Medicine and Health Sciences Commons^™

A Retrospective Chart Review Of Avulsion Injuries Treated At Virginia Commonwealth University., Ryan Hediger

Theses and Dissertations

A RETROSPECTIVE CHART REVIEW OF AVULSION INJURIES TREATED AT VIRGINIA COMMONWEALTH UNIVERSITY. By: Ryan Hediger, DMD

Objective: Outcomes related to healing following an avulsion injury are multifactorial. However, contemporary literature suggests that tooth survival can be enhanced after such injuries by promptly replanting the tooth and adhering to proper management guidelines. Despite the abundance of resources available, the actions taken immediately after the avulsion injury play a pivotal role in determining the fate of an avulsed tooth. The primary objective of the current investigation is to unveil prognostic factors associated with the survival of avulsed teeth.

Methods: A chart review …

Exploring Drivers Of Sex-Based Disparities In Relapsing Multiple Sclerosis, Stephanie K. Buxhoeveden

Theses and Dissertations

Females are three times more susceptible to relapsing multiple sclerosis (MS) and males typically have more severe disease, but the molecular underpinnings of these sex-based disease disparities are unknown and represent a critical knowledge gap.Subject Population: Blood samples from a demographically homogenous group of treatment naïve males and females with relapsing-MS and healthy controls. Research Design: Cross-sectional combinatorial omics pilot study. Instruments: Whole transcriptomic analysis with messenger RNA (mRNA) expression profiling using next generation sequencing (RNA-seq) and micro-RNA (miRNA) expression using NanoString technology. Aim 1) Identify and compare the actively expressed mRNAs in the transcriptome of males and …

The Splice Index As A Prognostic Biomarker Of Strength And Function In Myotonic Dystrophy Type 1, Marina Provenzano

Theses and Dissertations

Myotonic dystrophy type 1 (DM1) is a slowly progressive, multisystem disorder caused by a CTG repeat expansion in the DMPK 3’UTR that leads to global dysregulation of alternative splicing. The resulting decline in physical function is slow, and no reliable biomarkers exist for predicting disease progression; however, an RNA mis-splicing biomarker associated with weakness may have utility in predicting functional outcomes. Here we validate the Splice Index (SI) as a potential biomarker of DM1-associated strength and function. Muscle biopsies of the tibialis anterior were collected from DM1-affected individuals at baseline (n = 46) and 3-months (n = 34), along with …

The Role Of Notch1 Signaling In Regulating Neurogenesis In The Olfactory Bulb Following Traumatic Brain Injury, Sarah A. Baig

Theses and Dissertations

In the United States, more than 20.5 million adults over the age of 40 suffer from olfactory dysfunction, with TBI attributing to 5-17% of all olfactory dysfunction cases. Although often initially undetected and less conspicuous than other cognitive and behavioral impairments, olfactory dysfunction may have a significant negative impact on patients' quality of life and ability to accomplish activities of daily living, therefore the pathophysiology of these disorders should be understood. The production of neural stem cells enhances the repair and regeneration of the injured brain following a TBI. One of the primary endogenous neural stem cell generation sites in …

Intersectionality, Racial Discrimination And Oral Healthcare Utilization Among Black Adults In Baltimore City, Maryland, Briona M. Phillips

Theses and Dissertations

INTRODUCTION: Oral health is essential for overall well-being, yet disparities persist, particularly among marginalized populations including Black adults. Limited access to and underutilization of oral healthcare services exacerbate these disparities. Discrimination, both individual and systemic, acts as a significant barrier to accessing care, contributing to disparities in oral health outcomes. Individuals facing discrimination experience mistrust and fear within oral healthcare settings, leading to delayed or avoided care. Therefore, investigating and addressing discrimination among Black adults is essential for promoting equitable access to oral healthcare, improving overall oral health outcomes, and lessening existing disparities.

PURPOSE: The purpose of this dissertation was …

Cross-Sectional Analysis Of Primary Care Clinics' Policies, Practices, And Availability Of Patient Support Services During The Covid-19 Pandemic, Kendra Ratnapradipa, Runqiu Wang, Josiane Kabayundo, Walter Marquez Lavenant, Eleanore Nelson, Muskan Ahuja, Ying Zhang, Hongmei Wang

Journal Articles: Epidemiology

BACKGROUND: Healthcare accessibility and utilization are important social determinants of health. Lack of access to healthcare, including missed or no-show appointments, can have negative health effects and be costly to patients and providers. Various office-based approaches and community partnerships can address patient access barriers.

OBJECTIVES: (1) To understand provider perceptions of patient barriers; (2) to describe the policies and practices used to address late or missed appointments, and (3) to evaluate access to patient support services, both in-clinic and with community partners.

METHODS: Mailed cross-sectional survey with online response option, sent to all Nebraska primary care clinics (n = 577) …

Evaluating The Performance Of Flukecatcher At Detecting Urogenital Schistosomiasis, Louis Fok, Berhanu Erko, David Brett-Major, Abebe Animut, M. Jana Broadhurst, Daisy Dai, John Linville, Bruno Levecke, Yohannes Negash, Abraham Degarege

Journal Articles: Epidemiology

Urine filtration microscopy (UFM) lacks sensitivity in detecting low-intensity Schistosoma haematobium infections. In pursuit of a superior alternative, this study evaluated the performance of FlukeCatcher microscopy (FCM) at detecting S. haematobium eggs in human urine samples. Urine samples were collected from 572 school-age children in Afar, Ethiopia in July 2023 and examined using UFM and FCM approaches. Using the combined UFM and FCM results as a reference, the sensitivity, negative predictive value, and agreement levels for the two testing methods in detecting S. haematobium eggs in urine samples were calculated. The sensitivity and negative predictive value of detecting S. haematobium …

Polygenic And Transcriptional Risk Scores Identify Chronic Obstructive Pulmonary Disease Subtypes In The Copdgene And Eclipse Cohort Studies, Matthew Moll, Julian Hecker, John Platig, Jingzhou Zhang, Auyon J. Ghosh, Katherine A. Pratte, Rui-Sheng Wang, Davin Hill, Iain R. Konigsberg, Joe W. Chiles, Craig P. Hersh, Peter J. Castaldi, Kimberly Glass, Jennifer G. Dy, Don D. Sin, Ruth Tal-Singer, Majd Mouded, Stephen I. Rennard, Gary P. Anderson, Gregory L. Kinney, Russell P. Bowler, Jeffrey L. Curtis, Merry-Lynn Mcdonald, Edwin K. Silverman, Brian D. Hobbs, Michael H. Cho

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Genetic variants and gene expression predict risk of chronic obstructive pulmonary disease (COPD), but their effect on COPD heterogeneity is unclear. We aimed to define high-risk COPD subtypes using genetics (polygenic risk score, PRS) and blood gene expression (transcriptional risk score, TRS) and assess differences in clinical and molecular characteristics.

METHODS: We defined high-risk groups based on PRS and TRS quantiles by maximising differences in protein biomarkers in a COPDGene training set and identified these groups in COPDGene and ECLIPSE test sets. We tested multivariable associations of subgroups with clinical outcomes and compared protein-protein interaction networks and drug repurposing …

Antenatal Depression And Its Associated Factors: Findings From Kuwait Birth Cohort Study, Reem Al-Sabah, Abdullah Al-Taiar, Ali H. Ziyab, Saeed Akhtar, Majeda S. Hammoud

Community & Environmental Health Faculty Publications

Background: Pregnant and postpartum women are at high risk of depression due to hormonal and biological changes. Antenatal depression is understudied compared to postpartum depression and its predictors remain highly controversial.

Aim: To estimate the prevalence of depressive symptoms during pregnancy and investigate factors associated with this condition including vitamin D, folate and Vitamin B₁₂ among participants in the Kuwait Birth Study.

Methods: Data collection occurred as part of the Kuwait Birth Cohort Study in which pregnant women were recruited in the second and third trimester during antenatal care visits. Data on antenatal depression were collected using the Edinburgh …

Diagnostic Accuracy Of Cbct In The Differential Diagnosis Of Apical Cysts And Granulomas Using Histopathological Findings As A Reference Standard: A Systematic Revew, Fatima Zohra Rouggani, Chaimaa Kabil, Rachida Mayou, Sidi Mohamed . Bouzoubaa

Health Sciences

Introduction

The periapical lesions represent a complex group. Granulomas and cysts represent the two most frequent forms in routine clinical practice.

Aim: Highlight the diagnostic accuracy of CBCT imaging in the differential diagnosis between a cyst and a granuloma compared to histopathological examination as a reference technique.

Materials and Methods:

Our literature search involved articles published in the following databases: PubMed, Cochrane, science direct and Google scholar.

Our intention was to review recent articles from the last 5 years and to select studies conducted in significantly changed socio-medical contexts that could have a positive impact on the validity of our …

Inclusive Integration Of Refugees And Migrants In Djibouti's National Healthcare System: Current Situation And Prospects For Improvement, Farhan Houssein Ali, Njah Mansour, Kenza Hassouni

Health Sciences

Cet examen narratif vise à décrire et synthétiser les données actuelles sur la situation des migrants et des réfugiés à Djibouti, ainsi que les progrès de la stratégie d'intégration inclusive mise en œuvre par le gouvernement djiboutien. Il s'appuie sur diverses sources, notamment la littérature grise et les publications scientifiques. Les résultats indiquent que le nombre de migrants et de réfugiés est en augmentation constante depuis 2019, avec un état de santé vulnérable et des risques sanitaires alarmants. Il est urgent d'accélérer la mise en œuvre de la stratégie tout en l'adaptant aux données actuelles et d'établir un système fiable …

Non-Alcoholic Fatty Liver Disease: Genetic Susceptibility, Shakil A. Saghir, Nicole Shams, Lianette Veliz, Saleh Alfuraih, Yadollah Omidi, Jaleh Barar, Ajay Sharma, Rais Ansari

Pharmacy Faculty Articles and Research

The prevalence of Non-alcoholic Fatty Liver Disease (NAFLD) is increasing, particularly in individuals who consume minimal to no alcohol. Currently, NAFLD affects at least 32% of the global population. Although not all but approximately 5-10% cases of NAFLD progress to non-alcoholic steatohepatitis (NASH), a condition arising from lipotoxicity. Patients with NASH may further develop liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). However, it is important to note that progression from NAFLD to NASH and HCC is not inevitable for all patients. The pathogenesis of HCC in the context of NAFLD and NASH remains poorly understood, however, fat accumulation, often due …

A Case Study Assessing The Integration Of Nuclear Safety And Security In Facilities Using A Monte Carlo Simulation Aided Analytical Hierarchy Process, Theodore A. Thomas, Shraddha Rane, Jason Timothy Harris

International Journal of Nuclear Security

Nuclear safety and security are essential in all operations using nuclear and radioactive materials. Even though both elements are important, the evolution of these programs has not developed at the same rate. As such, their integration has been met with challenges. This study analyzed the potential for synergy across different criteria and settings when integrating nuclear safety and security. The criteria included eight points where overlap could be identified between nuclear safety and security. Three work settings—industrial, medical, and research—were evaluated. Responses were collected from nine individuals who worked with nuclear materials in various capacities and different nuclear work settings. …

The Impact Of Autoimmune Endocrine Disorders On Pregnancy: A Comprehensive Review Of Pathophysiology And Clinical Outcomes, Aiysha Gul, Rizwanullah, Samah Badr Hamad, Esraa Awad, Fardin Akbar Hyderi, Giftty E. Obadan

Transitional Year Resident Research

Pregnancy is a transformative period characterized by extensive physiological, psychological, and immunological changes, which play a critical role in the health of both the mother and the fetus. The immune system undergoes significant modifications to tolerate the fetus, an entity resembling a temporary histoincompatible allograft, with sex hormones such as progesterone (P4) and estrogen (E) modulating these changes. This review explores the intersection of endocrine autoimmunity and pregnancy, focusing on the physiological adaptations and their clinical implications for autoimmune disorders.

The review highlights the unique role of progesterone in immune modulation, including its effects on Th1 and Th2 cell responses, …

Health And Lifestyle Behavioral Changes To Prevent Myocardial Infarction (Mi): Mixed Methods Approach To Understand Secondary Mi Prevention, Naila Saghir

Global Public Health | Student Research Posters

• Annually in the United States, 605,000 individuals experience their first MI & 200,000 experience their second.
• Lack of exercise, an unhealthy diet, and hypertension are some of the causing behavioral factors of a primary myocardial infarction but can also put the individual at risk for a secondary.
• The choice to adopt positive health and lifestyle behaviors lies on the individual.

Understanding Covid-19 Booster Hesitancy Amongst Those Experiencing Homelessness And Housing Instability, Kelsey Bas

Global Public Health | Student Research Posters

The COVID-19 vaccine had an efficacy of 80-90% against symptomatic and asymptomatic COVID-19 infections in those who have completed the primary series of the vaccine. The booster vaccine restored infection protection with an efficacy of 75-85%.

California marks the highest rate of homelessness in the nation which was influenced by the pandemic. The COVID-19 pandemic also caused 17 million Californians (44%) who live in rented homes to be at risk for eviction moratoriums and rental assistance. Those experiencing homelessness and housing instability are at higher risk of contracting severe COVID-19 due to prior medical conditions, poor health status, and lack …

Root Causes Of Homelessness In Marin County And Prevention Strategies, Michaela George, Kelsey Bas, Joe Blakely, Naila Saghir, Garrett Siebels, Liliana Valle-Contreras, Sehrish Khan

Global Public Health | Student Research Posters

Even with increased prevalence of homelessness in the US, there is limited research that investigates circumstances that can lead to homelessness. This lack of understanding perpetuates the inequities in health and wellbeing, access to basic necessities, effective prevention strategies and meaningful policy changes.

More individuals are experiencing homelessness in California than ever before In Marin, the Ritter Center (RC) strives to prevent and resolve homelessness and improve the health and well-being of individuals living in poverty

How Financial Status Affects Food Decisions In Households Of Marin City, Joe Blakely

Global Public Health | Student Research Posters

• Food insecurity is a multifaceted issue influenced by various factors, including socioeconomic status and access to nutritious foods. Research has shown that low-income households often face challenges in accessing healthy food options due to financial constraints.
• Cultural and psychological factors also play significant roles in shaping food choices among low-income populations. Additionally, the availability and affordability of healthy foods within local food environments significantly impact dietary behaviors.
• Economic factors such as income levels and household expenses further compound the challenges of food insecurity. Studies on food spending decisions among low-income demographics revealed that financial constraints often force families to prioritize …

Health And Lifestyle Behavioral Changes To Prevent Myocardial Infarction (Mi): Mixed Methods Approach To Understand Secondary Mi Prevention, Naila Idreesa Saghir

Global Public Health | Senior Theses

Cardiovascular diseases are the leading causes of death globally and about 200,000 individuals experience their second myocardial infarction yearly. There is a lack of understanding about how lifestyle and behavioral changes can prevent secondary myocardial infarction a year in the United States. The objective of this study is to use a mixed methods approach to understand how individuals who have made lifestyle behavioral changes to prevent their secondary myocardial infarction. Surveys and interviews consisted of questions about the participants' health behaviors and health history. Demographics, background information, and lifestyle behavioral changes were measured using Qualtrics. Valid and reliable tools such …

Examining The Sleep Habits Of College Aged Individuals, An Intervention Study, Garrett Siebels

Global Public Health | Senior Theses

Background-

Sleep deprivation, characterized by insufficient or poor-quality sleep, is a prevalent public health issue. Recent statistics reveal that over 110 million Americans are suffering from sleep deficiency, and about 60% of college aged individuals suffer from sleep deprivation. Previous research suggests that theta wave therapy may help induce sleepiness. We aim to discover how these intervention strategies may contribute to improved sleep quality and overall well-being among college-aged individuals.

Methods-

Participants were recruited using convenient sampling, then randomized into the intervention group and control group. Individuals self-reported demographics, baseline information and initial Pittsburgh Sleep Quality Index (PSQI) scores using …

‘Door-To-Prophylaxis’ As A Novel Quality Improvement Metric In Prevention Of Venous Thromboembolism Following Traumatic Injury, Jan-Michael Van Gent, Thomas W Clements, David E Lubkin, Carter W Kaminski, Jonathan K Bates, Mariela Sandoval, Thaddeus J Puzio, Bryan A Cotton

Faculty, Staff and Student Publications

OBJECTIVE: Venous thromboembolism (VTE) risk reduction strategies include early initiation of chemoprophylaxis, reducing missed doses, weight-based dosing and dose adjustment using anti-Xa levels. We hypothesized that time to initiation of chemoprophylaxis would be the strongest modifiable risk for VTE, even after adjusting for competing risk factors.

METHODS: A prospectively maintained trauma registry was queried for patients admitted July 2017-October 2021 who were 18 years and older and received emergency release blood products. Patients with deep vein thrombosis or pulmonary embolism (VTE) were compared to those without (no VTE). Door-to-prophylaxis was defined as time from hospital arrival to first dose of …

Unveiling The Complex World Of Extracellular Vesicles: Novel Characterization Techniques And Manufacturing Considerations, James J Lai, John J Hill, Casey Y Huang, Gino C Lee, Karol W Mai, Maggie Y Shen, Simon K Wang

Faculty, Staff and Student Publications

Extracellular vesicles (EVs) function as potent mediators of intercellular communication for many in vivo processes, contributing to both health and disease related conditions. Given their biological origins and diverse functionality from correspondingly unique "cargo" compositions, both endogenous and modified EVs are garnering attention as promising therapeutic modalities and vehicles for targeted therapeutic delivery applications. Their diversity in composition, however, has revealed a significant need for more comprehensive analytical-based characterization methods, and manufacturing processes that are consistent and scalable. In this review, we explore the dynamic landscape of EV research and development efforts, ranging from novel isolation approaches, to their analytical …

A Global Perspective Of Advanced Practice Nursing Research: A Review Of Systematic Reviews, Kelley Kilpatrick, Isabelle Savard, Li-Anne Audet, Gina Costanzo, Mariam Khan, Renee Atallah, Mira Jabbour, Wentao Zhou, Kathy Wheeler, Elissa Ladd, Deborah C. Gray, Colette Henderson, Lori A. Spies, Heather Mcgrath, Melanie Rogers

Ellmer School of Nursing Faculty Publications

Introduction

The World Health Organization (WHO) called for the expansion of all nursing roles, including advanced practice nurses (APNs), nurse practitioners (NPs) and clinical nurse specialists (CNSs). A clearer understanding of the impact of these roles will inform global priorities for advanced practice nursing education, research, and policy.

Objective

To identify gaps in advanced practice nursing research globally.

Materials and methods

A review of systematic reviews was conducted. We searched CINAHL, Embase, Global Health, Healthstar, PubMed, Medline, Cochrane Library, DARE, Joanna Briggs Institute EBP, and Web of Science from January 2011 onwards, with no restrictions on jurisdiction or language. Grey …

The Effectiveness Of Aac Training For Nursing Students To Increase The Knowledge And Success For Communicating With Patients With Complex Communication Needs, Hanna Hill Webb

Murray State Theses and Dissertations

Effective communication is an essential practice for nurses and is fundamental for the care of patients. Nurses have significant difficulties communicating with patients with complex communication needs (CCN), which can lead to communication breakdowns and sentinel events. While AAC is a viable option for communicating with patients with CCN, nurses do not receive any training on how to effectively communicate or use AAC with patients with CCN. Nursing students are in the ideal position for learning how to use AAC and communicate with AAC, as they are in the process of learning and entering the field for medical placements. This …

Bird’S Nest Drawing: Exploring The Attachment Of Left-Behind Children In China, Ziyi Su

Expressive Therapies Dissertations

To explore the attachment of left-behind children (LBC), this mixed-methods study analyzed the Bird’s Nest Drawings (BND) and narratives from 117 fourth graders from Shaanxi and Gansu, China. Overall, the BND of LBC showed less secure-attachment features. These distinctions can be seen in several pictorial elements, and manifest differently across gender groups and rural versus urban groups. Drawings and narratives revealed eight underlying themes of absence, longing, and support from parent and peer attachment. Children creatively communicated complex emotions and attachment experiences through the metaphor of the bird’s nest, ranging from abandonment, loneliness, and vulnerability, to coping, hope, and resilience. …

Characterizing The Relationship Between The Presence Of Depression Risk, Post-Traumatic Stress Disorder, And Benzodiazepine Use To Get High, Julia Kollitz

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Aim: To determine if there is a relationship between depression risk, post-traumatic stress disorder (PTSD), and engaging in benzodiazepine misuse.

Methods: A secondary cross-sectional analysis was conducted on data from a sample of people who use drugs (n=743). Depression risk was assessed via the Center for Epidemiological Studies-Depression scale. Meeting DSM-IV criteria for PTSD was identified using the Mini International Neuropsychiatric Interview (MINI). We used simple and multivariable logistic regression models to estimate the association between mental health factors of interest and benzodiazepine misuse, defined as self-reported benzodiazepine use “to get high” in the past six months.

Results: Of the …

A Case Study In Program Evaluation: A Prospective Program Evaluation Of Timely Reporting And Action Of An Infectious Disease Outbreak, Destiny Cozart

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Methicillin-resistant Staphylococcus aureus also known as MRSA is an infection of a staph bacteria. High school athletes are at risk of contracting MRSA through skin to skin contact and/or MRSA contaminated equipment. This case study uses the CDC's six-step framework for program evaluation to measure the effectiveness of the online training modules designed to increase the knowledge of staff and stakeholders about MRSA and infectious disease outbreaks. The findings from this evaluation will advise the potential change(s) implemented in training modules, ultimately to enhance competency for decision makers and prevent MRSA and infectious disease outbreak amongst high school athletic programs.

Prevalence Of Hpv16 E6 Antibodies And Oral Hpv Among Men Living In Kentucky, Christopher O. Otieno

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

ABSTRACT

Objective: The incidence of human papillomavirus-driven oropharyngeal cancer (HPV-OPC) is surging in the United States, particularly in the southeast and Appalachia. The reason for this increase is unknown. We evaluated the prevalence of two markers of increased risk, HPV16 E6 antibodies and oral HPV infection, among men in Appalachian and non-Appalachian Kentucky.

Methods: This study was nested within an ongoing HPV-OPC screening study of healthy men aged 45+ residing in urban (non-Appalachian) and rural (Appalachian) Kentucky and included the first 1,581 participants with either HPV serologic and/or oral HPV testing. Blood and oral rinse samples were collected at enrollment. …

Dental Outreach In Academic Dental Settings, Tisha Clayborn

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Creating an effective outreach program in a dental academic setting involves a strategic approach combining educational objectives and community service. This Dental Outreach Program Guide aligns with organizational objectives, contributes to community well-being, and serves as a model for future outreach initiatives in academic dental settings. This program utilizes the PRECEDE-PROCEED planning model to design and evaluate an oral health strategy. This program aims to outline a strategic plan incorporating evidence-based decision-making, data-driven metrics, and a comprehensive roadmap for successful implementation.

Fall 2023 Covid-19, Influenza, And Respiratory Syncytial Virus Vaccine Uptake In Kentucky, Abigail Dial

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Fall 2023 COVID-19, Influenza, and Respiratory Syncytial Virus Vaccine Uptake in Kentucky

Background: In the fall of 2023, vaccine recommendations included updated COVID-19 and influenza vaccines, as well as a new vaccine and immunization for respiratory syncytial virus (RSV). Vaccine co-administration, the administration of more than one vaccine in one vaccination session, is safe and effective for COVID-19, influenza, and RSV vaccines and can improve vaccine uptake for all recommended vaccines (Bonanni, et al., 2023; CDC, 2023). The COVID-19 pandemic altered the landscape for locations where people receive vaccinations, and it may be beneficial to public health to have …