Medicine and Health Sciences Commons^™

A Framework For Digital Energy Modulation And Translation In Projectional X-Ray Imaging, Richard R. Wargo

Theses and Dissertations

In projectional X-ray imaging, acquisition energy fundamentally influences subject contrast, image noise, and radiation dose. While dual-energy techniques exploit spectral differences to optimize contrast and enable material separation, acquiring multiple images of the same anatomy often requires additional exposures and increased system complexity.

This dissertation presents a framework for digital energy modulation (DEM), in which computational models are trained to translate projection images between energy domains without requiring additional X-ray acquisitions. DEM is conceived as a generalizable strategy for controlled contrast modulation in projection imaging, with potential applications in image optimization, radiation therapy alignment, and dual-energy applications.

The framework was …

Generating Synthetic Ct From Mri Data, Foysal Ahmed

Theses and Dissertations

Magnetic resonance imaging (MRI) provides excellent soft tissue contrast without ionizing radiation, making it a strong alternative to computed tomography (CT) in medical imaging workflows. However, CT remains essential for applications requiring electron density information, such as radiation therapy treatment planning. This study investigated the feasibility of generating synthetic CT (sCT) images from MRI using a deep learning-based U-Net architecture. A two-dimensional U-Net was trained on paired MRI-CT data from the SynthRAD 2025 dataset, consisting of 120 T1-weighted (T1W) and 60 T2-weighted (T2W) axial cases, including deformed CT (dCT) aligned to MRI. Model testing used an independent dataset of 30 …

Magnetic Resonance Only Planning Validation Using Synthetic Ct By Mvision, Eric D. Brass Sr

Theses and Dissertations

Problems: Adaptive radiotherapy requires clinically practical methods for responding to patient-anatomy changes that occur between the original planning images and the day of treatment delivery. Registering a previously acquired computed tomography scan to a newly acquired magnetic resonance image can introduce cross-modality uncertainty and may delay replanning. This thesis evaluates whether synthetic computed tomography generated from same-day magnetic resonance imaging can reduce registration-related uncertainty while supporting rapid dose recalculation for fraction-level adaptation.

Procedure: Magnetic resonance imaging DICOM data were exported from the ViewRay MRIdian treatment planning system and uploaded to MVision for synthetic computed tomography generation. The synthetic computed tomography …

Development Of A Practical Lu-177 Activity Calibration Protocol For Clinical Nuclear Medicine: Dosimetric Impact Analysis And Implementation Tools, Azam Almolaiki

Theses and Dissertations

Lutetium-177 (Lu-177) is widely used in radionuclide therapy, where accurate activity measurement prior to administration is essential for safe and effective treatment delivery. However, variability in dose calibrator response due to measurement conditions and source geometry remains a practical challenge in routine clinical settings. This study presents a practical clinical calibration strategy under real-world constraints for Lu-177 activity measurement using standard nuclear medicine instrumentation. A vial-based approach was implemented using a well-type ionization chamber (Capintec CRC-15R) to evaluate measurement repeatability, temporal stability, and geometry dependence. All measurements were performed under consistent conditions with appropriate decay correction applied using the physical …

Commissioning & Daily Qa Of Converted Linac For Electron Flash, Tomaj Javidtash

Theses and Dissertations

Ultra-high dose rate (FLASH) radiotherapy has demonstrated promising normal tissue sparing in preclinical studies; however, the lack of standardized dosimetry, commissioning, and quality assurance (QA) methodologies remains a major barrier to its reproducible and safe implementation. In particular, conventional clinical commissioning and QA protocols are not directly applicable at FLASH dose rates due to challenges associated with detector response, dose-per-pulse effects, and beam control limitations.

This thesis presents the commissioning of a converted Varian 21EX linear accelerator for electron FLASH operation within the Division of Medical Physics at the Virginia Commonwealth University (VCU) Department of Radiation Oncology. Comprehensive beam characterization …

Socialization Interventions For Older Adults In Assisted Living Facilities: A Systematic Review, Anoop S. Muvva

Honors Undergraduate Theses

Older adults, defined as individuals over the age of 65, are a growing population in the United States, with projections estimating this group will reach approximately 80 million persons by 2050. Over 90% of older adults are diagnosed with a chronic condition, which can make it difficult to carry out the activities of daily living. As a result, some older adults reside in assisted living facilities, where dedicated staff provide daily support. However, issues in the delivery of care within these settings, including unmet socialization needs and complications among care staff, may contribute to social isolation. Programs designed to address …

Perceptions, Expectations, And Attitudes About Adolescent Telepsychiatry Among Indian American Family Caregivers, Udayvir Jalf

Honors Undergraduate Theses

Adolescent mental health concerns have risen sharply in the United States. The COVID-19 pandemic marked a significant turning point in mental health care access, with telehealth having become a central mode of care delivery. With adolescent telehealth, caregiver involvement has shown to improve treatment adherence and outcomes. Little is known, however, about how Indian American caregivers experience and navigate their adolescent’s virtual mental health care. This qualitative study investigated the perceptions, expectations, and attitudes of Indian American family caregivers regarding adolescent telepsychiatry and caregivers’ involvement. In depth semi-structured interviews were conducted with Indian American caregivers of adolescents who completed at …

Comparative Spatial Biology: A Cross-Species Analysis Of Canine Oral Cancers As Models For Human Disease, Ram Pradhyumnan

Honors Undergraduate Theses

Oral squamous cell carcinoma (OSCC), one of the most common malignancies of the oral cavity, remains a clinically challenging disease due to its aggressive behavior, late-stage diagnosis, and limited improvements in therapeutic outcomes over recent decades. A significant barrier to progress in OSCC research and treatment is the lack of suitable preclinical models that recapitulate the complexity and natural progression of the disease. Most current models—including cell lines, xenografts, and genetically engineered mice—fail to capture key features such as the spatial organization of tumor epithelium, interactions with an intact immune system, and the stepwise evolution from normal mucosa to invasive …

Invasion Of Microplastics Into The Reproductive Tissues Of Feral And Domestic Felines, Emma K. Quade

Honors Undergraduate Theses

Although plastics have many useful properties in modern society, once these materials are introduced into the environment, they can cause extensive damage. Following degradation into microplastics (MP), plastic particles less than 5 mm in size, these contaminants can make their way into a variety of different environments and organisms. There are many studies that have investigated the prevalence of MP in marine environments, but fewer studies have looked into terrestrial systems, and even less that have focused on contamination in companion animals. This study sought to investigate the invasion of MP into the reproductive tissues of felines, Felis catus, …

The Relationship Between Physical Behaviors, Perceived Stress, Oral Hygiene Awareness, And Periodontal Disease Among College Students, Gustavo Quilula

Honors Undergraduate Theses

Periodontal disease (PD) is a preventable inflammatory disease that targets the supporting tissues that surround teeth. PD is extensively studied among older adults, but there is limited evidence of the prevalence of PD and potential modifiable risk factors among young adults. The purpose of this study is to assess the prevalence and severity of PD among U.S. college students and (2) examine the association between objectively measured physical activity (PA), oral hygiene awareness, perceived stress, and PD symptoms. College students from a large metropolitan university were enrolled in this cross-sectional study. Oral hygiene knowledge, PD symptoms, and perceived stress were …

Examining The Barriers To Healthcare Among Native Hawaiian And Pacific Islander Populations Living In Hawaii, Gracie L. Kaye

Honors Undergraduate Theses

The state of Hawaii was annexed by the United States in 1898, and served as a starting point from which the U.S. influenced Hawaii's socioeconomic conditions and healthcare access. The literature review examines healthcare views and outcomes among Native Hawaiian and Pacific Islander residents, utilizing various tools and resources to investigate how these factors have impacted overall health statistics and the reasons behind these trends. Results found that the western colonization of the island and the disease outbreaks led to an initial mistrust of “western ideas.” Additionally, due to long-standing cultural beliefs, there is a natural preference for traditional cultural …

How Does The Frequency Of Visits Impact The Quality Of Life For Nursing Home Residents?, Sophie M. Carlton

Honors Undergraduate Theses

This integrative literature review examines the relationship between quantity of visitation and quality of life (QOL) of nursing home residents. The purpose of this review is to examine existing research to determine whether an optimal “dosage” of visitation exists that meaningfully enhances QOL for this vulnerable population. Establishing an evidence based- guideline may help reduce uncertainty for families and promote more consistent improvements in resident well-being. Nursing home residents are the focus of this work because their limited ability to leave the facility makes visitation one of their primary sources of non-occupational social interaction. The COVID19 pandemic further heightened the …

Analyzing Early Medieval Perspectives Of Fetal Development, Nivedha Srinivasan

Honors Undergraduate Theses

This thesis examines early medieval perspectives of fetal development by analyzing two manuscripts: British Library, Cotton Tiberius A III and Leiden University, Vossianus lat. Q69. This study will investigate how knowledge of pregnancy was shared throughout England before the establishment of universities. Interest in medieval reproductive language has piqued in importance in recent years, especially due to modern legal debates surrounding reproductive rights. By examining descriptions of the nine months of fetal development in these two manuscripts, as well as in widely known earlier medical texts like Pliny’s Natural History and Vindicianus’ Gynaecia, this research explores how monastic writers in …

The Knowledge, Experiences, And Attitudes Of Nurses Regarding Trauma-Informed Care For Sexually Abused Intrapartum Patients, Kayleigh Mcgraw

Honors Undergraduate Theses

Labor and delivery nurses care for women from diverse backgrounds who are preparing for a life-changing event, often marked by fear, excitement, sadness, and joy. However, 1 in 5 women in the United States have experienced rape or attempted rape, and for these survivors, labor can become re-traumatizing. Many report flashbacks, dissociation, and a sense of “being back in the rape” during childbirth. Research further links prior sexual assault to unplanned cesareans, traumatic births, and childbirth-related PTSD. Trauma-informed care (TIC) provides a framework to reduce these risks by encouraging providers to understand trauma, recognize signs of distress, and act to …

Timelines Of Care: Analyzing Treatment Access For Women With Ongoing Reproductive Health Needs, Nyla M. Keith

Honors Undergraduate Theses

Mandates in the United States created pressure on an already strained healthcare system post-COVID-19 pandemic. With new regulations placed upon abortion care forcing the closing of low-cost health clinics such as Planned Parenthood, legislation that has made health insurance more expensive, and rising pharmaceutical prices, women’s OB/GYN care in America has struggled to meet patient needs. A cross-sectional survey was developed and distributed to four clinics in the Orlando area to assess patients' perceived access to care and identify barriers to receiving OB/GYN care. The survey took approximately 10 – 15 minutes to complete, was available in print and online …

Evaluating The Efficacy And Safety Of Inactivated Dengue Vaccines In Vulnerable Populations, Alaa Daghash

Honors Undergraduate Theses

Dengue virus is a mosquito-borne flavivirus responsible for over 390 million annual cases worldwide. While there are live-attenuated vaccines available to prevent dengue, none are currently approved for use in the United States, and existing platforms pose significant risks of viral reactivation and antibody-dependent enhancement in vulnerable populations, such as pregnant women, children under the age of nine, and the immunocompromised. This widespread exclusion of vulnerable populations exposes a significant vaccine equity gap in dengue prevention, as the populations most at risk for severe dengue are the same ones who are currently excluded from vaccination. In this study, I conducted …

Studying Chronotypes And Their Role In Sleep And Mental Health: A Scoping Review, Evan Nguyen

Honors Undergraduate Theses

Sleep patterns remain a significant public health concern globally, impacting several aspects of life, including mental health. This scoping review examined how chronotype and circadian typology predict mental health, with sleep quality serving as a crucial mediator. While the importance of sleep is widely acknowledged, there is a lack of studies specifically investigating chronotype-aligned interventions to reduce psychological distress. To address the shortage, a comprehensive review of the peer-reviewed literature was conducted, identifying six papers for analysis. These studies mostly utilized cross-sectional designs to assess diverse global groups, including university students, healthcare workers, and military personnel. The results indicate that …

The Role Of Resistance Training In Managing Menopause-Related Changes, Alyson K. Strauss

Honors Undergraduate Theses

Resistance training serves as a critical non-pharmacological strategy for mitigating the physiological and psychological declines associated with the menopausal transition. This natural biological phase, marked by declining estrogen levels, typically leads to accelerated bone mineral density loss, sarcopenia, metabolic regulation disturbance, and heightened mood disturbances. To evaluate the efficacy of targeted exercise interventions, a systematic review was conducted following PRISMA guidelines. From an initial pool of 60 relevant articles, 13 studies met the specific inclusion criteria, focusing on structured resistance training protocols for perimenopausal, menopausal, and postmenopausal cohorts.

The synthesis of these studies indicates that resistance training is a highly …

Life In Laughter: Comedy’S Impact On Student Health And Success, Julia Weinstein

Honors Undergraduate Theses

College students face rising rates of anxiety, depression, and stress, highlighting the need for accessible, stigma-free wellness interventions. While comedy is often seen as entertainment, research indicates laughter produces measurable psychological and physiological benefits, including reduced cortisol and increased endorphins. Life in Laughter, a creative-research hybrid project, investigates how live and digital comedy experiences affect college students’ mood, stress, and sense of belonging. Using mixed methods, data were collected through anonymous audience surveys, app-based reflections via JoyScroll, and interviews, supplemented by a mini-documentary. Findings suggest humor functions as both an emotional regulation tool and a means of fostering …

Oral Health Access Among Ethnic Minority Older Adults In The United States, Jasleen K. Sodhi

Honors Undergraduate Theses

Oral healthcare is a critical yet often overlooked component of overall health among U.S. adults. Ethnic minorities for older adults face heightened risks of poor oral health and related health conditions, while experiencing disparities in access to care. This study aimed to systematically examine and synthesize existing literature to assess the extent to which oral health disparities exist among ethnic minority older adults in the U.S. and explore the roles of socioeconomic factors on these disparities. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, we conducted a systematic review of peer-reviewed articles published in English …

Looking Beyond Traditional Therapy: The Promising Alternative Of Ketamine-Assisted Treatments In Improving The Quality Of Life Of Veterans, Noa Gutmann

Honors Undergraduate Theses

Posttraumatic stress disorder (PTSD) in United States veterans has a long history of treatment with standard care interventions and therapies. Unfortunately, many modern-day veterans experience treatment resistance and comorbid depressive symptoms that have yet to be resolved. This results in suicidal ideation, hospital readmission, and high treatment dropout rates of care plans. Recent evidence has shown a positive impact of ketamine, and esketamine, therapy on PTSD and depressive symptoms severity. Although, the outcomes and generalizability of this emerging therapy, compared to standard care, are not fully elucidated on. The purpose of this literary review was to further examine the current …

Risk And Protective Factors Of South Asian American Youth Mental Health, Jasmine Kaur

Honors Undergraduate Theses

South Asian American youth represent a rapidly growing yet understudied population in United States mental health research. Much of the existing literature aggregates diverse Asian American subgroups, obscuring the unique sociocultural experiences of South Asian adolescents and young adults. This thesis examines the risk and protective factors influencing the mental health of South Asian American youth aged 15–25. A systematic review of peer-reviewed literature was conducted using the databases Web of Science, MEDLINE, PsycINFO, and CINAHL Plus with Full Text. Search terms included culturally specific identifiers, migration-related terminology, youth demographic terms, and mental health outcomes. After removing duplicates and applying …

The Impact Of Parental Influence On The Sexual Health Of College Students In South Florida, Lauren Barthel

Honors Undergraduate Theses

College students account for some of the highest rates of sexually transmitted infections (STIs) annually in America. Interventions aimed at reducing the number of cases in this emerging population are needed. This study utilized a secondary data analysis of an online survey administered to college students from August 2018 to December 2022 to examine their sexual literacy and overall sexual health. The objective of this study was to explore the relationship between parental influence and the sexual health of college students by exploring variables such as parent-child communication, race/ethnicity, and parental background. Using IBM SPSS Statistics 30, results indicated that …

Acute Changes In Muscle Thickness And Perceptual Responses Following Different Applications Of Blood Flow Restriction, Anuj J. Prajapati

Honors Undergraduate Theses

The use of blood flow restriction (BFR) allows for reductions in exercise intensity without compromising muscular adaptations that are typically only manifested during high-load non-BFR exercise. There exist, however, several ways to implement BFR and there is a lack of information regarding which application may be beneficial over another. The purpose of this investigation was to examine acute changes in muscle size and perceptual responses following different pressure applications of BFR (i.e., continuous BFR [cBFR], intermittent during sets BFR [iBFR_sets], and intermittent during rest BFR [iBFR_rest]) relative to an unrestricted condition (i.e., nBFR). Participants completed cBFR, …

Double Burden: Exploring The Impact Of Epilepsy On Caregivers Of Children With Medical Complexities, Maria Eduarda Baldanzi Silva

Honors Undergraduate Theses

Children with medical complexities (MC) often have epilepsy as a comorbidity. The demanding management of conditions in children with complex needs requires specialized medical care. This care usually prioritizes the child’s health but often disregards caregivers' physical and mental health. This study examined the relationship between epilepsy in children with medical complexities (MC) and their caregivers' quality of life (QoL), with a focus on mental health, physical well-being, and financial stability. A national survey was conducted to compare the experiences of two groups of caregivers: 1) those who have children with MC and epilepsy, and 2) those who have children …

Assessing The Effects Of A Novel Breathing Exercise On Respiratory, Postural, And Muscular Performances, Tristan P. Wilson

Honors Undergraduate Theses

Background: Breathing exercises are used in both clinical and home settings for a variety of purposes. Their functions range from reducing anxiety and stress to recuperating pulmonary function, depending on the technique and style employed. Existing literature has demonstrated that breathing exercises increase Forced Vital Capacity (FVC) and may be able to improve postural stability due to engagement of the diaphragm when regularly practiced.

Objective: The purpose of this study was to determine whether a novel breathing exercise would be effective in improving respiratory, postural, and muscular function.

Methods: In order to evaluate this claim, a randomized, double-blind, controlled study …

Synthesis And Characterization Of Glass-Ceramic Nanoparticles And Nanobubbles For Integration Into Bone Regenerative Biomaterials, Sun Latt

Honors Undergraduate Theses

Osteoporosis affects over 200 million individuals worldwide and is characterized by an imbalance between osteoclastic bone resorption and osteoblastic bone formation, leading to fragility fractures that significantly diminish quality of life. Current clinical bone cements, such as poly(methyl methacrylate), are limited by poor osseointegration, toxic monomers, and an inability to address the underlying pathophysiology of osteoporosis. This work presents the synthesis, characterization, and systematic in vitro evaluation of a sol-gel-derived, magnesium-incorporated glass-ceramic (GC) nanoparticle within the CaO-MgO-SiO₂ system for incorporation into a novel hydrogel bone cement and bioresorbable magnesium implants. XRD confirmed a biphasic amorphous-crystalline diopside composition, and TEM …

Post-Metabolites Of Two Commensal Bacteria Suppress Dna Damage In An Experimental Model Of Acid Reflux Disease, Maanya Pradeep

Honors Undergraduate Theses

Chronic heartburn or gastroesophageal reflux disease (GERD) affects approximately 25% of the US population [1]. Repeated bile acid exposure from the regurgitation of stomach contents leads to the production of reactive oxygen species (ROS), which can cause oxidative DNA damage and promote genomic instability [2]. Barrett’s esophagus (BE), which can develop as a response to chronic bile acid exposure, increases the risk of esophageal adenocarcinoma (EAC) by 30% to 125% [1].

There are more than 18,000 new cases of esophageal cancer in the United States each year, and while its incidence is relatively low compared to other cancers, its mortality …

The Role Of P2y1 And P2y2 Receptors In Human Neural Stem Cell Proliferation, Daria Sokolova

Honors Undergraduate Theses

Endogenous neural stem cells (NSCs) are located in specialized niches of the adult brain and play a vital role in both neurogenesis and neuronal repair. However, declines in NSC proliferation and metabolism associated with age and pathology make these cells less efficient at responding to neurodegenerative disease. Understanding signaling pathways that regulate NSC function is therefore essential for the understanding and development of treatments for these conditions. P2Y receptors are G-protein-coupled purinergic receptors that are activated by extracellular nucleotides and regulate cellular metabolism and proliferation. Among the eight known P2Y subtypes, P2Y1 and P2Y2 have been linked to neuronal signaling …

Recurrence And Co-Occurrence Of Enhancer-Promoter Interactions Across Human Samples, Satvik Gunjala

Honors Undergraduate Theses

Experimental mapping of enhancer-promoter interactions (EPIs) is resource-intensive, and current computational prediction methods struggle with intrinsic genomic complexity and reliance on limited training data. To address this bottleneck and provide insights for improved computational methods, this study systematically analyzed chromatin contact datasets to investigate the recurrence and co-occurrence of enhancer-promoter interactions across human samples. Putative interactions were evaluated across two HiChIP datasets comprising 218 total samples and one Hi-C dataset comprising 266 samples to assess recurrence across samples and assess sequencing depth related to unique EPIs. Additionally, a preliminary item-based collaborative filtering recommender model was developed to assess co-occurrence patterns …