Medicine and Health Sciences Commons^™

Bystander Cpr Training For Laypersons And Caregivers Of Those At High Risk For Sudden Cardiac Arrest: An Integrative Review, Ragan Scott

Doctoral Dissertations and Projects

Sudden Cardiac arrest (SCA) is the leading cause of death in the United States (U.S.) with approximately 475,000 deaths annually (AHA, 2018). Approximately 70% of these deaths occur as out-of-hospital cardiac arrests (OHCA; AHA, 2018). Currently, the survival rate for OHCA is 10% with the lack of bystander CPR being a large contributor to the high mortality rate (AHA, 2018). This project evaluated the literature related to bystander CPR training to determine if this training improves willingness to perform bystander CPR and overcomes common barriers that inhibit the initiation of bystander CPR in OHCA. The projected outcome for this project …

Walking Through Smoke: Implementation Of The 5a'S For Smoking Cessation Counseling In Rural Virginia, Cristina Maria Minotti

Doctoral Dissertations and Projects

Tobacco use represents a significant cause of morbidity and mortality in the U.S. and is a contributing risk factor for multiple pulmonary, cardiovascular, and oncologic diseases. Despite documented evidence of these health hazards, use of tobacco products remains high, particularly in rural America. While providers may frequently question patients regarding tobacco use and inform patients of associated health hazards, a standardized, structured process for delivering smoking cessation counseling (SCC) is rarely established in practice settings. One such method for standardization of SCC is the 5A’s (Ask, Advise, Assess, Assist, Arrange) model which has a robust body of evidence to support …

Nighttime Quiet In The Intensive Care Unit: An Integrative Review, Heather Rae Smith

Doctoral Dissertations and Projects

Excessive environmental noise in the ICU often negatively impacts patient sleep. The World Health Organization (WHO) and Environmental Protection Agency (EPA) have published recommendations for hospital decibel levels, but the literature indicates that noise levels in the ICU often exceed these values. Patients experience disturbed sleep and rarely enter into N3 and REM sleep. The integrative review examined both the patients’ and healthcare workers’ perception of noise in the ICU environment to identify contributors and suggested interventions to mitigate these occurrences. In addition, this study evaluated objective measurements of patient sleep to further determine how well patients were sleeping in …

Diabetes Health Literacy In The Rural Community: An Integrative Review, Shannon M. Elrod

Doctoral Dissertations and Projects

Health literacy is paramount for successful management of health and prevention of disease. Yet a majority of adults have low health literacy. The impact of low health literacy on chronic disease management effects health outcomes and health care costs. With six out of 10 adults in the US diagnosed with a chronic disease such as diabetes, health literacy is a serious concern. Diabetes impacts over 30.3 million Americans. Since diabetes is one of the most common chronic diseases in the country, it is imperative that health literacy be addressed as part of this population’s health management. Diabetes health literacy plays …

Development Of A Ct Metal Artifact Management Algorithm For Proton Therapy Planning (Ampp) For Head And Neck Cancer Patients, Daniela Branco

Dissertations and Theses (Open Access)

Purpose: Dental amalgams (high Z materials) are common sources of artifacts in Head and Neck (HN) images. Commercial artifact reduction techniques have been offered, but many are impractical, produce inaccurate CT images or are not clinically available, thus not widely implemented. The goal of this work is to use CT gantry tilts to develop and evaluate a stereoscopic HN metal artifact management algorithm and investigate its improvement in proton treatment planning.

Methods: The in-house CT metal artifact management method for proton planning (AMPP) uses two angled CT scans to generate a single image set with no metal artifacts posterior …

Characterization Of Treatment Planning System Photon Beam Modeling Errors In Iroc Houston Phantom Irradiations, Mallory Glenn

Dissertations and Theses (Open Access)

In radiation therapy, proper commissioning of the treatment planning system’s (TPS) dose calculation algorithm is critical because any errors in this process impact all treatment plans prepared in the system. Previously, TPS errors have been identified as a major cause for poor phantom irradiation performance, which may also mean that patients are treated suboptimally. The purpose of this work was to investigate the TPS beam modeling developed by the radiotherapy community to understand where inconsistencies may arise, which variables are most susceptible to variations, and in what way changing these variables can alter dose calculations.

Using the Imaging and Radiation …

Bringing Til Therapy Beyond Melanoma: Advancing The Treatment Of Advanced Pancreatic And Ovarian Cancers, Donald Sakellariou-Thompson

Dissertations and Theses (Open Access)

The success of checkpoint blockade immunotherapy (CBI) has reinvigorated the cancer therapy field, particularly for advanced melanoma which has doubled the survival rates compared to 20 years ago. However, there are many solid tumor types that are yet to receive substantial benefit from this groundbreaking therapy, two of which are pancreatic cancer (PDAC) and ovarian cancer (OvCa). As such, the 5-year survival rate for PDAC and OvCa stand at 9% and 28% respectively. Despite the lack of efficacy of CBI so far, there is still evidence for the role of immune control in these cancers as evidenced by presence of …

Directed Evolution Of Macrocyclic Peptides For Inhibition Of Autophagy, Joshua Gray

Dissertations and Theses (Open Access)

In recent decades it has become increasingly clear that induction of autophagy plays an important role in the development of treatment resistance and dormancy in many cancer types. Chloroquine (CQ) and hydroxychloroquine (HCQ), two autophagy inhibitors in clinical trials, suffer from poor pharmacokinetics and high toxicity at therapeutic dosages. This has prompted intense interest in the development of targeted autophagy inhibitors to re-sensitize disease to treatment with minimal impact on normal tissue. We utilized Scanning Unnatural Protease Resistant (SUPR) mRNA display to develop macrocyclic peptides targeting the autophagy protein LC3. The resulting peptides bound LC3A and LC3B—two essential components of …

Investigating The Role Of Quaking In Antigen Uptake And Cross-Presentation By Dendritic Cells, Yating Li

Dissertations and Theses (Open Access)

Dendritic cells (DCs) are considered the most potent antigen presenting cells (APC) due to their superior capability of cross-presenting exogenous antigens to CD8⁺ T cell for strong adaptive immune responses. They internalize foreign antigens by phagocytosis, endocytosis or macropinocytosis, which are then processed in endosomal compartments and loaded onto MHC Class I molecules. However, the molecular mechanisms regulating exogenous antigen uptake and cross-presentation by DCs are not fully understood.

In this study, we discovered that an RNA-binding protein, Quaking (QKI) plays a pivotal role in antigen uptake by DCs. Our previous studies in neural stem cells and microglia have …

Active Magnetic Radiation Shielding For Long-Duration Human Spaceflight, Kristine Ferrone

Dissertations and Theses (Open Access)

Exploration of interplanetary space presents dramatic hazards to human survival.

Space radiation hazards outside the protection of the Earth’s magnetosphere can

produce both acute and chronic health risks and thus become limiting factors for

NASA’s planned mission to Mars by the 2030s. Radiation exposure on a Mars mission

is delivered primarily by high energy ions from galactic cosmic rays and moderate

energy protons from solar particle events. The chronic radiation dose due to galactic

cosmic rays on a typical Mars mission is on the order of 1 Sv, and additional acute

radiation dose from solar flares can reach over 4 …

Targeting Unique Domains Of Lsd1 Regulates Pediatric Glioma Innate Immunity And Nk Cell Metabolism, Cavan Bailey

Dissertations and Theses (Open Access)

Regulation of chromatin accessibility is a key mechanism of cellular identity, allowing different tissues to develop using the same DNA template. Cancers will often hijack these epigenetic pathways, reactivating developmental genes to drive growth and deactivating tumor suppressor and immune recognition genes. Chromatin-modifying proteins deposit and remove chemical moieties from histone tails to aid in governing gene expression, and these proteins have become a new therapeutic target in cancer. Traditional chemotherapeutics aim to damage DNA, dysregulate cell division, or block hormonal growth signals, but epigenetic therapy can target vulnerabilities specific to cancer cells and broadly change gene expression patterns that …

Investigating The Metabolic Progression Of Glioblastoma With Hyperpolarized Magnetic Resonance, Travis Salzillo

Dissertations and Theses (Open Access)

Rapid diagnosis and therapeutic monitoring of aggressive diseases such as glioblastoma (GBM) can improve patient survival by providing physicians the time to optimally deliver treatment. This includes early in development, while the tumor is still manageable, or following initial therapy, when alternative treatments should be considered. The main goal of this project was to determine whether metabolic imaging with hyperpolarized magnetic resonance spectroscopy (MRS) could detect changes in tumor progression more rapidly than conventional anatomic magnetic resonance imaging (MRI) in patient-derived GBM murine models. To comprehensively capture the dynamic nature of cancer metabolism, in vivo pyruvate-to-lactate conversion with hyperpolarized MRI, …

Mechanistic Insights Into Vancomycin Resistance In Clostridioides Difficile, Ayesha Mahmood

Dissertations and Theses (Open Access)

C. difficile is a nosocomial, opportunistic pathogen that has become more hypervirulent over the last decade. Vancomycin is currently a frontline antibiotic for the treatment of C. difficile infections. Yet, strains of C. difficile are becoming non-susceptible to vancomycin. Emergence of the vancomycin non-susceptible phenotype has led to various questions including: What resistance elements are present that might contribute to the phenotype? Are these elements located on the chromosome or a plasmid? Where did these elements originate from? To address these questions, whole genome sequence analysis was performed to survey genes that may be involved in the vancomycin non-susceptible phenotype. …

Methods To Investigate Hyperthermia Induced By Tumor Treating Fields, Ruchi Singh

Dissertations and Theses (Open Access)

Tumor Treating Fields (TTFields) are an antineoplastic treatment delivered via application of alternating electric fields using insulated transducer arrays placed directly on the skin in the region surrounding the tumor. TTF’s is a non-invasive application of low-intensity (1-3 V/cm), intermediate-frequency (100-500 kHz) alternating electric fields. The predominant mechanism by which TTFields are thought to kill tumor cells is the disruption of mitosis through the depolymerization of microtubules and interruption of the spindle structure leading to mitotic catastrophe and the formation of non-viable daughter cells. Tumor Treating fields do not stimulate nerves and muscle because of their high frequency, and do …

Histological And Functional Characterization Of Cervical Spinal Cord Injury After Graded Contusion, Chrystine Gallegos

Dissertations and Theses (Open Access)

Most spinal cord injuries (SCIs) are cervical contusions and result in deficits for both locomotion and reaching and grasping functions. Previous studies have characterized histological and functional deficits in locomotion using primarily thoracic contusions, but most patients have cervical injuries. Damage to descending long spinal tracts (dLSTs) is one well-established cause of functional loss after SCI and has been explored in laceration and transection models, but these are not clinically relevant. In this study, I will explore the histological and functional deficits after graded cervical hemicontusion SCI and examine the potential contribution of different histological deficits to forelimb function after …

Statistical Methods For Resolving Intratumor Heterogeneity With Single-Cell Dna Sequencing, Alexander Davis

Dissertations and Theses (Open Access)

Tumor cells have heterogeneous genotypes, which drives progression and treatment resistance. Such genetic intratumor heterogeneity plays a role in the process of clonal evolution that underlies tumor progression and treatment resistance. Single-cell DNA sequencing is a promising experimental method for studying intratumor heterogeneity, but brings unique statistical challenges in interpreting the resulting data. Researchers lack methods to determine whether sufficiently many cells have been sampled from a tumor. In addition, there are no proven computational methods for determining the ploidy of a cell, a necessary step in the determination of copy number. In this work, software for calculating probabilities from …

Telehealth Among Behavioral Health Providers In Louisiana During Covid-19 And A Mandatory Stay At Home Order, Evidence To Practice, Cep Briefs, Stephen Phillippi, Sonita Singh, Brian Bumbarger, Kaylin Beiter, Lindsay Simpson, Ashley Fenton

Policy & Position Papers

No abstract provided.

Metagenomic, Viral And Host Genetic Analyses Of Congenital Tremor In Pigs, Kylee Marie Sutton

School of Biological Sciences: Dissertations, Theses, and Student Research

The Pestivirus genus contains several viral species having a major impact on the livestock species. While there were only four major pestiviral species for a time, recent metagenomic sequencing approaches identified additional species, such as atypical porcine pestivirus (APPV). Congenital tremor was first identified almost a hundred years ago and since still has an impact on swine health. There are two main types of congenital tremor, type A and B, with type A congenital tremor further subcategorized based on causative agent. Until recently, type A-II congenital tremor did not have a known cause. Recent viral sequencing of affected samples, including …

Perioperative Anticoagulation Management In Spine Surgery: Initial Findings From The Ao Spine Anticoagulation Global Survey., Philip Louie, Garrett Harada, James Harrop, Thomas Mroz, Khalid Al-Saleh, Giovanni Barbanti Brodano, Jens Chapman, Michael Fehlings, Serena Hu, Yoshiharu Kawaguchi, Michael Mayer, Venugopal Menon, Jong-Beom Park, Sheeraz Qureshi, Shanmuganathan Rajasekaran, Marcelo Valacco, Luiz Vialle, Jeffrey C Wang, Karsten Wiechert, K Daniel Riew, Dino Samartzis

Department of Neurosurgery Faculty Papers

STUDY DESIGN: Cross-sectional, international survey.

OBJECTIVES: This study addressed the global perspectives concerning perioperative use of pharmacologic thromboprophylaxis during spine surgery along with its risks and benefits.

METHODS: A questionnaire was designed and implemented by expert members in the AO Spine community. The survey was distributed to AO Spine's spine surgeon members (N = 3805). Data included surgeon demographic information, type and region of practice, anticoagulation principles, different patient scenarios, and comorbidities.

Results: A total of 316 (8.3% response rate) spine surgeons completed the survey, representing 64 different countries. Completed surveys were primarily from Europe (31.7%), South/Latin America (19.9%), and …

Use Of Video Modeling In Developing Social Skills Among Children With Autism Spectrum Disorder, En Ying Irene Tan

Student Works (2020-2029)

Children with Autism Spectrum Disorder (ASD) are poor in social interaction and following instruction. Most researchers of today focus on having the children to interact with toys to enhance their social skills, but not with other peers. This study was carried out to investigate the use of video modeling in developing social skills among children with ASD. The study uses single-subject design with multiple baseline graphs to examine the development of children’s social skills. This study consists of three sequential phases: 1) Baseline, 2) Intervention, and 3) Maintenance. Results show that children with ASD have social interaction with peers after …

Physical Activity, Eating Behaviours And Body Satisfaction Among Private Preschoolers In Putrajaya, Poh Then Woh

Student Works (2020-2029)

Numerous studies had focused on examining the physical activity level, eating behaviours and body satisfaction worldwide. Additionally, some researchers have explored the gender differences of primary school students and adolescents as well as the correlation between these three variables. However, there are fewer studies that involve preschoolers and young children. Hence, the purpose of this study is to seek better understanding of the physical activity level, eating behaviour and body satisfaction among pre-schoolers in Malaysia. The Federal Territory of Putrajaya was being selected as the study’s location as it marked the highest percentage of children; and highest overweight and obesity …

So Others May Live: The Price Of Healthcare In Combat, Robert Del Toro

War, Diplomacy, and Society (MA) Theses

“Medics carried more responsibilities than dry feet, salt tablets, syphilis, and puncture wounds,” U.S. Army Medic Ben Sherman stated after reflecting on his tour in Vietnam. On the battlefields of North Africa, Italy, France, and Vietnam, the medics of the U.S. Army Medical Department faced the difficult duty of preserving life while death surrounded them. Their patients were not strangers but, men they had grown close to, they were comrades and family. Analyzing the memoirs and letters of forward medical personnel from the Second World War and the Vietnam War, this thesis analyzes how a medic’s care went beyond the …

Intratracheal Lidocaine And Postoperative Sore Throat At Providence Sacred Heart Medical Center And Providence Holy Family Hospital, Jennifer Cowgill, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Postoperative sore throat (POST) is a common side effect from general anesthesia (GA) and has a prevalence of 14.4-50%.1 The experience of POST contributes to patient discomfort during recovery from surgery. The etiology of this is thought to be from tracheal mucosal erosion from the cuff of the endotracheal tube (ETT), trauma from intubation, coughing and bucking, and friction between the ETT and the tracheal mucosa during general anesthesia.2 Risk factors shown to contribute to the development of POST include, but are not limited to, elderly age, smoking history, patient positioning, ETT cuff pressure, and movement of ETT during …

A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso

Electronic Theses and Dissertations

Legal induced abortion is a safe option for terminating a pregnancy for women of reproductive age in the United States (U.S.), though access has varied since the Roe v. Wade and Doe v. Bolton cases in 1973. Information is lacking on women’s attitudes toward and perceptions of abortion as well as on related constructs such as pregnancy attitudes and contraceptive use. Exploring these constructs is important in that it can provide much needed context to women’s reproductive life planning. This research aimed to explore perceptions of abortion access and safety and examine the potential associations between attitudes toward abortion access …

The Long-Term Multidimensional Impact Of Persistent Multisite Pain On Physical And Psychological Disability, And Mortality In Community-Dwelling Older Adults, Saurja Thapa

Graduate Doctoral Dissertations

Persistent multisite pain is highly prevalent, affecting 25-43% of community-dwelling older adults. Although existing evidence suggests that persistent multisite pain is associated with physical and psychological disability, studies use a cross-sectional assessment approach that overlooks pain duration or persistence. This study aimed to estimate the persistence of multisite pain and the proportion of incident multisite pain and examine the association between persistent multisite pain and physical (ADL and IADL) and psychological disability (depression and anxiety) at 18 months and six years. Also, the association between baseline persistent multisite pain and mortality was assessed.

Secondary data analysis of the MOBILIZE Boston …

The Relationship Between Physical Activity And Emotional Intelligence In Adolescents, Marie C. Gabour

Graduate Doctoral Dissertations

PURPOSE: We assessed the association of Physical Activity (PA) measures on overall Emotional Intelligence (EI) and domains of EI: Intrapersonal, Interpersonal, Adaptability, General Mood, and Stress Management in adolescents.

METHODS: Cross-sectional and two-year follow up analyses were conducted relating EI to PA measures using the National Longitudinal Survey of Children and Youth in adolescents between 10- 13 years. EI score was measured by using a validated the youth version of the Emotional Quotient Inventory; PA was self-reported. Regression analysis adjusted for age, gender, household annual income, and health status and was summarized using regression coefficients. A test of linear trend …

The Inhibitory Effects Of An Antimicrobial Gel On The Staphylococcus Species, Mara Trinkle

Undergraduate Honors Theses

The prevalence of antibiotic resistant bacteria has made the choices for topical treatments for patients who experience burns wounds extremely limited. The Staphylococcus genus is naturally occurring in and on the human body but can become harmful once it enters the bloodstream. A novel antimicrobial gel has been shown by our laboratory to inhibit both the planktonic growth and biofilm formation of Staphylococcus aureus in previous studies. The antimicrobial gel is made of seven natural compounds including antioxidants (vitamin C and E). We wanted to examine the effects of the antimicrobial gel on numerous other Staphylococcal species because it is …

Scope Of Artificial Intelligence In Screening And Diagnosis Of Colorectal Cancer, Hemant Goyal Md, Rupinder Mann Md, Zainab Gandhi Mbbs, Abhilash Perisetti Md, Aman Ali Md, Khizar Amani Ali, Neil Sharma Md, Benjamin Tharian Md, Shreyas Saligram, Sumant Inamdar

PCI Publications and Projects

Globally, colorectal cancer is the third most diagnosed malignancy. It causes significant mortality and morbidity, which can be reduced by early diagnosis with an effective screening test. Integrating artificial intelligence (AI) and computer-aided detection (CAD) with screening methods have shown promising results for colorectal cancer screening. AI could provide a “second look” for endoscopists to decrease the rate of missed polyps during a colonoscopy. It can also improve detection and characterization of polyps by integration with colonoscopy, various advanced endoscopic modalities like magnifying narrow-band imaging, endocytoscopy, confocal endomicroscopy, laser-induced fluorescence spectroscopy, and magnifying chromoendoscopy. In this review, we have discussed …

Impact Of Immunotherapy Use In Patients With Stage Iv Pancreatic Carcinoma, Achuta K. Guddati, Takefumi Komiya Md, Sunny J. Patel, Neil Sharma Md, Emily Powell

PCI Publications and Projects

Background: Most patients with pancreatic cancer have non-resectable disease at the time of diagnosis and usually die within 6-12 months. Despite indications in other solid tumors, the role of immunotherapy (IO) is unknown for late stage, advanced pancreatic cancer.

Methods: Using the National Cancer Database (NCDB), cases of Stage IV pancreatic cancers diagnosed in the period of 2014-2016 with at least 30-day follow up were retrospectively analyzed. The following clinical demographics were included: age (younger than 70 vs. older than 70), sex (male vs. female), race (whites vs. others), insurance (uninsured vs. insured), type of institution …

Association Between Concussion History And Factors Relating To Cognitive, Behavioral, And Emotional Health Among American High School Athletes: A Cross-Sectional Analysis, Gregory Knell, Scott O. Burkhart, Todd J. Caze, John D. Polousky, Harold W. Kohl, Sarah E. Messiah

Faculty Publications - Doctor of Psychology (PsyD) Program

Background: The cognitive, behavioral, and emotional deficits that may be associated with sports-related concussions among adolescents are unclear.

Purpose: To examine the association between reported concussion history and factors relating to cognitive, behavioral, and emotional health among a population-based sample of US high school-aged adolescents.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: Participants included a representative sample of US high school student-athletes who reported a concussion history (in the past 12 months) and relevant behaviors/outcomes within 3 domains: cognitive (academics, difficulty concentrating), behavioral (drinking and driving, carrying a weapon, physically fighting, tobacco use, marijuana use, binge drinking), and …