A Radiographic Analysis Of Teeth With Carrier-Based Obturation Requiring Retreatment, Robert W. Rudnicki

Theses and Dissertations

Objective: The purpose of this study was to determine observer accuracy and agreement in detecting carriers using preoperative radiographs, as well as to identify potential radiographic indicators for the presence of carriers.

Methods: A chart review was conducted for patients seen at the VCU graduate endodontic clinic. Eligible cases included previously treated teeth that were nonsurgically retreated, with and without identified carriers. 100 cases were identified, including 61 carrier and 39 non-carrier cases. Preoperative radiographs were randomized, and evaluators assessed each case for the presence of carrier-based obturation. Evaluators included three endodontists, one general dentist, and four endodontic residents. Statistical …

Characteristics Of Permanent Teeth Diagnosed With Pulpal Necrosis: A Retrospective Study, William Lee

Theses and Dissertations

Objective: To determine associations of pulpally necrotic teeth with demographics, clinical findings, radiographic presentation, and periapical status.

Methods: Virginia Commonwealth University uses AxiUm software to record dental treatment and treatment notes. The current study involves a keyword search using the term “pulpal necrosis”. Factors compiled and evaluated included but not limited to patient demographics, location in the dental arch, clinical findings, radiographic presentation, and periapical status.

Results: Data has revealed that teeth with pulpal necrosis can present with a variety of different clinical findings. All of the following were observations of teeth with pulpal necrosis. A total of 325 teeth …

Chronobiology Of Meal Timing In Early-Stage Hypertension: Effects On Renal And Vascular Function, Natalie J. Bohmke

Theses and Dissertations

Introduction: Previous research determined that a Western-style meal acts as a stressor to the kidney and contributed to impaired blood pressure and vascular function. Despite an understanding of acute postprandial physiology in humans, studies have not investigated the impact of the time of day of meal consumption on physiology. Methods: Ten participants with elevated or stage-one hypertension underwent a randomized crossover trial with a controlled feeding intervention of a Western-style meal in the morning or the evening. Participants completed a run-in day to standardize diet followed by the experimental day. On day 2, participants completed ambulatory blood pressure, core temperature, …

Investigating Black Emerging Adult Health And Model Of Care Choices, Alexandra Wynn

Theses and Dissertations

This mixed methods study aimed to analyze the health profiles of Black emerging adults (who do not seek medical care for chronic condition management) college students to identify factors influencing their use of preventive services and their choices in healthcare plans. The study revealed distinct profiles of Black emerging adults based on patterns of factors related to their engagement with healthcare, such as barriers to care, insurance access, usual source of care, self-rated health, intention to seek care, discrimination, trust in physician, medical mistrust, and sex-assigned at birth. Interviews were conducted to investigate the similarities and differences among all participants …

Associations Between Childhood Trauma And Tobacco Dependence Among Latine Adults: Testing The Protective Effects Of Compassion For Self And Others, Camila Tirado

Theses and Dissertations

Tobacco dependence has posed a significant public health challenge in the United States and disproportionately affects Latine adults' risk of developing a variety of adverse health conditions. Childhood trauma is a recognized risk factor for dependence, overall health, and mental health concerns. Still, the influence of compassion for self or compassion for others in this context remains unclear. This cross-sectional study investigated the moderating effects of self-compassion and compassion for others on the relationship between childhood trauma and cigarette dependence among Latine adults. Data was collected through questionnaires assessing childhood trauma, self-compassion, cultural values and factors, compassion for others, and …

Exploring The Relationship Of Intact Limb Knee Joint Loading With Step Lengths And Step Length Symmetry In Individuals With Lower Limb Amputation, Edward D. Syrett

Theses and Dissertations

Individuals with unilateral lower limb amputation (LLA) frequently experience intact limb knee pain, dysfunction, and osteoarthritis. These problems can worsen pre-existing reductions in mobility and quality of life that this population regularly experiences. It is widely accepted that knee joint loading is implicated in the development of knee joint issues, and intact limb knee joint load alterations are thought to be widespread in individuals with LLA. Prior work suggests that gait deviations frequently present in this population may be a contributory cause of these altered forces. These deviations can take many forms, but individuals with LLA commonly demonstrate alterations in …

Levofloxacin Incorporated Extracellular Matrix Nanoparticles For Pulmonary Cystic Fibrosis Infections, Raahi Patel

Theses and Dissertations

Cystic fibrosis (CF) is a progressive genetic disorder that affects around 40,000 people in the United States. CF is characterized by a mutation in the CFTR protein that causes dysregulated ion transport across epithelial cells, producing viscous mucus in the lung that increases bacterial invasion, causing persistent infections and subsequent inflammation. Pseudomonas aeruginosa and Staphylococcus aureus are two of the most common infections in CF patients that are resistant to antibiotics. One antibiotic approved to treat these infections is levofloxacin (LVX) that functions to inhibit bacterial replication, but can be further developed into tailorable particles. Nanoparticles are an emerging inhaled …

Drugging The Histone Acetyltransferase Ep300 Modulates Alternative Splicing At Schizophrenia Risk Genes, Shravani Malay

Theses and Dissertations

Purpose. We will evaluate the effects of drugging the epigenetic histone acetyltransferase (HAT) enzyme p300, encoded by the schizophrenia risk gene EP300, on genome-wide gene expression in neural cells. We hypothesize that drugging p300 will affect gene expression and alternative splicing of other schizophrenia risk genes. Our motivation is to identify potential new epigenetic treatment avenues for schizophrenia.

Methods. Prior to my joining the lab, an experiment was conducted using the novel p300 HAT inhibitor, A-485, to modulate genomic regulation in a neural cell line (SH-SY5Y). SH-SY5Y cells were exposed to 10μM of A-485 or vehicle (DMSO) for 24 …

Revealing The Elusive Mechanism Of Action Of The Lipid Chaperone Fatty Acid Binding Protein 4, Abdul J. Castillo Ibanez

Theses and Dissertations

Fatty acid binding proteins (FABPs) are pivotal in orchestrating lipid trafficking within cells. This dissertation aims to reveal the mechanism of action of adipocyte FABP (FABP4) by meticulously detailing steps for producing uniformly isotopically labeled protein, understanding dynamics and structural changes in aqueous conditions, analyzing protein-membrane interaction with membrane mimicking models, and revealing its membrane-bound state through novel NMR structural elucidation. Chapter 1 provides an overview of FABP4's indispensable role in lipid trafficking, emphasizing its significance in maintaining cellular homeostasis and metabolic regulation. Chapter 2 delves into the optimization of FABP4 protein expression and proposes a high yield recovery and …

Age Of First Dental Visit And Early Childhood Oral Health Quality Of Life, Richard Greene

Theses and Dissertations

Objective: This project aims to examine the association between the age of a child's first dental visit and their Early Childhood Oral Health Impact Scale (ECOHIS) score.

Methods: A 22-item cross-sectional survey was distributed to caregivers of healthy children aged 5 years and younger with an American Society of Anesthesiology (ASA) I and II status who presented for new patient exams.

Results: In total, 117 caregivers participated in the survey. The ECOHIS was assessed on a 5-point Likert scale and scores ranged from 0-52; higher values indicate poor oral health having a greater impact on the child and family. Those …

Assessment Of Maxillary Sinus Pneumatization In Dentate And Edentulous Areas Using Cone Beam Computed Tomography, Catherine Ramundo

Theses and Dissertations

Objectives: The primary goal of this retrospective analysis is to analyze the morphologic changes that occur following extraction in regards to sinus pneumatization.

Methods: The patient population was selected from the VCU School of Dentistry Graduate Periodontics Department. Cone Beam Computed Tomography scans (CBCT) was obtained from patients that had a posterior tooth extracted. A horizontal tangent line was drawn to the inferior border of the nasal cavity, acting as a constant reference point for measuring the extent of maxillary sinus pneumatization. Radiographic measurements were performed from a horizontal line at this fixed anatomical marker to the deepest level of …

The Value Of Educating Teachers, Coaches, And Athletic Trainers On The Management Of Dental Trauma., Darlene W. Jean

Theses and Dissertations

Purpose: To investigate the benefit of educating teachers, coaches, and athletic trainers about dental trauma to prevent incidents and improve the management of students/athletes with dental trauma.

Methods: Teachers, coaches, and athletic trainers throughout the greater Richmond metro area were recruited via email. Participants answered a pre-seminar survey to evaluate their baseline knowledge and determine whether they have experienced dental trauma with their students/athletes previously. The participants were given the option to attend an in-person or virtual seminar educating them on the basic management of traumatic dental injuries and how to guide affected students/athletes and their families to obtain optimal …

Clinical Outcomes Of Primary Anterior Esthetic Crowns In Pediatric Dentistry, Jenan Alahmad

Theses and Dissertations

Clinical Outcomes of Primary Anterior Esthetic Crowns in Pediatric Dentistry - A Prospective Cohort Study

By: Jenan Alahmad, BDS

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University.

Virginia Commonwealth University, 2024

Thesis Advisor: Parthasarathy Madurantakam, DDS, MDS, PhD

Department of Pediatric Dentistry

BODY

Purpose: This prospective cohort study aimed to compare the effectiveness of restoring maxillary anterior teeth in children (aged 3-6 years) with three different materials: Zirconia Crowns (ZC), Resin Composite Crowns (RC), and Pre-veneered Stainless-Steel Crowns (PVSSC). The study aims to assess the Oral …

A Preliminary Report Of A Randomized Controlled Clinical Trial Comparing Ferric Sulfate With Zin Oxide Eugenol And Non-Eugenol Based Material For Pulpotomy In Primary Molar Teeth, Sarah Balal

Theses and Dissertations

Purpose: This study aimed to evaluate the effect of eugenol and non-eugenol-based Zinc Oxide Eugenol (ZOE) cements on primary tooth pulpotomies where Ferric Sulfate (FS) is used as a medicament.

Methods: Children aged 3-7 years with dental caries in their primary molars that have clinical and radiographic diagnosis of reversible pulpitis and undergoing dental treatment under Oral Conscious Sedation (OCS) or General Anesthesia (GA) were recruited. Children were randomly assigned to receive either FS and ZOE (IRM) or FS and non-eugenol based (CAVIT). The outcomes were assessed based on failure rates of the materials separately for clinical or radiographic evidence …

Established Colonization Of Sneathia Vaginalis In A Mouse Model, Kailyn E. Turcios-Gonzalez

Theses and Dissertations

Sneathia vaginalis (Sv) is a gram-negative anaerobic bacterium associated with adverse reproductive outcomes. Sv can traverse the fetal membrane and damage epithelial cells in vitro by producing a pore-forming cytotoxin, cytopathogenic toxin A (CptA). To further understand the transition of Sv from normal flora to a pathogen, an animal in vivo model needs to be created to observe the preliminary ascending infection before we begin to study the effects on pregnancy. Experimentation was conducted to optimize mouse breed, bacteria administration methods, and other variables that arise when working in vivo. The C57BL/6 mouse strain displayed the most consistent …

Acute Effects Of An Oral Nicotine Pouch In People Who Use Smokeless Tobacco, Alisha Eversole

Theses and Dissertations

People who use smokeless tobacco (SLT) are exposed to a variety of carcinogenic toxicants, yet, despite health risks, nearly 6 million people in the US use SLT. SLT contains and delivers nicotine, a psychostimulant that causes dependence and hinders cessation efforts. An orally-administered nicotine pouch marketed as “tobacco-free” recently has become available for purchase in the US. However, there are very few non-industry-sponsored studies regarding the effects of these oral nicotine pouches.

The current study used clinical laboratory methods to determine the acute effects of an oral nicotine pouch in people who use SLT. Participants completed four sessions (within subjects, …

Mental Health Help-Seeking Behaviors And Service Utilization Of Black College Students, Troy J. Keys

Theses and Dissertations

Black college students are less likely to seek mental health services compared to other students. While previous research has identified barriers and facilitators contributing to Black college students’ help-seeking behaviors, the current political and social climate and pandemic have negatively impacted their mental health thus warranting the exploration of these factors again. This study aimed to identify the mental health help-seeking behaviors and attitudes of Black college students, the barriers and supports for help-seeking behaviors, their preferred service utilization providers, and their thoughts about promoting mental health help-seeking among their peers. Black college students (n = 21) enrolled at an …

Assessing Providers’ Readiness To Integrate Mat Services In A Primary Care Setting, Carmen Ingram-Thorpe

Theses and Dissertations

Opioid use disorder is a growing concern in the United States. Despite medication-assisted treatment (MAT) being a more effective treatment option than behavioral treatment alone, primary care providers’ rate of adoption and utilization of MAT has not matched the demand of the opioid crisis. The largest barrier facing our local community is the availability of organizations and providers that can and will actually provide MAT services. The purpose of this study was to identify factors that impact primary care providers’ readiness to treat individuals with opioid use disorder (OUD) using MAT. This study used the ADKAR model as framework, which …

Memory Impairments Due To Binge Ethanol Are Impacted By Age And Sex, Maria Alexis M. Bent

Theses and Dissertations

Ethanol is the most consumed drug among adolescents, which can cause long-term effects on memory and changes in gene and protein expression. While both adolescents and adults engage in binge drinking, the neurological and behavioral effects differ, with adolescents showing fewer adverse physiological effects but greater memory deficits than adults. Sex differences related to ethanol occur with women showing higher BEC than men and similar cognitive deficits despite fewer years of ethanol consumption. During adolescence the mPFC and dHPC undergo maturation development with both brain regions playing a role in spatial and recognition memory. Proteins critically involved in memory and …

The Relationship Between Outcomes Associated With Patient Blood Management Programs And Transfusion Safety Officers, Gary Morral

Theses and Dissertations

BACKGROUND: Patient Blood Management (PBM) has become the standard of care for transfusion services in hospitals. Transfusion Safety Officers (TSOs) have been identified by some as being a crucial part of a successful PBM program; however, no studies have been done to show their effectiveness, or if there is even a relationship between having a TSO and outcomes associated with PBM programs. The purpose of this study was to describe and test the relationship between having a TSO and six outcomes associated with PBM programs including blood product wastage (red blood cells, plasma, and platelets), hospital lengths of stay, rates …

Behavioral Effects Of Adolescent Social Isolation Stress And/Or Binge Drinking And The Role Of The Vhip --> Mpfc Circuit, Jyoti Lodha

Theses and Dissertations

Adolescence is characterized by heightened social interaction and risk-taking behavior. Disruptions to cortical development by binge ethanol or social isolation can lead to attention, social, and cognitive deficits later in life, and increase risk for alcohol use disorders. During adolescence, proper development of a monosynaptic connection from the ventral hippocampus (vHip) to the medial prefrontal cortex (mPFC) is critical to proper social and working memory. We ask whether these factors affect neurobiological factors such as gene expression and the role of the vHipmPFC circuit in these behaviors. Social stress was modeled by social isolation (aSI) during adolescence. We expect aSI …

Transforming Children's Oral Health: The Impact Of Oral Healthcare Policies On Virginia Medicaid Dental Health Outcomes., Anita M. Kumar

Theses and Dissertations

Abstract: Transforming Children's Oral Health: The Impact of Oral Healthcare Policies on Virginia Medicaid Dental Health Outcomes.

Objectives: This dissertation uses Department of Medical Assistance Services (DMAS) administrative files at the individual and provider level from fiscal years (FY) 2011 to 2021 to systematically study the effect of recently implemented oral health policies (EBD guidelines on sealants, CMS updated quality measures, expansion of Medicaid oral healthcare for qualifying pregnant women) on oral health outcomes of Virginia Medicaid-enrolled children.

Methods: The studies employ a difference in differences regression methods (negative binomial, Poisson, and logistic) to examine the effects of oral health …

Exploration Of Dopaminergic And Serotonergic Pathways Utilizing Pleiotropic Agents, Charles B. Jones Iii

Theses and Dissertations

2-(Benzoyl)piperidines (BPs) are at a crossroads of therapy and abuse. These compounds are a hybrid between the ADHD medication methylphenidate and abused stimulant cathinones. Here we use computational molecular modeling, synthesis, mutagenesis, and epifluorescence microscopy to further improve the understanding of and potential treatments for several neuropsychiatric disorders. Utilizing the BP scaffold and controlling chirality and aryl substitution, these agents were examined at DAT and SERT. From these investigations it has now been established that R isomer BPs are favored for DAT while S isomer BPs are favored for SERT. Aryl-substitution can greatly affect the selectivity of these agents with …

Mild Traumatic Brain Injury In Yucatan Minipigs: Assessing Changes In Approachability And Mechanical Nociception Following Diffuse Central Fluid Percussion Injury, Mark D. Pavlichenko

Theses and Dissertations

Traumatic brain injury (TBI) is a major healthcare concern affecting millions. Symptoms of TBI include sensory sensitivity and social changes that may persist long-term. Due to similarities in cytoarchitecture, metabolism, and inflammation, higher order minipig models are advantageous for translational TBI research, however, there remains a shortage of information regarding their behavioral and sensory sequelae following injury. Therefore, in this study, we assessed changes in sociability and somatosensation in adult male and female Yucatan minipigs for up to one-week following a sham or central fluid percussion injury (cFPI). Specifically, the voluntary human approach task (VHAT) and the forced human approach …

Longitudinal Analysis Of Maternal Depression, Physical Work Demand, And Working Hours Before, During, And After Pregnancy On Offspring Blood Pressure Trajectories, Medhin Tsegaye Haile

Theses and Dissertations

Overall Abstract

Background: Pediatric high blood pressure (BP) is a growing global concern, with 1 in 7 adolescents in the U.S. experiencing elevated BP or hypertension. Maternal lifestyle factors, including depressive symptoms, physically demanding work, and work hours during pregnancy, may influence offspring BP trajectories. However, prior studies often focus on single time points or specific age groups, limiting understanding of long-term effects. This study investigates the associations between maternal depressive symptoms, physically demanding work-related factors, and work hours before, during, and after pregnancy with offspring systolic blood pressure (SBP) trajectories from early childhood to adolescence.

Methods: We utilized …

Cellular Metabolism Is A Viable Therapeutic Target For Radiation-Induced Pulmonary Fibrosis, Josly Pierre-Louis Odoom

Theses and Dissertations

Herein, we provide evidence for cellular metabolic reprogramming as a driver of radiation-induced pulmonary fibrosis (RIPF). We are the first to identify a distinct metabolic signature for RIPF in a cohort of patients with radiographic sequela. We also used a RIPF mouse model to detect the metabolic pathways that enrich during pathogenesis. Our previous work highlighted the importance of lactate, a derivative of the glycolysis end-product pyruvate. Consequently, we took a special interest in the effects of radiation on the glycolysis pathway. We learned that radiation accelerates and reprograms glycolysis to an anabolic state in a pyruvate kinase M2 (PKM2)-dependent …

Life After Discharge: Predicting Longitudinal Trajectories Of Community Integration And Global Functioning In Black Individual With Traumatic Brain Injury, Chimdindu Ohayagha

Theses and Dissertations

The onset of traumatic brain injury (TBI) begins a chronic health pathway that contributes to various impairments and comorbidities across the lifespan. Common consequences of TBI include mental health issues, cognitive impairments, and reduced functional independence, all of which impact how an individual integrates into their community. Community integration is a primary goal for rehabilitation after TBI. Studies show that racially/ethnically minoritized individuals have a higher incidence of TBI, higher rates of mortality, and report poorer functional and community integration outcomes. Limited studies have explored longitudinal outcomes of community integration in a Black-only sample of individuals with TBI. Additionally, no …

The Patient Experience Of Language Discordance And Interpreter Services In The Emergency Department, Keri L. Baker

Theses and Dissertations

Background: Clear communication is critical to the interaction of a patient and medical provider. For non-English speaking patients, language discordance, described as the lack of proficiency in a shared language, with the medical team results in a poor patient experience and poor patient outcomes. The predominant solution to language discordance is the use of interpreter services, however these services are underused in the emergency department (ED). Studies examining underuse of interpreter services have primarily focused on the clinician and little is known about the patient’s influence on the use of interpreter services.

Methods: Semi-structured interviews were conducted with 12 Spanish-speaking …

Continuous Flow As A Process Intensification Tool For The Preparation Of Pharmaceutically Relevant N-Heterocycles, John W. Tomlin Jr

Theses and Dissertations

Continuous flow as a process intensification tool for the preparation of pharmaceutically relevant N-heterocycles

John W. Tomlin

Thesis Defense: 17 January 2024

Committee: B. Frank Gupton, Ph.D. (Advisor), Suzanne M. Ruder, Ph.D. (Chair), Heather R. Lucas, Ph.D., James K. Ferri, Ph.D., Matthew C.T. Hartman, Ph.D.

A dissertation submitted in partial fulfillment of the requirements of Doctor of Philosophy at Virginia Commonwealth University

© 2024 John W. Tomlin Jr All Rights Reserved

Abstract

Essential medicines must be produced in large quantities to accommodate large global demand. The preparation of these active pharmaceutical ingredients (API) must therefore strive to be both cost-effective …

The Genetic Architecture Of Cervical Change During Pregnancy: From Modeling To Mechanism — Does The Cervix Mediate Maternal Risk For Spontaneous Preterm Birth?, Hope M. Wolf

Theses and Dissertations

This project leverages clinical data and biospecimens from a prospective longitudinal cohort of pregnant women to study the genetic and phenotypic relationships between cervical shortening and the duration of pregnancy. Sonographic cervical length (CL) was measured throughout pregnancy in a cohort of 5,160 Black/African American women in Detroit, Michigan. Maternal DNA samples were sequenced with a next-generation low-pass whole genome platform. The heritability of cervical change during pregnancy and its genetic correlation with gestational age at delivery (GAD) were estimated using Genome-Wide Complex Trait Analysis. These estimates suggest that cervical change is heritable (h²CL = 51%) and highly polygenic trait. …