outcomes have been observed, and what the racial/ethnic identities and international contexts are for survivors who have benefited from …

Application Of Third-Wave Cognitive-Behavioral Interventions In The Treatment Of Obsessive-Compulsive Disorder, Emily Hanna

Theses and Dissertations

Obsessive-compulsive disorder (OCD) has a high comorbidity rate, with substantial risks for anxiety, mood, and substance use disorders. Exposure and response prevention (ERP) is considered the first-line psychotherapy treatment for OCD. While highly efficacious, not all patients achieve full remission with ERP, and given the chronicity of OCD and its sensitivity to stress-related events, many patients struggle with ongoing symptoms. A growing area of research has been the use of third-wave behavioral and cognitive therapies that potentially enhance patients’ willingness to engage with exposure-based treatment and provide strategies to cope with residual symptoms. This integrative systematic review summarizes and synthesizes …

Trust In Integrated Medical Care Using A Population-Based Normative Approach, Heather Summers

Theses and Dissertations

The role of integrated care partnerships in addressing health care and social needs to achieve whole person care is important as health care costs rise and quality of care outcomes are incentivized. Medicaid reform and 1115 Medicaid waiver programs are implemented statewide as innovative programs aimed at achieving cost savings and improved clinical quality of care outcomes. Understanding how cross sector partnerships can meet the needs of individuals through integrated care cross sectoral coordination between government, social services and managed care is needed. This research study examined the role of normative care values, vision, trust, shared care, and leadership. The …

Molecular Target And Circuitry Underlying The Preclinical Effects Of Psychedelics In Models Of Opioid Use Disorder, Alaina M. Jaster

Theses and Dissertations

Opioid use disorder (OUD), like other substance use disorders (SUD), is characterized by maladaptive behavioral allocation away from other rewarding aspects of life following prolonged use, as well as large rates of relapse. While pharmacotherapies exist for OUD, they tend to only target the opioid receptors rather than the underlying mechanisms behind the maladaptive behaviors. Serotonin (5-hydroxytryptamine; 5-HT) is involved in modulation of cravings and regulation of motivational reward-related behaviors, thought to be due to a top-down processing method of external and internal stimuli. Serotonin 2A receptors (5-HT_2AR) are widespread throughout the brain and most densely populate layer …

Provider Racial Concordance And Medical Mistrust In Pediatric Dentistry, Chinelo Eke

Theses and Dissertations

Purpose: Studies have drawn varying conclusions on the importance of a racially concordant patient provider relationship. Medical mistrust has continued to garner attention as healthcare enterprises thread equity, diversity and inclusion throughout their organizational policies, practices and systems.

Methods: Parents/caregivers of pediatric patients at VCU Pediatric Dentistry were invited to participate. Surveys included questions about demographics, racial concordance, language preference, and the validated Group-Based Medical Mistrust Scale.

Results: A total of 246 guardians completed the survey. For guardians, 40% reported Black or African American, 31% Hispanic, and 19% Caucasian. Seventy-one percent of guardians reported speaking English, 18% Spanish, and 11% …

The Use Of Silver Diamine Fluoride In Dentistry In Virginia, Jessica Eisenberg

Theses and Dissertations

Purpose: The purpose of this research was to determine the use of silver diamine fluoride (SDF) in dentistry in Virginia and the factors that affect the practitioners’ decision. Methods: A survey was sent to the members of the Virginia Dental Association (VDA) by email and posted on the VDA social media accounts. The survey questions measured the practitioner’s demographics, knowledge, and factors that affect their utilization of SDF. Results: Most providers were general dentists (77%). The most common clinical situations for SDF use were to arrest caries in children with behavioral issues (77%), to delay restorative treatment (73%), in medically …

The Age And Primary Reason For The First Dental Visit In Children With Special Health Care Needs, Amanda Dickerson

Theses and Dissertations

Purpose: The aim of this project is to evaluate the average age and primary reason for the first dental visit among patients with special health care needs as well as to examine socioeconomic factors and other barriers related to children with special health care needs accessing care.

Methods: This is a cross-sectional survey that was distributed to caregivers of children with special health care needs. Study data was collected through REDCap, a secure web-based survey application. The inclusion criteria for participating in the survey included having a child with a special health care need that presented for a recall or …

Histone Acetylation In Periodontal Diseases, Sarang Saadat

Theses and Dissertations

Background: Emerging data has indicated the significant role of epigenetic control in inflammation. Acetylation of lysine residues on histones is a major epigenetic modification of chromatin, which is required for cytokine gene expression and regulated in inflammatory diseases. It has been shown that periodontal bacteria induce histone acetylation in oral epithelial cells and experimental periodontitis in rodents. In this study, we investigated the acetylation level of histone 3 (H3) in gingival tissue from healthy and periodontitis patients. We hypothesize that cytokine over-production in periodontitis is associated with the hyper acetylation of histones. Methods: Periodontitis and healthy subjects who need periodontal …

Contribution Of Metabolic Cell Swelling On Microcirculatory Perfusion In Septic Shock, Charles E. Payne

Theses and Dissertations

Sepsis, a systemic immunological response that leads to organ-dysfunction, the development of septic shock, and death has mortality rate of 15-25%. A subset of sepsis, septic shock, has an in-hospital mortality rate of 30-50%. Sepsis and its treatment are the most expensive healthcare problem in the United States with the US Agency for Healthcare Research and Quality estimating annual costs over $20 billion. Hypoxia experienced in septic shock induces metabolic cell and tissue swelling leading to further microcirculatory dysfunction and poor tissue perfusion. Reversing metabolic cell swelling corrects these perfusion defects. Two models were used in rats to induce septic …

Combining Novel Direction Modulated Brachytherapy Tandem-And-Ovoids Applicators For Treatment Planning Of Multi-Institutional Cervical Cancer Cases: Removing Needles In Intracavitary-Interstitial Techniques, Sharmin Alam

Theses and Dissertations

Lack of standard guidelines for optimal needle insertion during high-dose-rate (HDR) intracavitary-interstitial (IC-IS) brachytherapy of the cervix means a sophisticated and technical skillset of inserting needles next to IC applicators must be developed to enhance plan quality. This study sought to evaluate the performance of two separate direction modulated brachytherapy (DMBT) tandem applicators used in conjunction with one set of novel DMBT ovoids, to effectively obviate the need for IS needles.

A cohort of 32 retrospective clinical HDR brachytherapy plans was re-planned with Varian’s BrachyVision^® treatment planning system, using VEGO^® inverse optimization algorithm, with dose heterogeneity accounted for …