Cardiac Arrest And Global Ischemia Reperfusion Injury: Role Of Mitochondria And Cannabinoid Receptor 2 Signaling., Jennifer L. Bradley

Theses and Dissertations

We explored the effects of cardiac arrest on mitochondria populations and heart whole tissue lysate proteomics utilizing the Weil Institute’s in vivo rat model of cardiac arrest and cardiopulmonary resuscitation. We have discovered that brain mitochondria are more sensitive to global ischemia compared to heart mitochondria. Additionally, complex I is the most sensitive electron transport chain complex to ischemic injury and is a major control point of the rate of oxidative phosphorylation following cardiac arrest and cardiopulmonary resuscitation. Preservation of brain mitochondrial activity and function during cardiac arrest may enhance outcomes and recovery.

A recent article focusing on acute myocardial …

Knowledge, Perception, And Clinical Management Strategies Of Us Pediatric Dentists On Molar Incisor Hypomineralization, Courtney T. Brashier

Theses and Dissertations

Purpose: The purpose of this cross-sectional, survey-based study is to determine current US pediatric dentists’ knowledge, perceptions, and clinical management strategies for patients with molar incisor hypomineralization (MIH).

Methods: Following appropriate protocol and authorizations, all active pediatric dentists, general dentists, and post-doctoral student members identified by the 2020 American Academy of Pediatric Dentistry’s membership list were invited to partake in an anonymous email survey. Data regarding participants sociodemographic, education, and clinical backgrounds were collected in addition to information obtained from MIH-focused questions. Descriptive statistics and chi-square tests were used to compare and analyze data. A significance level was set at …

The Value Of Postoperative Appointments Following Full Mouth Dental Rehabilitation Under General Anesthesia, Priyanka Patel

Theses and Dissertations

Purpose: Follow-up appointments after full mouth dental rehabilitation under general anesthesia (GA) have been suggested as a method for preventing future caries and need for repeat treatment under GA. The purpose of this study is to determine current practitioner and parental perceived value of the postoperative GA appointment.

Methods: Three separate surveys were administered for this study. The pre-appointment survey asked about the guardian’s desire to have a follow-up appointment. At the follow-up appointment, the post-appointment survey ascertained the level of patient satisfaction with their follow-up appointment and postoperative experience. American Academy of Pediatric Dentistry (AAPD) members were e-mailed a …

Symptom Self-Management In Adolescents Following A Concussion, Amanda Hodges

Theses and Dissertations

Background: Adolescents experience a variety of symptoms following a concussion that affect their everyday life. Initial management consists of physical and cognitive rest followed by a gradual return to activities while monitoring symptoms. Managing concussion symptoms in adolescents is a challenge due to their lifestyle and developmental needs but it is the key to improving adolescents’ lives. Symptom self-management is the prevention and control of symptoms and has been shown to improve health outcomes but has not been studied in adolescents with concussion symptoms. Using the Individual and Family Self-Management Theory (IFSMT), the purpose of this study was to …

Comparing The Sensitivity And Specificity Of Cbct And Mri In Detecting Osteoarthritis Of The Tmj: A Systematic Review, Gabriel R. Saavedra

Theses and Dissertations

The aim of this systematic review was to compare the sensitivity and specificity of cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) in detecting osteoarthritis (OA) of the temporomandibular joint (TMJ). This was done by using computed tomography (CT) and the research diagnostic criteria for temporomandibular disorders (RDC/TMD) as reference methods and using CBCT and MRI as index methods. A specific search strategy was developed and applied to these electronic databases: PubMed, Embase, DOSS, and Cochrane. The search results returned 802 articles, which were then narrowed down using the inclusion/exclusion criteria, to four final articles that were included in …

Psychological Sense Of Community Among Older Adults In Puerto Rico Two Years After Hurricane María, Thomas D. Buckley

Theses and Dissertations

Hurricane María devastated Puerto Rico in 2017 and resulted in adverse long-term outcomes. Psychological sense of community (PSOC) may serve as a protective factor against the effects of Hurricane María for older adults in Puerto Rico. Using a three-paper format, this dissertation draws on a resilience framework and theories of PSOC and the Ecological Theory of Aging to examine the role of PSOC among older adults in Puerto Rico two years after Hurricane María.

Paper one is a scoping review of the concept of PSOC in research with community dwelling older adults. I begin by presenting findings on study characteristics …

Impact Of Targeting Glycosylated Ceramides On Tumorigenic Properties, And Characterization Of Sphingolipids In Head And Neck Tumors, Katherine E. Hylton

Theses and Dissertations

Sphingolipids play a crucial role in signaling, membrane structure, and migration, making them important molecules in cancer development, metastasis, and drug resistance. While some sphingolipids have been associated with pro-apoptotic or pro-survival behaviors, the role of many sphingolipids in cancer remains poorly defined. Chapter 1 of this study investigated the impact of three enzymes that compose most of the ceramide to Lc3 ceramide pathway – UGCG, GBA, and B3GNT5 – and how their alteration impacts chemoresistance and basal membrane invasion in vitro. It was found that the CΒE-induced inhibition of GBA, which converts glucosylceramide to ceramide, has no effects on …

The Effects Of Interleukin-1Β On Cardiac Reserve And Exercise Capacity In The Mouse, Habeebah Z. Vohra

Theses and Dissertations

Heart failure (HF) is characterized by dyspnea, fatigue, and exercise intolerance. Clinical evidence points to increased interleukin-1β (IL-1β) activity in patients with HF, with an IL-1 blockade improving the exercise capacity in HF patients. In healthy mice, recombinant-mouse IL-1β (rmIL-1β) induces acute systolic dysfunction, peaking 4 hours after administration. However, the direct effects of rmIL-1β on exercise capacity are unknown. We hypothesized that rmIL-1β diminishes the exercise capacity in the mouse. Adult mice were trained to run on a treadmill and exercise capacity was assessed before, 4 hours, and 96 hours after intraperitoneal administration of rmIL-1β (3 μg/kg) or vehicle …

The Role Of Community Belongingness In The Mental Health And Well-Being Of Black Lgbtq Adults, Keith Justin Watts

Theses and Dissertations

The impact of racial and sexual minority stigma, prejudice, and discrimination on the mental health and well-being of Black and LGBTQ individuals, respectively, has been well documented in the literature. Research on these relationships for Black LGBTQ individuals who are multiply marginalized due to their position at the social intersections of gender identity, sexual orientation, and race/ethnicity is less common. Belongingness to identity-based communities can protect against the negative impact of these minority stressors for Black and LGBTQ individuals and aid coping processes. However, Black LGBTQ individuals often experience stigma and discrimination in their racial, sexual, and gender minority communities …

Kanceri I Lëkurës, Mirlinda Maliqaj

Theses and Dissertations

Qëllimi i kësaj teme është të shihet se sa është e njoftuar popullata për kancerin e lëkures, si dhe të njoftohet për këtë sëmundje për një diagnostikim më të hershëm. Vlerësimi i gjendjes së kancerit bëhet me anamnezë, ekzaminim klinikë dhe me metoda të tjera diagnostike. Nëse është diagnostikuar kanceri i lëkurës bëhen analiza të tjera. Pastaj vazhdohet me vlerësimin e stadit të kancerit. Mjekimi varet nga stadi i sëmundjes dhe lloji i kancerit, mjekimi mbështetet në intervenim kirurgjik, kimioterapi, imunoterapi etj.

Këtu do të trajtojë një çështje me shumë rëndësi e cila është në inters të çdo kujt nga …

Perceived Efficacy Of Extrusion Of Maxillary Lateral Incisors With Aligners, Mason T. Bates

Theses and Dissertations

Purpose: To assess the perceived efficacy of aligners (Invisalign, Align Technology Inc) at performing extrusive movements of maxillary lateral incisors, determine a general threshold of when a maxillary lateral incisor is not extruding as predicted and requiring intervention, evaluate the frequency and methods of intervention to achieve the predicted extrusion, and to evaluate any related differences between orthodontists and general dentists, and between clinicians having treated various numbers of patients with Invisalign in the past 12 months.

Methods: An original 18-question survey was sent by mail to a randomized and geographically proportionate selection of orthodontic specialists (N = …

Patient Perspectives On Teledentistry And Face-To-Face Doctor Interaction During Orthodontic Treatment, Jackson K. Griffeth D.M.D.

Theses and Dissertations

Purpose: Orthodontic patients were surveyed to determine the perceived value of doctor-to-patient face-to-face interaction, the desire for convenience and attitudes toward specific uses of teledentistry.

Methods: Participating private practice orthodontists emailed the survey to active patients. 75 self-pay patients from VCU Orthodontic clinic were also invited to complete the survey. Patients 18 years or older were asked to complete the survey regarding their own treatment. Parents of patients under age 18 were asked to complete a separate survey regarding their child’s treatment. Questions asked patients about the importance of face-to-face interaction with their orthodontist and their preferences for the inclusion …

Bisphosohoglycertae Mutase: A Potential Target For Sickle Cell Disease, Anfal S. Aljahdali

Theses and Dissertations

Bisphosphoglycerate mutase (BPGM) is a part of the erythrocyte glycolysis system. Specifically, it is a central enzyme in the Rapoport-Leubering pathway, a side glycolytic pathway involved in the regulation of the concentration of the natural allosteric effector of hemoglobin (Hb), 2,3-bisphosphoglycerate (2,3-BPG). BPGM catalyses the synthesis and hydrolysis of 2,3-BPG through its synthase and phosphatase activities. The synthase activity is the main role of BPGM, while the phosphatase activity is low and is activated by the physiological effector, 2-phosphoglycolate (2-PG) with the latter mechanism poorly understood.

BPGM activity and 2,3-BPG levels in red blood cells (RBCs) have a significant role …

The Strategic Orientation Of Skilled Nursing Facilities, Jennifer R. Palazzolo

Theses and Dissertations

Since the early 2000s, skilled nursing facilities (SNFs) have operated in an environment made uncertain by changes in health care policy, growth in substitutes for nursing care, and increasing demand for services. To better understand how SNFs are strategically positioning themselves to survive and thrive, this study develops a taxonomy of strategic groups of SNFs.

A conceptual framework is based in Strategic Management Theory and classification of SNFs is based on scope of business decisions including length of stay, complexity of patients, and referral networks with hospitals. Two-step, hierarchical cluster analysis finds six strategy groups of SNFs: Post-Acute Care Focus …

Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili

Theses and Dissertations

This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:

1. Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
2. Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …

Glycosaminoglycan Modulation Of Key Proteins In Alzheimer's Disease, Tamim Chiba

Theses and Dissertations

Glycosaminoglycans (GAGs) are linear polysaccharides whose disaccharide building blocks consist of an amino sugar (D-glucosamine) and either uronic acid (D-glucuronic acid or L-iduronic acid) or galactose. Nearly all GAGs (with the exception of hyaluronic acid) are covalently attached to proteins, forming proteoglycans, and are ubiquitous in nature. The monomeric units, chain length, degree and pattern of sulfation, and epimerization are important properties that determine the influence of these molecules. Through Coulombic forces, hydrogen bonds and hydrophobic interactions, they regulate many physiological and pathophysiological processes such as blood coagulation, cell growth and differentiation, inflammatory processes, host defense and viral infection mechanisms. …

Regulation Of Osseous Healing By Macrophage-Derived Wnt Ligands, Jefferson Overlin Abaricia

Theses and Dissertations

Osseous healing is regulated by various classes of cells and signaling mechanisms. Of these, Wnt signaling has long been known to be critically important in directing the differentiation of mesenchymal stem cells (MSCs) into osteoblasts during bone healing. However, the source of these Wnt ligands is not known. Recently, a body of literature has arisen finding both beneficial and detrimental effects of macrophage-derived Wnt ligands on the regeneration of other tissues (liver, kidney, heart, and intestine), often by regulating inflammatory activation and stem cell behavior. As macrophages have been well-characterized as orchestrators of healing, their use of Wnt signaling to …

Evaluating The Clinical Utility Of A Novel Electroencephalography System For Assessing Perioperative Neurocognition In Older Surgical Patients, Lloyd H. Barnwell Iii

Theses and Dissertations

Postoperative delirium (POD) is a public health and research priority (American Society of Anesthesiologists, 2019). POD is a risk factor for long-term neurocognitive decline, and the rate of decline is directly proportional to the severity of POD (Vasunilashorn et al., 2018). Baseline cognitive function is a strong, independent predictor for POD (Culley et al., 2017). The International Perioperative Neurotoxicity Working Group recommends baseline cognitive function be assessed for older patients prior to surgery and anesthesia (Berger, et al., 2018). Perioperative cognitive screening tools trialed in anesthesia are not routinely incorporated into clinical practice related to validity, reliability, or practicality problems …

Intermittent Theta Burst Stimulation: Application To Spinal Cord Injury Rehabilitation And Computational Modeling, Neil Mittal

Theses and Dissertations

Loss of motor function from spinal cord injuries (SCI) results in loss of independence. Rehabilitation efforts are targeted to enhance the ability to perform activities of daily living (ADLs), but outcomes from physical therapy alone are often insufficient. Neuromodulation techniques that induce neuroplasticity may push the limits on recovery. Neuromodulation by intermittent theta burst transcranial magnetic stimulation (iTBS) induces neuroplasticity by increasing corticomotor excitability, though this has most frequently been studied with motor targets and on individuals not in need of rehabilitation. Increased corticomotor excitability is associated with motor learning. The response to iTBS, however, is highly variable and unpredictable, …

Stat5a Regulation By Serine Phosphorylation In Breast Cancer, Alicia E. Woock

Theses and Dissertations

The neuroendocrine hormone prolactin (PRL) and its cognate receptor (PRLr) have been implicated in the pathogenesis of breast cancer. PRL signaling relies on activating kinases such as the tyrosine kinase Jak2 and serine/threonine kinases ERK1/2, NEK3, PI3K, and AKT. In the canonical pathway of PRL signaling, JAK2 phosphorylates the transcription factor STAT5a at tyrosine residue 694 (pY694-STAT5a), preceding STAT5a nuclear translocation and transcriptional activity. However, STAT5a exists with functional duality as a transcription factor, having both pro-differentiative and pro-proliferative target genes. Other STAT family members (STATs 1, 3, and 6) have been shown to have transcriptional activity in the un-tyrosine-phosphorylated …

The Harm In Seeking Care: Assessing The Relationship Between Healthcare Discrimination And Healthcare Avoidance Behaviors In The Past Year And Since The Start Of The Coronavirus Pandemic In A Transgender And Gender Independent Sample, Kyle L. Mason

Theses and Dissertations

Background: Gender minorities encounter a myriad of barriers to accessing general and gender affirming healthcare. Financial disparities impacting affordability of healthcare costs and insurance-based denials for gender-affirming care are among prominent barriers discussed. Considerations of the prevalence of stigma, discrimination, and erasure of gender minority identities must not be neglected when seeking to understand healthcare accessibility and utilization in this population. Previous researchers have examined gender minority patients’ experiences of discrimination in healthcare settings and delaying care due to fear of discrimination. There is a dearth of knowledge about the relationship between lifetime exposure to varied forms of healthcare discrimination …

A Mixed Methods Approach To Examine Racial Disparities In Adherence To Surveillance Mammography Among Breast Cancer Survivors, Megan C. Edmonds

Theses and Dissertations

PURPOSE: Annual surveillance mammography is a critical part of routine cancer care for breast cancer (BC) survivors; reducing mortality by 39%. However, disparities exist with regard to adherence to surveillance mammograms among BC survivors; Black women are 44% less likely to adhere than their White counterparts. Despite the existence of this racial disparity for over a decade, little is known about factors that explain reasons for Black BC survivors’ non-adherence. This is because most studies have not evaluated the role of healthcare delivery or psychosocial factors. Guided by the Behavioral Model for Vulnerable Populations, the purpose of this mixed methods …

The Therapeutic Potential Of Glycosaminoglycan Directed Metalloglycomics: Elucidating New Targets And Mechanisms For Polynuclear Platinum Complexes, James D. Hampton

Theses and Dissertations

Cancer remains a serious clinical problem and in order to continue to improve patient health outcomes, novel treatment strategies must continue to be developed. Platinum chemotherapies remain as one of the most widely successful classes of cancer therapeutic, with over 50% of cancer patients receiving a platinate at some point over the span of their treatment. However, intrinsic and extrinsic resistances limit their effectiveness, long term efficacy, and broad applicability to multiple cancer subtypes. Therefore, the development of new agents and strategies which can overcome these limitations are crucial for patient health. To this end a novel class of polynuclear …

Modeling Substance Use And Mental Disorder Comorbidity Using Latent Variable And Network Approaches, Courtney T. Blondino

Theses and Dissertations

Introduction. Substance use disorder (SUD) is a common condition that affects millions of Americans. Addressing SUD has been complicated by comorbid mental disorders and co-occurring substance use. Consequently, detailing and addressing SUD and comorbid SUD represent an important goal to improve the health of Americans.

Objective. The research goal of this dissertation was to characterize the comorbidity between substance use, including tobacco use, and mental disorder symptoms measured as negative affect and externalizing symptoms in a population-based sample using latent variable and network approaches.

Methods. Waves 1 – 3 from the Population Assessment of Tobacco and Health Study were used. …

Single-Molecule Investigation Of I-Motif Folding And Dynamics In Bioinspired Dna Platforms, Anoja Megalathan

Theses and Dissertations

Although the canonical right-handed B-DNA is the predominant form of DNA in cells, DNA can adopt other secondary structures such as hairpins, G-quadruplexes (G4), and intercalated motifs (i-motif). These secondary structures are typically formed in the regions with repeat sequences. Among many secondary structures DNA can adopt, G-quadruplexes and i-motifs (tetraplex structures formed in the G-rich and C-rich sequences, respectively) caught significant research interest in recent years due to the prevalence of G-rich and C-rich sequences in the human genome. While G-quadruplexes are extensively studied, little is known about i-motifs – especially their formation and stability under cellular environments. For …

Preclinical Pharmacokinetic Studies Of Pterostilbene, And Its Human Pharmacokinetic Prediction Using Physiologically Based Pharmacokinetic Modeling, Palak S. Phansalkar

Theses and Dissertations

This dissertation research aimed to determine the preclinical pharmacokinetics of pterostilbene in vitro and develop a physiologically based pharmacokinetic (PBPK) model to simulate the animal and human PK profiles for pterostilbene. The in vitro PK characteristics of pterostilbene, including Caco-2 cell permeability, plasma protein binding, and metabolic stability were determined using rat and human intestinal & hepatic S9 subcellular fractions. The in vitro metabolic parameters determined in rat subcellular fractions were extrapolated to in vivo values to predict the oral bioavailability (F_oral) in rats. The predicted F_oral was found to be 43.0 %, which is similar to …

Structural Reorganization Of The Cisternal Organelle In Neuroinflammatory Disease, Myshak S. Abdi

Theses and Dissertations

The axon initial segment (AIS), an axonal sub compartment located immediately distal to the soma, is an important structure in mediating action potential generation and modulation. The morphology of this domain can be altered by a wide variety of activity-dependent, environmental, and pathological triggers. Dysregulation of axonal calcium (Ca²⁺) concentrations, and subsequent enzymatic degradation of AIS cytoskeletal architecture have been reported to underlie structural modifications of the AIS. Moreover, pharmacological inhibition of neuronal Ca²⁺ channels have been shown to mitigate the disruptive effects of neuroinflammation on AIS structural integrity. Here we investigate the Cisternal Organelle (CO), a …

Conformational Modulation Of Α-Helical N-Acetylated Α-Synuclein, Ricardo Fernandez

Theses and Dissertations

Human N-acetylated α-synuclein (^NAcαSyn) has long been accepted as an intrinsically disordered protein (IDP) predominantly found in terminal nerve regions in healthy subjects. ^NAcαSyn structural fluidity enables the formation of transient or dynamic assemblies. Some of these assemblies may serve functional, yet undefined purposes. ^NAcαSyn is highly susceptible to the surrounding environment, leading to misfolding under high cytosolic oxidative stress conditions, which in turn assemble in the form of toxic oligomers or amyloid fibrils. These ^NAcαSyn inclusions along with their accretion and migration within neurons, are pathological hallmarks of Parkinson’s disease (PD), dementia, and multiple …

Copper Sulfide Manganese Nanoparticles For Multimodality Imaging And Therapy, Ali S. Gawi Ermi

Theses and Dissertations

Abstract

COPPER SULFIDE MANGANESE NANOPARTICLES FOR MULTIMODALITY IMAGING AND THERAPY

By Ali S. Gawi Ermi, MSc

Inorganic nanoparticles (NPs) are compatible with metal-based multi-modality molecular imaging and targeted therapy. Copper sulfide nanoparticles (CuS NPs) are attractive photoacoustic and photothermal agents and are amenable to incorporation of radionuclides and paramagnetic elements to facilitate image-guided therapy. The aim of this work is to develop manganese (Mn)- doped CuS NP, intrinsically radiolabeled with radionuclides such as (Zirconium-89 (⁸⁹Zr), Copper-64/67 (^64/67Cu) and Manganese-52/55 (^52/55Mn)). This novel approach combines Photoacoustic (PA), Positron emission tomography (PET), Single-photon emission computed tomography …

Therapists' Perspectives On Aiding Individuals To Maintain Social Connection While Struggling With Health Concerns, Shari Howington-Carlin

Theses and Dissertations

This applied dissertation was designed to explore therapists’ perspectives on aiding individuals to maintain social connection while struggling with health concerns. Social relationships support physical and psychological well-being, yet individuals struggling with physical or mental health issues often have difficulty maintaining their relationships. Therapists, as health professionals, often discuss physical as well as emotional health concerns with their patients, including components of physiological and psychological heath care. Emerging neuroscience is aiding in understanding how research in this field supports early intervention for health outcomes around healthy social and family relationships during chronic disease or illness onset.The researcher conducted a phenomenological …