Medicine and Health Sciences Commons^™

Comparative Assessment Of Lower Limb Neuromusculoskeletal Activation And Joint Kinematics In Normal And Impaired Gait, Jack Ryan Schule

Theses and Dissertations

This thesis evaluates whether accessible and affordable technologies can provide clinically significant, quantifiable gait analysis comparable to traditional marker-based motion capture systems. Modern high-end systems offer excellent accuracy but remain financially and logistically inaccessible to many clinicians and researchers. To address this gap, a framework was developed using markerless pose estimation using the model, MediaPipe, inertial measurement units (IMUs) processed through an Extended Kalman Filter (EKF), and surface electromyography (sEMG) to measure joint kinematics and neuromuscular activity during gait. An experiment was performed where data was collected from participants with both normal gait and pathologies including: Osgood–Schlatter disease, Plica Band …

Food Insecurity And Social Connection Of Nicaraguan Refugees And Asylum Seekers In Costa Rica: A Qualitative Study, Keren Herran

Theses and Dissertations

Background

Given the physical and mental health consequences of food insecurity, solutions should be evidence-based and seek to prioritize vulnerable populations. This qualitative study adds to limited literature on how refugees and asylum seekers use their social connections to mitigate food insecurity by investigating how Nicaraguan refugees and asylum seekers in Costa Rica foster social connections and use these connections to acquire and manage food.

Methods

In fall 2024, 35 in-depth semi-structured interviews were conducted in San José, Costa Rica. Participants were recruited through six migrant-serving nonprofit organizations. For study inclusion, participants had to: 1) be 18 or older; 2) …

Development Of A Strategy To Neutralize Ccl8 Activity And Ablate Ccl8 Cellular Targets, Bernardo Chavez

Theses and Dissertations

The chemokine CCL8 (monocyte chemoattractant protein-2) is a versatile signaling molecule involved in tumor progression, immune cell recruitment, and therapeutic resistance. Through activation of receptors including CCR1, CCR2B, and CCR5, CCL8 promotes leukocyte trafficking, epithelial–mesenchymal transition, and the establishment of immunosuppressive tumor microenvironments. In breast cancer and inflammatory diseases, elevated CCL8 levels correlate with poor clinical outcomes, making it a promising therapeutic target.

A strategy was developed to block CCL8 activity and selectively ablate CCL8 receptor expressing cells. A neutralizing monoclonal antibody, 1G3E5, was identified from a panel of murine candidates based on high affinity CCL8 binding. Sequencing revealed two …

The Role Of Fibroblast Activation Protein On Left Ventricular Growth And Extracellular Matrix Remodeling As A Function Of Age And Pressure Overload, Amelia Marie Churillo

Theses and Dissertations

Fibroblast activation protein (FAP) is abundantly expressed in cancer associated fibroblasts and contributes to extracellular matrix (ECM) remodeling. Recent studies using imaging techniques have identified increased levels of FAP in the left ventricle (LV) of patients identified as at risk for developing heart failure. However, the role of FAP in regulated LV myocardial structure and function remains unclear. This project tested two hypotheses: First, genetic ablation of FAP would modify LV structure and function and be more pronounced with aging. Second, genetic ablation of FAP would modify LV structure and function with LV pressure overload (LVPO) accompanied by ECM remodeling.

Copper Oxide Nanoparticles As Delivery Vehicles For Different Pt (Ii)-Drugs: Experimental And Theoretical Evaluation, Shahdan Abdelkareem

Theses and Dissertations

Platinum(II)-based chemotherapeutic agents such as cisplatin, oxaliplatin, and nedaplatin are mainstays in the treatment of a wide range of solid tumors, yet their clinical application is severely restricted by rapid degradation, poor bioavailability, and dose-limiting side effects. These challenges arise in part from the drugs’ susceptibility to premature hydrolysis, off-target interactions in the bloodstream, and degradation in the gastrointestinal tract, which collectively limit their ability to reach and act on tumor cells. To address these limitations, we explored the use of copper(II) oxide nanoparticles (CuO NPs) as nanocarriers for platinum(II) drugs, aiming to enhance drug stability, loading, and controlled release. …

Social Participation And Health-Related Quality Of Life For Adults With Neurodevelopmental Disabilities: Capabilities Mediation And Employment Status And Social Security Disability Insurance Moderation, Kayi Ntinda

Theses and Dissertations

Social participation is a key determinant of health-related quality of life (HRQoL) of adults with neurodevelopmental disabilities (NDDs), yet how individuals with NDDs engage socially to support their HRQoL remains poorly understood. Furthermore, the influences of personal capabilities, employment status, and Social Security Disability Insurance (SSDI) as social factors for well-being are underexplored with this population.

This cross-sectional study investigated the direct and indirect effects of social participation on HRQoL, examining capabilities as a mediator and employment status and SSDI receipt as moderators. The study sample comprised 304 adults with NDDs (females = 83.3%; age range 18 to 60 years …

Occupational Therapy Educators’ Perceptions Of Preparedness To Teach Students Culturally Responsive Care For Diverse Patient Populations, Jack Ruelas

Theses and Dissertations

This phenomenological investigation examined occupational therapy faculty preparedness for teaching culturally responsive care to entry-level doctorate students in Texas. Despite Accreditation Council for Occupational Therapy Education (ACOTE) mandates requiring cultural competence education, significant gaps persist between regulatory requirements and faculty readiness to deliver such instruction effectively. The study explored three interrelated dimensions: (1) faculty perceptions of their preparedness to teach cultural competence, (2) institutional training and support mechanisms, and (3) pedagogical integration strategies for culturally responsive content.

Employing interpretive phenomenology grounded in Freire's critical pedagogy and Iwama's Kawa Model, this investigation utilized a two-phase data collection methodology with eleven faculty …

Chronic Lower Extremity Anomalies: Impact Of Diabetic Induced Foot Amputations On Human Locomotion, Anthony Arnoldo Melgar

Theses and Dissertations

This research aims to understand the physiological changes that the human body undergoes post partial foot amputation (PFA). A total of three studies were conducted to fully comprehend biomechanical changes and adjustments that occur during locomotion for affected individuals. The first study of this thesis focuses on obtaining kinematic data for both the ankle joint angle and ankle joint torque for the healthy population, as well as for the affected PFA population. Results were compared, and notable differences were present between the two. The second study of this thesis dealt with individual muscle forces. To obtain the muscle force data, …

Novel Piperidone And Bispidine Derivatives: A New Approach In Cancer Therapy, Lereen Khaled Youssry

Theses and Dissertations

Cancer remains the second leading cause of death worldwide. As a result, scientists have been trying to find novel therapeutic approaches that target specific metabolic pathways selective to tumor cells. In this study, two novel piperidone and bispidine derivatives, organic molecules that target polyamine metabolism, were synthesized, and their potential cytotoxic, antioxidant and anti-inflammatory effects were investigated. Polyamines are naturally occurring metabolites that were reported to be in excess at cancer cells and were accounted for tumor proliferation, invasion and metastasis. Accordingly, the novel piperidone and bispidine derivatives were expected to disrupt tumor growth and progression via up-regulation of key …

Inorganic Nanoparticle And Nanoplastic Transformations And The Impact On Biouptake By Freshwater Algal Cells Using Single Cell And Single Particle Inductively Coupled Plasma Mass Spectrometry, Elizabeth Carey Bair

Theses and Dissertations

The ubiquitous presence of nanoparticles (NPs) and nanoplastics (NPPs) and their effects on environmental and human health is a significant concern. They are used in every aspect of our lives, and while they offer many benefits, there are concerns about their impacts on ecosystems and human health. The primary aim of this dissertation is to quantify NP and NPP transformations in the presence of algae and determine how those transformations influence bioavailability. The methodology involves two complementary analytical techniques: single particle (SP) and single cell (SC) inductively coupled plasma mass spectrometry (ICP-MS). These techniques are tested and applied to two …

A Mixed Methods Study Exploring The Lived Experience Of Shared Trauma In Psychiatric Nurses During Covid-19, April Lynne Hutto

Theses and Dissertations

Introduction: Psychiatric nurses (PNs) had a unique lived experience of shared trauma (ST) during the COVID-19 pandemic. These nurses experienced the same traumatic event, COVID-19, with associated trauma symptoms as their patients. This mixed methods study aims to triangulate data on ST in PNs using a quantitative and qualitative study. Methods: PN (N=24) completed a semi-structured interview during the summer and fall of 2024. A quantitative study PN (N=552) in spring 2023, using the Shared Trauma and Professional Posttraumatic Growth (STPPG) inventory, was completed with descriptive and inferential statistics using SAS 9.4. A thematic analysis of the interviews was completed …

The Influence Of Sex Education On Sexual Behaviors From Adolescence To Young Adulthood In South Carolina, Megan Elizabeth Austin

Theses and Dissertations

Sex education in South Carolina (SC) is known to be limited, which may influence adolescent sexual behaviors, leading to a higher likelihood of lower ages of sexual initiation, more sexual partners, and more experiences of sexual violence. These behaviors are associated with many negative health outcomes.

A political content analysis of bills, laws, and educational standards provides insight to changes in political discourse around sex education from when the Comprehensive Health Education Act (CHEA) was passed in 1988 until 2024. A variable created through this analysis is used along with SC Youth Risk Behavior Survey data to assess changes in …

Aggressive, Adaptive, And Underestimated: From Allergy To Arboviruses, The Rise Of The Lone Star Tick, Emily Ellen Owens Pickle

Theses and Dissertations

Once considered a nuisance with little medical importance, the lone star tick (Amblyomma americanum, Acari:Ixodidae) has emerged as a formidable vector driving a new era of public health threats across the United States of America. This dissertation traces the rise of the lone star tick from obscurity to infamy, exploring its expanding geographic range, unique immunologic impacts on humans, and role in the transmission of emerging tickborne viruses. Through a series of integrated studies, this work characterizes the epidemiology, immunology, and ecological context of tick-borne diseases in the southeastern U.S., with a particular focus on α-Gal syndrome (AGS), …

Assessing Health And Academic Disparities In The Deep South: The Enduring Impact Of Segregation And Redlining In Georgia, Bridget Hamilton

Theses and Dissertations

Background: Within the American South, marginalized Black populations continue to suffer from health disparities. A key resource that could aid in the prevention of health disparities such as teen pregnancy is the school nurse. School nurses are well positioned to assist in the development of independent health maintenance among student populations. However, school nurses remain understaffed and underfunded throughout most of the United States, which limits their effectiveness. It is possible that within southern states there are inequities in how school resources are allocated that have ties to segregation and redlining practices that systemically marginalized Black populations throughout the 1900s. …

Effects Of Stressor Exposure And Locus Coeruleus Opioid Signaling On Coping And Anxiety-Like Behavior In Rats, John Arthur Tkaczynski

Theses and Dissertations

Stress is a physiological state of altered neuroendocrine signaling and heightened indices of behavioral vigilance and arousal in response to threatening stimuli. This project aimed to investigate the adaptations to stress that occur in the noradrenergic locus coeruleus (LC) and how these changes affect stress coping behavior. We began by investigating how adolescent restraint and predator odor stress affects coping when presented with a secondary noxious stimulus in the defensive shock probe burying task one week following stressor exposure, finding that stressed male rats demonstrate a more active coping response and stressed female rats demonstrate a more passive coping response, …

The Social Standing Versus The Mind Standing Of Older Adults In Egypt: Cross-Sectional Analysis Of The Relationship Between Social Capital And Cognitive Functions, Shaza H. Shinaishen Dr

Theses and Dissertations

Introduction: Egypt's population, much like that of other countries, is expected to age considerably over the course of the coming decades. Although biological and socioeconomic predictors of cognitive function have been studied widely, personal level social capital remains unexplored, especially in LMICs.

Purpose: This study primarily investigates the relationship between individual social capital and cognitive functioning among older adults aged 65 years and older in Egypt using the structural and cognitive components of social capital, including group membership, civic engagements, and caregiving roles.

Methods: A cross-sectional survey on 363 older individuals in different geographical and demographic segments of Egypt using …

Assessing The Impact Of Digital Transformation On Regulatory Processes And Systems Compared To Traditional Paper-Based Processes At The Egyptian Drug Authority, Rania Aa Soliman

Theses and Dissertations

In the past several decades, the rate of scientific and technological advancements in drug development and digital fields have been extraordinary. Internet of Things and block chain technologies are currently viable in the mature cloud computing industry, these transformative examples contrast starkly with the current pharmaceutical regulatory submission, review, and approval process of the EDA. However, with the emergence of initiatives that aim to improve and expedite regulatory decision-making, there is a promising future ahead. These initiatives, if successful, will not only transform the current transactional structure but also leverage scientific and technological advances to deliver patient-centric therapies. This radical …

Development Of Preventive Dental Guidelines In The Primary Healthcare Setting In Egypt: A Delphi Method, Basant Mehriz

Theses and Dissertations

This study addresses the critical need for standardized preventive dental care guidelines within Egypt's primary healthcare system amid the rising burden of oral diseases. Through a systematic two-phase methodology combining a comprehensive literature review and a Delphi consensus-building process engaging 35 dental professionals, the research established priorities for contextually appropriate preventive measures. The consensus framework revealed strong support for clinical interventions (mean of 83% agreement), particularly fluoride-based prevention; community initiatives (mean of 83%), especially school-based programs; policy measures (mean of 77%) such as workforce and educational development, though with variable support for taxation and social determinants approaches. Statistical analysis demonstrated …

The Dubr/Mir-210-5p/Retsat Axis In Cholesterol-Associated Steatohepatitis: Clinical Signatures And Molecular Mechanisms, Hana Mahmoud Abdelzaher

Theses and Dissertations

Metabolic-associated fatty liver disease (MAFLD) represents an increasing global health challenge, with cholesterol-associated steatohepatitis (CASH) emerging as a distinct pathological entity warranting investigation. While CASH demonstrates unique features compared to traditional triglyceride-driven steatohepatitis, its underlying molecular mechanisms remain poorly understood. This study investigates a novel regulatory axis involving DPPA2 Upstream Binding RNA (DUBR), miR-210-5p, and retinol saturase (RETSAT). 170 patient samples revealed progressive axis dysregulation in disease states, with RETSAT emerging as a highly accurate diagnostic marker (AUC=1.000). Using novel in vitro models of MASH and CASH, we demonstrated that miR-210-5p modulation significantly affects lipid accumulation and cellular phenotype, with …

Mechanisms Underlying Estrous Cycle-Dependent Changes In Incubated Cocaine Craving, Erin Elizabeth Wannen

Theses and Dissertations

Cues associated with cocaine use are one of the most common relapse triggers and understanding what promotes cue-induced cocaine craving and relapse is a critical question in the field. Human studies have shown that these measures are impacted by fluctuations in ovarian hormone levels, as higher levels of estradiol promote cue-induced cocaine craving in women while higher levels of progesterone reduce craving in both sexes. Enhanced or incubated cue-induced cocaine seeking or craving also changes across the rodent reproductive (estrous) cycle as levels of estradiol and progesterone fluctuate, with enhanced seeking behavior observed during the estrus stage of the cycle. …

In Vitro Evaluation Of A Novel Computationally Designed Anticancer Peptide In Ovarian Cancer Cell Models, Basma A. Shaala

Theses and Dissertations

Ovarian cancer remains one of the leading causes of cancer-related mortality among

women, highlighting the need for novel therapeutic agents with improved selectivity and

reduced toxicity. Anticancer peptides (ACPs) have emerged as promising candidates

due to their ability to selectively target cancer cells. In this study, the anticancer activity

of a computationally designed ACP was evaluated in vitro using the SKOV-3 ovarian

cancer cell line, with HEK cells employed as a non-cancerous control.

Cell viability was assessed using the MTT assay, and cytotoxicity was further confirmed

by the trypan blue exclusion method. Apoptosis and necrosis were analyzed using

Annexin V-FITC/Propidium …

Raised Spirits The Visceral Journey Of Black Generational Female Trauma And The Transcendent Healing Power Of Spiritual Dance, Wendy Ann Powell

Theses and Dissertations

Black female bodies have endured sustained trauma globally since the transatlantic slave trade, and it continues into 2025. The collective consciousness has carried the generational burden and mobilized it within the womb. Powell uses this intergenerational knowledge to frame the basis for spiritual dance practices as a healing praxis.

One Can Only Dream, Sophia V. Yacca

Theses and Dissertations

One Can Only Dream is an interactive installation in which players are invited to navigate a liminal, dream-like game, engage with a branching series of questions, and introspect upon the relationships between unconscious expression, conscious self-perception, and the inherent difficulty of depicting, sharing, and understanding subconscious thought.

Rooted in both my personal experience with a rare neurophysiological condition and in my desire to create, this project examines dreams not only as a medical and cultural phenomenon, but also as a means to form identity, reflect trauma, and inspire creativity. Drawing from modern interactive storytelling and my lived experiences, this work …

Behavioral Responses To The Medicare Part D Coverage Gap And Its Closure, Selene Urbatsch

Theses and Dissertations

The author examines how exposure to the Medicare Part D coverage gap affects future prescription drug use and whether the closure of the gap under the Affordable Care Act (ACA) altered beneficiary behavior. Using 2007–2019 MEPS data, the analysis compares Part D enrollees to similarly aged, privately insured individuals, producing first-differences and difference-in-differences estimates. Before the ACA, exposure to the gap was associated with 4.9 fewer prescription fills relative to comparable non-Part D individuals. After the ACA, the effect fell to a reduction of 2.2 generic fills, with no significant decline in branded use. Sudden out-of-pocket cost increases prompted sharp …

Out From Under: Stories Of Endometriosis, Prisca Edwards

Theses and Dissertations

Six individuals. One diagnosis. In Out From Under, people living with endometriosis gather for an art-centered workshop. Through collage and conversation, they transform isolating medical experiences into paths of connection and collective healing.

Endometriosis affects approximately one in ten women of reproductive age, yet diagnosis is often delayed by nearly a decade. During this time, many suffer from debilitating symptoms without adequate care or accessible treatment. Out From Under explores the lived experience of endometriosis through the lens of socially engaged documentary filmmaking. Participants share their medical histories, emotions, and frustrations in a structured yet open environment designed for intimacy, …

Joint Modelling Of Longitudinal Egfr Trajectory And Time To Acute Kidney Injury In Lung Transplant Patients, Samiha Zakir

Theses and Dissertations

Progressive declines in estimated glomerular filtration rate (eGFR) often precede acute kidney injury (AKI), yet the relationship between eGFR trends and AKI risk remains unclear. This study investigates longitudinal eGFR changes and their association with AKI in 459 lung transplant patients followed for up to 7 years (n = 6419). We applied a piecewise linear mixed-effects model to evaluate eGFR trajectories and a Cox proportional hazards model to assess time to AKI. A joint model was used to explore the interplay between longitudinal and survival processes. Key covariates included gender, age at transplantation, antibody-mediated rejection (AMR), and pre-transplant eGFR. Males …

Developing A Small Molecule To Inhibit Hsf1 Expression In Cancer And Evaluating Natural Genetic Variation In Small Molecule Toxicity., Michaela Kendal Foley

Theses and Dissertations

Each year cancer affects nearly 20 million people worldwide and genetic differences across populations can impact cancer onset and progression. Specifically, tumors with high levels of HSF1, the master regulator of the cytoprotective heat shock response (HSR), are correlated with poor patient outcomes in multiple cancers such as prostate, breast, and melanoma. Subsequently, the development of pharmacological inhibitors of HSF1 represents a promising strategy for anticancer therapeutics. Using a luciferase-based transcriptional reporter, two small molecule libraries were screened for inhibitors of HSF1 expression in human embryonic kidney cells, yielding ten compounds that decrease HSF1 expression. To identify if cancer lines …

Exploring The Effects Of Serotonin And Selective Serotonin Reuptake Inhibitors On The Neurological, Behavioral, And Cardiovascular Systems Using The Animal Model Of The Syrian Hamster (Mesocricetus Auratus), Ariana Vianey Hinojosa

Theses and Dissertations

Serotonin is a neurotransmitter widely recognized for its role in neuropsychological processes, particularly in regulating mood, cognition, and emotional responses. However, its influence extends beyond the central nervous system (CNS), playing a crucial role in various physiological functions, including metabolism, the gastrointestinal system, reproductive processes, and cardiovascular regulation. As a key modulator of homeostasis, serotonin contributes to maintaining equilibrium within these systems, ensuring proper function and response to environmental stimuli. Despite its well-documented effects on mood and behavior, the broader physiological implications of serotonin remain less understood, particularly in the context of its interactions among neural, behavioral, and cardiovascular systems. …

Implementing And Evaluating An Ai-Powered Visual Decision Support System To Improve Antibiotic Usage Among Physicians With A Built-In Early Warning System, Akua Sekyiwaa Osei-Nkwantabisa

Theses and Dissertations

The widespread misuse and excessive prescription of antibiotics have played a pivotal role in the emergence and proliferation of antibiotic-resistant bacteria, posing a critical global public health crisis. Addressing this challenge necessitates innovative solutions that enhance antimicrobial stewardship. This study presents the development and implementation of a visual decision support system designed to monitor and optimize antibiotic usage among healthcare providers. The proposed system integrates advanced machine learning algorithms with real-time data analytics to provide a dynamic, evidence-based decision support tool. Specifically, a neural network model was developed after evaluating multiple machine learning approaches, including Random Forest, Logistic Regression and …

#Helpplz: Mental Health Representation In Theatre For Young Audiences, Kate Elizabeth Dirrigl

Theses and Dissertations

#HELPPLZ is a play for young theater audiences that depicts four teenagers with various mental health challenges. It’s target audience is for children ages ten to fifteen and should be performed by actors of similar ages. #HELPPLZ is an immersive theatre experience, as a audience members watch four actors perform from four different lifestyles and point of views, all while broadcast on screens behind the actors. Every seat is a good seat in the house. This play follows a shift in trends of mental health depiction in contemporary theatre. No longer demonized and much more accessible, plays such as Dear …