Medicine and Health Sciences Commons^™

The Impact Of Maternal Environmental Exposures On The Immune Landscape Of The Maternal-Fetal Interface, Heather E. True

Theses and Dissertations--Pharmacy

Maternal environmental exposures and inflammation are known to impact fetal development in utero as well as increase the risk for chronic diseases later in life. Therefore, it is essential that we understand how the maternal environment alters placental structure and immune function.

Therefore, we isolated fetal (chorionic villous) tissues from the placentas of healthy pregnant participants (control) and those with inflammatory conditions, including SARS-COV-2 infection, pregravid obesity, and opioid use disorder. Isolated placental leukocytes were subjected to a series of assays to uncover the phenotypic, functional, and transcriptional (single-cell RNA-sequencing) landscape of placental immune cells. Additional placental tissues were subjected …

Impact Of Hyperthermia And Mitomycin C On Heat Shock Proteins, Mismatch Repair Proteins, And Cytotoxicity In Colon Cancer, Anna M. Reagan

Theses and Dissertations--Clinical and Translational Science

Cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) is a treatment used for primary peritoneal malignancy or metastases, including colon cancer. We aimed to explore the effects of hyperthermia and/or mitomycin C (MMC) on mismatch repair (MMR) proteins and heat shock proteins (hsps) and the potential for post-HIPEC treatment with pembrolizumab treatment. Colon cancer cells were treated with hyperthermia and/or MMC for 90 minutes. Subcellular fractionation and immunofluorescent imaging were performed to identify protein abundance and localization of MSH2, MLH1, hsp70, and hsp27. Proteomics analysis was performed for HT29 cells. HT29 cells and patient-derived organoids (PDOs) underwent simulated HIPEC and treatment …

Early Adversity, Impulsivity, And Health Behaviors, Amy Lynn Meadows

Theses and Dissertations--Clinical and Translational Science

Childhood trauma and early adversity are associated with a variety of negative health outcomes, some of which may be mediated by changes to impulsivity as described by the cumulative risk model. The purpose of this project is to provide insight into the effects of cumulative adverse childhood experience on impulsivity in various populations. Three studies examine the effects of early adversity on impulsivity in normal volunteers, parents caring for a child with medical needs, and in patients with diabetes or pre-diabetes with data collected through crowdsourcing. The strongest effects for early adversity on impulsivity were seen in the patients with …

Enhancing Public Health Surveillance: Development And Validation Of Machine Learning Models For Suspected Opioid Overdose Detection In Emergency Medical Services Data, Peter J. Rock

Theses and Dissertations--Clinical and Translational Science

The ongoing opioid overdose crisis in the United States requires timely and accurate surveillance systems to inform public health responses. Traditional public health surveillance methods rely on hospital discharge data and death certificates, which suffer from significant reporting delays and miss cases where patients refuse hospital transportation. Emergency Medical Services (EMS) data presents a promising alternative with advantages in timeliness and case ascertainment but lacks validated definitions for suspected opioid overdose (SOO).

This dissertation addresses this critical gap through the development, validation, and fairness assessment of machine learning models with natural language processing (ML-NLP) for identifying SOOs in EMS data. …

Exploring Healthcare Access In Telehealth Through Spanish-Speaking Patients’ Perspectives: A Scoping Review, Abigail J. Verst

Theses and Dissertations--Communication Sciences and Disorders

Background: Telehealth offers a potential solution to addressing access barriers experienced by Spanish-speaking patients. This scoping review aimed to explore whether a comprehensive view of healthcare access is being considered when creating telehealth programs for Spanish-speakers. The Conceptual Framework of Access to Healthcare (Levesque et al., 2013) was used to guide access analysis.

Methods: A literature search was conducted across three databases to identify empirical studies in the United States that reported Spanish-speaking patients’ perspectives of telehealth through quantitative questions. Data was collected from the included articles to characterize the type of healthcare providers and telehealth modalities examined in the …

Practicing Clinicians' Views Of The Life Participation Approach To Aphasia Therapy, Stephanie H. Mays

Theses and Dissertations--Communication Sciences and Disorders

The Life Participation Approach to Aphasia therapy (LPAA) aligns with a person-centered, functional approach to speech therapy. Past research has demonstrated that persons with aphasia (PWA) benefit from this approach and prefer it when compared to the traditional medical model to therapy. However, a disconnect between PWA preferences and SLP treatment approaches in therapy persists. This study aims to identify both barriers and facilitators that SLPs face when implementing LPAA. Five CCC-SLPs practicing in the state of KY with experience working with PWA were recruited as participants. Participants were placed into two focus groups, with each group meeting for 2-3 …

M1 Macrophage-Engineered Vesicles Have Anti-Cancer Activity In Ovarian Cancer, Connie Du Cao

Theses and Dissertations--Clinical and Translational Science

Ovarian cancer typically presents at an advanced stage, has a poor prognosis, and is a leading cause of cancer-related deaths in women. Extracellular vesicles (EVs) are cell-derived membrane-bound nanoparticles that function in specific cell-to-cell communication and are under development as novel drug delivery vehicles and modulators of the tumor microenvironment. Artificial cell-derived vesicles (ACDVs) derived from M1 macrophages are able to repolarize M2 macrophages to the M1 phenotype and target tumor cells in in vitro studies.

In this study, we generated engineered EVs (EEVs) by membrane disruption of M1 macrophages (MEVs) in the presence and absence of cisplatin to generate …

Zebrafish Models To Uncover Targetable Mechanisms Of Self-Renewal In T-Cell Acute Lymphoblastic Leukemia, Majd Al-Hamaly

Theses and Dissertations--Pharmacology and Nutritional Sciences

Relapsed T-cell Acute Lymphoblastic Leukemia (T-ALL) patients have dismal prognosis, with 5-year overall survival rates of 10% for adults and 36% for children. Relapse is attributed to the inability of chemotherapy agents to eliminate Leukemia Stem Cells (LSCs) that can repopulate the leukemia. Those cells exist with a unique genetic, transcriptomic, and metabolic profile compared to the rest of the leukemia and thus, finding targeted therapies toward this population of cells can result in disease eradication and elimination of relapse. However, investigating LSCs is challenging-particularly in T-ALL- for two reasons: 1) the lack of robust surface markers that define LSCs …

Cell-Type Specific Apoe4 To Apoe2 ‘Switching’ In Astrocytes And Microglia Alters Alzheimer’S Disease Neuropathology, Lesley R. Golden

Theses and Dissertations--Physiology

Apolipoprotein E (APOE) is the strongest genetic risk factor for late-onset Alzheimer’s disease (LOAD). APOE exists in three common protein isoforms throughout the population: ApoE2 (E2), ApoE3 (E3), and ApoE4 (E4). While APOE allele frequencies and the degree of AD-associated risk vary across different ethnic groups, when compared to the ‘neutral’ and most common E3 allele, the E4 allele confers up to a 33-fold increase in Alzheimer’s Disease (AD) risk. Conversely, the neuroprotective E2 allele decreases AD risk by up to 67%. Here, we aimed to determine the therapeutic potential of cell-type specific APOE allele ‘switching’ and explore …

Biochemical And Biophysical Properties Of Failing Myocardium In Rare Patient Populations, Gregory Nathaniel Milburn

Theses and Dissertations--Physiology

Heart failure has diverse underlying etiologies, complicating research. While some types, like ischemic disease or inherited mutations, are well-studied, research on rarer forms has lagged. Understanding the molecular drivers in these populations may enhance diagnostics and therapies. This work examines two rare groups: patients with ATTR cardiac amyloidosis and those receiving mechanical assist device support. We show that myocardium from patients with amyloidosis has increased fibrosis and reduced force production without changes in cross-bridge kinetics. Additionally, we show that the passive stiffness of amyloidosis myocardium is not different from non-failing myocardium, indicating increased ventricular wall thickness may cause restrictive filling. …

Biochemical Properties Of Cardiac Sarcomeres In Human Heart Failure, Austin Grey Wellette-Hunsucker

Theses and Dissertations--Physiology

Heart failure (HF) exhibits considerable heterogeneity, posing significant challenges for research involving human cohorts. Diastolic dysfunction is a common pathophysiological feature; however, its molecular mechanisms remain incompletely elucidated. Sarcomeric proteins are integral to cardiac contraction and relaxation. Nonetheless, the phosphoproteome and the structural remodeling effects of these proteins on diastolic function within the context of HF have not been comprehensively characterized. This study examined sarcomeric modifications in diastolic dysfunction in human HF, focusing on Dilated and Ischemic HF, with non-failing donor hearts as controls. Analyzing myocardial samples from ~150 patients using electrophoretic and biochemical techniques, it found significant titin remodeling …

Development And Clinical Validation Of Automated Same-Day Stereotactic Treatment Procedures For Multiple Brain Metastases And Recurrent Head And Neck Cancers, Shane Mccarthy

Theses and Dissertations--Radiation Medicine

As technology advances, more and more cancer patients are benefiting from the use of stereotactic radiosurgery and radiotherapy (SRS/SRT) to treat their disease. One such technology, Varian’s HyperArc high-definition radiosurgery module, a tool to help facilitate the treatment of brain metastases on a medical linear accelerator (LINAC), has been demonstrated to achieve comparable low dose spillage and target conformity compared to the current gold standard for intracranial malignancies, the Elekta Gamma Knife. Furthermore, due to HyperArc’s single-isocenter multiple lesion approach, the treatment can be delivered in a significantly shorter amount of time. Unfortunately, the manual process of creating these stereotactic …

Assessing The Effectiveness Of A Modified Cook Together Eat Together Program On Food Resource Management Behaviors In A Rural Setting, Johanna K. Poysti

Theses and Dissertations--Nutrition and Food Systems

This study evaluated the effectiveness of a modified, hybrid Cook Together, Eat Together (CTET) program on food resource management behaviors in a rural setting. A six-week intervention combining virtual and in-person sessions aimed to improve health behaviors, food resource management skills, and self-efficacy. Although most behavioral changes were not statistically significant, participants reported increased confidence in cooking healthy meals on a budget. Positive qualitative feedback from focus group discussions indicated program feasibility and engagement. Strengths and limitations of the study were discussed as well as recommendations for future research were given.

Gene Expression In Relation To Bone Fractures In Throughbred Racehorses, Anna M. Rauber-Ramos

Theses and Dissertations--Veterinary Science

Evidence that fractures in Thoroughbred racehorses are outcomes of chronic bone microdamage has led to extensive research into identifying horses at increased risk of fracture. This includes the use of biomarkers and messenger RNA (mRNA) as a measure of bone turnover. Previous research has found expression differences in horses with fractures compared to controls. Utilizing pre-race whole blood samples collected over an 18-month period from Thoroughbred racehorses in Southern California, RNA-sequencing was conducted on horses with bone fractures and race-matched controls to identify differences in gene expression. Focusing on third metacarpal (MC3) and proximal sesamoid bone (PSB) fractures, differentially expressed …

Engineering Novel Biomimetic Models Of Equine Host-Microbe Interactions, Lynn M. Leedhanachoke

Theses and Dissertations--Veterinary Science

One major limitation to the study of equine disease is the lack of in vitro models that accurately reflect the dynamic physiology of the horse. Thus, there is a pressing need to develop in vitro systems that recapitulate diverse equine tissue and organ microenvironments. To overcome this deficiency, we developed multiple biomimetic equine organoid systems that can be employed for a variety of investigations aimed at resolving outstanding questions in infectious disease pathogenesis, therapeutic development and drug metabolism, host defense mechanisms, immune-modulated disease, and equine developmental biology. Our innovative platform incorporates novel equine intestinal enteroid and airway organoid models derived …

Researching Dementia Indicators Among Rural Populations, Justin S. Yount

Theses and Dissertations--Community & Leadership Development

The study explored potential dementia indicators and risk factors among older adults residing in rural areas who are actively engaged in farming operations. Data was collected in three components a questionnaire, an audiogram test, and a memory impairment screening. 104 people responded to the questionnaire, 133 participants took the audiogram test, and 94 participated in the memory impairment screening. The findings revealed that 80.9% of participants showed no sign of cognitive impairment while 19.1% showed signs of possible impairment. Participants reported moderate levels of physical and social activity, but common risk factors such as elevated BMI, diabetes, hearing loss, and …

Fabricating Silver-Ceria Polymer Nanocomposite Scaffolds For Biomedical Therapeutic Applications, Shreya S. Pawar

Honors Undergraduate Theses

Improper healing of bone fractures and limited regeneration of bone following bone tumor resection remain a prevalent complication worldwide. Long-term effects of this include joint instability, limited movement, and arthritis. Bone infections (osteomyelitis), reactive oxygen species (ROS) generation via excessive inflammation, and underlying conditions such as osteoporosis can contribute to suboptimal bone tissue regeneration. ROS accumulation stimulates osteoblast apoptosis, while promoting osteoclast differentiation. These processes inhibit mineralization and osteogenesis. Conventional therapeutics involve the utilization of drugs and bone grafts. However, these approaches pose limitations and can result in subsequent complications. Microbial infections, ROS accumulation, and excessive inflammations are factors that …

Stroke Recovery Throughout The Continuum Of Care: A Dual Component Educational Manual, Jordyn Marie Wolff

Occupational Therapy Capstones

Introduction: One of the leading causes of death in the United States are strokes (Centers for Disease Control and Prevention [CDC, 2024]). People who have had a stroke and their caregivers go through various phases of recovery throughout the continuum of care. Therefore, providing education to the individual who had a stroke and their caregiver is a critical component through different phases of recovery. Not only is education an important component, but addressing team communication strategies are critical as well for improved quality of care and team collaboration. The goal of this capstone was to improve the educational need by …

Pain Neuroscience Education With A Veteran Population, Kate Westphal

Occupational Therapy Capstones

Introduction: In 2021, upper extremity (UE) injuries accounted for 21.3% of injuries by U.S. active duty service members (Mahlmann et al., 2024). Right or left shoulder pain were the top two diagnoses in active-duty service members between fiscal years 2016 and 2021, with overuse/non-specific injury being the most common UE injury (Isaacson et al., 2024). Pain often follows service members after discharge. It is estimated 66% of the 20 million Veterans in the United States experience musculoskeletal pain, and chronic pain is more intense in a Veteran population, limiting their ability to engage in preferred activities of daily living (Areias …

Rehabilitation Not Punishment: Adults In Custody Learning Skills Needed To Survive In Society, Kaitlyn J. Wanner

Occupational Therapy Capstones

Introduction: The U.S has one of the highest populations of incarcerated individuals in the world and must shift from the use of punishment to rehabilitation for these individuals (Huynh et al., 2015; Muñoz, 2019; Phelps & Aldrich, 2022). While in prison, these individuals are limited in their ability to participate in meaningful activities and lose skills needed to function in society (Lares & Montgomery, 2020). Occupational therapy assists individuals of a variety of populations engage in activities that are meaningful to them. The set of skills that occupational therapy has to offer results in a broad area of settings that …

Brain Injury (Bi) In Survivors Of Intimate Partner Violence (Ipv): The Importance Of Identifying Bi Symptoms And The Impact On Daily Occupations, Alexis Walther

Occupational Therapy Capstones

Introduction: Survivors of intimate partner violence (IPV) and resulting brain injury (BI) often experience unmet occupational needs. Specifically, there are barriers to occupations like health management, social participation, work, and education. These barriers occur due to lasting IPV and BI related trauma and symptoms, negative societal views, underreported nature of the injury, and lack of awareness on the topic. This poses a problem, as many service providers may not be educated or aware of the link between IPV and BI, since it is an emerging area of practice. This results in a gap in literature and services related to IPV …

Cultural Competency Of The Interprofessional Team In Burn Care Through An Occupational Therapy Model, Brooklyn Wiest

Occupational Therapy Capstones

Purpose: Burn injuries are considered one of the most devastating injuries globally (Farzan et al., 2023). Those suffering from serious burns are likely to be affected in all areas of life (physical, social, mental, emotional, spiritual, environmental, intellectual, and psychological) (Abrams et al., 2016). Some of these impacts include changes in appearance, social isolation, stress, anxiety, depression, self-esteem, employment, financial burden, and family problems. These are devastating outcomes are seen throughout diverse populations (Nair & Adetayo, 2019). As diverse populations are rising, an increase in equitable medical care is needed (Peters et al., 2022). Education and increasing awareness of culturally …

Addressing Sleep Within The Hand Therapy Practice Context, Grant Edwin Tolkkinen

Occupational Therapy Capstones

Background: Sleep is an essential pillar for health and well-being, yet this is not well understood by the general public. Many clients seen within the occupational therapy advanced practice context of hand therapy are at risk of sleep disturbances which will impact the sensorimotor, cognitive, and psychosocial components of the client. Sleep disturbances also negatively affect many aspects which are required for successful recovery and return to occupational engagement for those with conditions of the upper extremity. Addressing sleep within practice allows occupational therapy practitioners within the advanced practice context of hand therapy to promote occupational performance across all waking …

Integrating A Canine Comfort Program With Occupational Therapy Services For Emerging Adults With Mental Health Diagnoses, Emily Vieth

Occupational Therapy Capstones

Background: Mental health plays a critical role in the lives of emerging adults (ages 18-29) including how they identify, their coping strategies, and social skills (Matud et al., 2020). Occupational therapists (OTs) can play a vital role in the management of depressive and anxiety symptoms for the promotion of an individual’s well-being (American Occupational Therapy Association [AOTA], 2020). OT can address depressive and anxiety symptoms through the incorporation of animal-assisted therapy (AAT). AAT is a therapeutic approach that uses animals to improve overall health and well-being (Pandey et al., 2024). Though still limited in evidencebased research, emerging interventions like canine …

Enhancing Quality Of Life: Occupational Therapy’S Role In Managing Chronic Conditions, Aubrey Rude

Occupational Therapy Capstones

Introduction: Chronic conditions are among the most common health concerns, and often cause disruption to daily routines, roles, self-identity, and quality of life (Fields & Smallfield, 2022). In fact, they are the leading cause of disability in the United States (Centers for Disease Control, 2019). It is estimated that 129 million adults are living with at least one chronic condition as defined by the US Department of Health and Human Services (Centers for Disease Control and Prevention, 2020). Trying to manage a chronic condition is extremely time consuming, with people spending at least two hours every day on health-related activities …

Caregiver Education In Early Intervention, Payton Schilke

Occupational Therapy Capstones

Background: Early intervention services are provided for children ages birth to three years who have identified developmental delays (North Dakota Health and Human Services, n.d.). Services that are provided in early intervention include home visits, consultations, and parent coaching from a multidisciplinary team (North Dakota Health and Human Services, n.d.). The health-related practices of parents during the first two years of their children’s lives plays an important role in terms of influencing children’s health and development (Boelsma et al., 2021). It is the responsibility of the caregivers to utilize the information that is provided and implement within the child’s daily …

Addressing Delirium In The Intensive Care Unit: An Interprofessional Approach, Olivia Grace O'Neill

Occupational Therapy Capstones

Purpose: Successful recovery from an intensive care stay is influenced by many factors, including length of stay, medical ventilation requirements, and the extent of surgical interventions such as cardiac, intracranial surgery, neurosurgery, and vascular neurosurgery. A major barrier to achieving a full recovery can be delirium, which is seen in 80% of critical care patients. Delirium is described as a severe change in mental abilities and a short-term cause of cerebral impairment that can present as distortion or psychosis and is associated with numerous conditions. While critical care-related delirium typically lasts less than a week, those affected by longer periods …

Chronic Pain Management In Adults In Rural Areas And Its Effect On Health And Well-Being: An Occupational Therapist’S Guide For Clients, Kinley Jo Nordin

Occupational Therapy Capstones

Background: Chronic pain is a common problem among individuals in the United States (Cleveland Clinic, 2021). It can affect any area of occupation including activities of daily living (ADLs), instrumental activities of daily living (IADLs), health management, rest and sleep, education, work, play, leisure, and social participation (American Occupational Therapy Association, 2020). It can also negatively influence an individual’s overall health, well-being, and quality of life (Cleveland Clinic, 2021).

Purpose: The purpose of this scholarly project was to address the need for additional resources for individuals living in rural areas who experience chronic pain to help manage their health and …

Pelvic Health Rehabilitation: A Guide For Postpartum Women In Rural Areas To Enhance Occupational Engagement, Joslynn Kay Parks

Occupational Therapy Capstones

Background: Of the over 3 million births in the US each year, 570,000 women experience a birth related injury, leading to pelvic health issues during the postpartum period (DeLancey et al., 2024). Pelvic floor dysfunction (PFD) affects 25% of American women, directly impacting quality of life (QoL), psychosocial factors, and the ability to successfully engage in meaningful occupation (Baker et al., 2017; Burkhart et al., 2021; Khan, 2023; Nygaard et al., 2008; Peinado Molina et al., 2023; Synder et al., 2022b). Although PFD has a neuromuscular etiology, the physiological effects can lead to psychosocial impacts, including, but not limited, to …

Nature-Based Practices In Early Childhood Through An Occupational Therapy Lens, Angela Mossman

Occupational Therapy Capstones

Background: Early childhood experiences are the building blocks for all future behavior and health (Warmbold,2015). These experiences, whether positive or negative, build the foundation of the brain's architecture (Center on the Developing Child at Harvard University, 2016). The developing brain comprises neural connections that develop through an ongoing process that begins before birth and continues into adulthood (Center on the Developing Child at Harvard University, 2016). This capstone project aims to demonstrate the therapeutic benefits of naturebased practices through the lens of occupational therapy. Ginsburg et al. (2007) stated that play is essential for optimal child development. The benefits of …