Medicine and Health Sciences Commons^™

Mechanistic Insight Into Maternal Electronic Cigarette Exposure And Its Effect On Offspring Cerebrovascular And Neurocognitive Health, Amber Victoria Mills

Graduate Theses, Dissertations, and Problem Reports (ETD)

Electronic cigarettes (Ecigs) have replaced smoking within the last decade as the preferred nicotine delivery system because of their advertising to the younger populations. Marketing has sold the idea that use of Ecigs are safer than smoking and this messaging has resonated with youth and other vulnerable populations such as pregnant women. Despite over 2.8 million children under 18 (Annual National Youth Tobacco Survey) deciding to vape, there is little information about what this will do to the next generation. Further, it is that same population that will soon reach an age when they will want to have children. There …

Effect Of Haemonchus Contortus Excretory/Secretory Protein On Differences In Host Neutrophil Migration, Hannah Grace Teddleton

Graduate Theses, Dissertations, and Problem Reports (ETD)

An excretory/secretory (E/S) product, common to many helminths, is neutrophil inhibitory factor (NIF) which negatively affects neutrophil migration and activity. Due to differences in neutrophil accumulation between parasite resistant St. Croix STC and parasite susceptible Suffolk (SUF) sheep, we hypothesized that Hc-NIF may inhibit migration of SUF and not STC neutrophils. Previous studies have demonstrated that Hc produces NIF but is not commercially available. To test our hypothesis, neutrophils were cultured from STC and SUF sheep in the presence of Ancylostoma caninum-derived NIF (Ac-NIF) and measure chemotaxis to Interleukin-8 (IL-8), HcLA or H. contortus third-stage excretory/secretory (E/S) products. Neutrophils were …

Contracture Management For Acute Burn Injury Patients, Brianna Paige Pestrosky

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The Occupational Therapists working within the burn unit at West Penn Hospital assess and treat patients utilizing the biomechanical approach FOR, as well as the support from MOHO and PEOP. The patients seen within the burn unit encompass a variety of injuries and occupational deficits that require an individualized and holistic approach to care.

Purpose: The purpose of the contracture management project is to provide an interdisciplinary approach to improve carryover and patient care within and out of the hospital.

Theoretical framework: The contracture management project is guided using the biomechanical frame of reference as well as supporting constructs …

Teaching Cultural Humility Practices In Appalachia: The Value Of Conducting Conversations Based In Education, Bailey A. Riggs

Graduate Theses, Dissertations, and Problem Reports (ETD)

Recent literature highlights the paradigm shift from utilizing cultural competence practices to cultural humility practices within the field of occupational therapy, and health sciences (Fisher- Borne, et al., 2015). The idea of cultural competency suggests that culture is unchanging, and individuals can master cultural knowledge. The perception of knowing culture can be perceived as an unwillingness to learn about culture. In contrast, cultural humility promotes the value of lifelong learning and introspection, encouraging greater self-awareness, reflection of personal biases, and recognition of power imbalances. This approach aims to better integrate educational approaches to serve diverse populations in a culturally affirming …

Developmentally Appropriate Care In The Neonatal Intensive Care Unit (Nicu), Ashten Cenkus

Graduate Theses, Dissertations, and Problem Reports (ETD)

As specialized healthcare professionals educated in developmental care, occupational therapy practitioners (OTPs) have a role in educating, coaching, and assessing the needs of infants, their families, and the staff in the NICU. These high-risk and medically fragile infants require specialized care that considers the incorporation of neurodevelopment, neurobehavioral regulation, sensory stimulation, and motor development through supportive and appropriate interventions. A project addressing these needs across 14 weeks was implemented as part of an Occupational Therapy Doctoral (OTD) capstone experience at WVU Medicine Children’s in Morgantown, West Virginia. This project examined the results of the NICU staff's confidence, knowledge, and awareness …

Comparison Between Coronally Advanced Flap With Sub-Epithelial Connective Tissue Graft And Tunnel Technique With Sub-Epithelial Connective Tissue Graft In Achieving Mean Root Coverage At Multiple Recession Defects: A Retrospective Study, Christian Daniel Davila

Graduate Theses, Dissertations, and Problem Reports (ETD)

Aim: The primary objective is to retrospectively compare the mean root coverage (MRC) achieved using a coronally advanced flap and sub-epithelial connective tissue graft (CAF + CTG) with that achieved using the tunnelling technique and sub-epithelial connective tissue graft (TUN + CTG) for the treatment of multiple recession defects. The secondary objectives are to compare the proportion of complete root coverage (CRC) achieved with CAF + CTG compared to TUN + CTG, compare the proportion of CRC achieved in these two techniques with respect to level of training (American board-certified periodontist or Graduate periodontics residents) and to evaluate the …

Development And Implementation Of Occupational Therapy Group Protocols For Individuals In Recovery For Substance Use Disorder: Considering Social Determinants Of Health And Occupational Areas Of Need, Samantha Jane Windisch

Graduate Theses, Dissertations, and Problem Reports (ETD)

Substance use disorders (SUDs) are becoming a more widespread issue globally. According to the National Survey on Drug Use and Health, 19.7 million adults in the U.S. suffered from an SUD in 2017. (SAMSHA, 2018). Recurrent alcohol and/or drug use that results in significant disability, including health issues, and/or a failure to prioritize obligations like employment, school, or family life are characteristics of SUD (SAMHSA, 2022). Research suggests that healthcare providers must integrate cutting-edge and successful treatments for this population to lower the risk of overdose and relapse rates, given the swift global spread of addictive disorders. In the past, …

Interactions Between Myeloid Cells And Neutrophil Extracellular Traps In Pancreatic Ductal Adenocarcinoma, Hillary Gabrielle Pratt

Graduate Theses, Dissertations, and Problem Reports (ETD)

The 5-year-survival rate for pancreatic ductal adenocarcinoma (PDAC) is only 12% due in part to a lack of therapeutic strategies that target the pathophysiology of the disease. The only known curative therapy is surgical resection of the PDAC tumor, but only 20% of patients are eligible at the time of presentation. To improve outcomes for patients, new therapeutic options are needed. The PDAC tumor microenvironment (TME) is uniquely fibrotic and hypoxic, which is in part driven by the immune cell composition in the TME. Myeloid cells are a prominent immune infiltrate within the PDAC TME, so these cells have been …

Implementing Best Practice Methods Of Endotracheal Tube Cuff Inflation In The Operating Room, Katherine Zeiger Brown

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Use of manometers, inflating the endotracheal tube (ETT) cuff with a 5-mL syringe, displaying the pressure-volume loop (PV-L) on anesthesia machines, and auscultating with a stethoscope over the trachea have been shown effective in preventing ETT cuff overinflation in the operating room (OR). Purpose: The aims of this project were to implement and evaluate a best practice guideline for ETT cuff inflation in the OR. Methods: This project was conducted in several ORs at J.W. Ruby Memorial Hospital, in Morgantown, West Virginia. Participants included anesthesiologists, certified registered nurse anesthetists (CRNAs), student registered nurse anesthetists, residents, and medics. The ETT …

Evaluating Outcomes Post-Adoption Of Reck Solution For Total Shoulder Arthroplasties: A Retrospective Quality Analysis, Benjamin Levi Tillis

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Evaluating Outcomes Post-adoption of RECK Solution for Total Shoulder Arthroplasties: A Retrospective Quality Analysis

Benjamin Tillis

Introduction: Local infiltration analgesia (LIA) has become an integral part of postoperative pain relief for West Virginia University (WVU) Medicine’s total joint arthroplasty procedures. However, not all LIAs are the same. Liposomal bupivacaine has a unique mechanism of delivery which could potentially lead to longer lasting effects. Ropivacaine, epinephrine, clonidine, and ketorolac (RECK) solution offers a multimodal approach to enhancing the duration of effect for the LIA. In 2022, WVU Medicine switched from liposomal bupivacaine to the RECK solution for total joint …

4d Epr Oximetry Imaging For 4d Bioprinting And Tissue Engineering, Sajad Sarvari

Graduate Theses, Dissertations, and Problem Reports (ETD)

Bioprinting, akin to 3D printing, employs cell-laden hydrogels such as GelMA (Gelatine Methacrylate) and Alginate instead of plastic or resin to create biological structures. The printing process followed by subsequent tissue maturation is known as 4D bioprinting, where the fourth dimension is time. Ensuring adequate and consistent oxygen, O2, supply within 3D bioprint volume over the entire maturation period process is crucial, as even transient hypoxia can impact cellular behavior and phenotypes. However, printing of fully developed vasculature remains an unresolved technical challenge. Several approaches to chemically (peroxides) or biologically (photosynthesis) generate oxygen during bioprint maturation have been proposed. However, …

Implementation Of A Pilot Quality Improvement Project To Guide The Administration Of Intraoperative Dexamethasone For Postoperative Nausea And Vomiting Prophylaxis In Patients With Diabetes Undergoing Orthopedic Procedures, Brittany W. Hall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: At a local tertiary care hospital, there was no recommendation to guide anesthesia providers in the administration of intraoperative dexamethasone to patients with diabetes. While dexamethasone is a highly effective antiemetic, it may promote hyperglycemia in patients with diabetes.

Purpose: The purpose of this project was to guide and educate about current recommendations for the administration of dexamethasone for PONV prophylaxis in patients with diabetes.

Intervention: 1) Examined pre-intervention practices of dexamethasone administration. 2) Educated about current and best practices to anesthesia staff. 3) Developed badge buddy cards outlining the guideline. 4) Examined post-intervention practices. 5) Evaluated the effect …

Influence Of Scaling And Root Planing With Minocycline Microspheres On Clinical Outcomes Of Patients With Periodontitis, Nupoor Sandeep Kulkarni

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Scaling and root planning (SRP) has been established as a “gold-standard” non-surgical initial treatment for periodontitis. Along with SRP, some systemic adjuncts like systemic antibiotics were used in the past to gain maximum benefits of SRP by reducing the need for further periodontal surgeries. Due to some drawbacks of systemic antibiotic use, like “transient antibiotic resistance”, “non-adherence” and “insufficient concentrations in the periodontal pockets to be clinically effective”, there was a shift towards the use of local antibiotic adjuncts to SRP like minocycline, tetracycline, chlorhexidine etc. Minocycline is a semi-synthetic tetracycline derivative which is available in a powder form, …

Comparative Analysis Of Chemical Compounds And Metal Contaminants In Medical Grade Versus Over-The-Counter Sodium Hypochlorite Solutions, Abdulrahman Essaedi

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction:

Abstract

Endodontic treatment aims to prevent or address apical periodontitis by reducing intracanal bacterial populations to promote tissue healing, requiring thorough debridement and disinfection of the canal space. This study aims to examine the presence of trace metal elements and chemical compounds in over-the-counter (OTC) and medical-grade sodium hypochlorite (NaOCl) solutions.

Method

Over-the-counter NaOCl brands (Clorox® and Great Value®) and medical grade 6% NaOCl solutions (CanalPro® and Chlor-Xtra®) were purchased, stored in amber glass bottles, and tested in triplicate. Each was analyzed using mass spectrometry, identifying 7881 chemical compounds with statistical comparisons via adjusted p-values, fold-change, and heat maps. …

Dentin-Sealer Bond Strength. A Review: An In-Vitro Comparison Between Guttaflow 2 ®, Endosequence Bc High Flow ®, Tubli-Seal ®, Sealapex ®, And Ah Plus Jet ® Sealers., Zied Diab

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: One objective of non-surgical endodontic therapy is the formation of a hermetic seal with elimination of any portal of entry of bacteria and their byproducts into the root canal space from periapical tissue. Extensive research has been conducted to determine ideal endodontic sealers. Bioceramic sealers have risen to prominence due to reported decreased shrinkage, less toxicity, and superior bond strength to root dentin compared to zinc oxide eugenol, calcium hydroxide, and resin-based sealers. GuttaFlow2®, a new sealer on the market, is composed of calcium silicate in combination with gutta-percha particles. Researchers from Coltene (Altstätten, Switzerland), the manufacturer of GuttaFlow2® …

Sex, Drugs, And Tbi: The Effects Of Sex Hormones And Trkb Activation On Alcohol-Related Behavior Following A Traumatic Brain Injury, Robin B. Oliverio

Graduate Theses, Dissertations, and Problem Reports (ETD)

Traumatic brain injury (TBI) and alcohol use disorder (AUD) exhibit a bidirectional relationship: AUD increases the risk of incurring a TBI and, inversely, a history of TBI increases the risk of future AUD. The second portion of this relationship has not been as thoroughly investigated. Our lab previously demonstrated that a juvenile TBI significantly increases alcohol self-administration in females compared to uninjured females and the injured females developed a conditioned place preference (CPP) for ethanol. Given this stark sex difference, this dissertation will examine the mechanism through which this occurred by investigating how manipulations of sex steroids might affect this …

Pilot Quality Improvement Project To Update Surgeon Preference Cards Of A Community Hospital's Orthopedic Service, Jessica R. Mitchell

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Implementation of a Pilot Quality Improvement Project to Update Surgeon Preference Cards

of a Community Hospital’s Orthopedic Service

Jessica R. Mitchell

Problem Statement: Over time, surgeons change preferences for surgical equipment, and their preference cards need updating. Failure to update preference cards leads to impaired staff communication, opening of unnecessary equipment, excess waste, increased cost to patients and facilities, and potential threats to patient safety.

Background: Members of the orthopedic surgical team in a community hospital in suburban West Virginia wanted to establish a process to regularly update outdated surgeon preference cards (SPC) for several common orthopedic procedures. The …

A Structured Diabetes Continuous Glucose Monitor Education Program To Improve Patient Knowledge And Self-Efficacy, Krystal Abucevicz-Swick

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/background: Continuous glucose monitor (CGM) is a recommended method of glucose monitoring for patients living with diabetes who are on insulin or experience documented hypoglycemia. CGM is a tool that can improve patient management of diabetes but works best when paired with education to achieve the maximum therapeutic benefits.

Purpose: The purpose of this project was (1) to develop an evidence-based structured CGM education program toolkit for people with diabetes who are ordered CGM, (2) to implement the CGM education toolkit into the Diabetes Self-Management and Education Services (DSMES) program at the project site, (3) to improve patient knowledge about …

Genetic Knowledge And Causal Beliefs: Implications For Health Behavior In Clinical And Non-Clinical Samples, Jamey T. Brumbaugh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Objective: As the genomic era in healthcare continues to surge, it is vital to examine genetically-related psychological concepts, such as genetic knowledge and genetic causal beliefs, in genetically relevant clinical groups. Parents /caregivers of children born with cleft lip and/or palate represent a population whose knowledge and beliefs about genetics may be influenced by their frequent utilization of genetically-related healthcare services (e.g., genetic testing and genetic counseling). To date, little is known about how such beliefs vary across disease types. Even less is known regarding how disease-specific genetic causal beliefs relate to perceived behavioral control for disease development. Method: A …

Characterizing 4,4’-Methylene Diphenyl Diisocyanate Exposure In Primary Human Epidermal Keratinocytes: A Multi-Omics Approach, Brandon F. Law

Graduate Theses, Dissertations, and Problem Reports (ETD)

Exploring the routes of exposure and biological fate of 4,4’-methylene diphenyl diisocyanate (MDI) has been a challenge for many years. Occupational exposure to MDI can result in the development of occupational asthma (MDI-OA) which results in loss of productivity, large economic costs, and costs to the individual worker. Initially, it was thought that respiratory exposure to MDI was the most likely route leading to MDI-OA. Industries utilizing MDI have been successful at controlling airborne concentrations according to industrial hygiene assessment and newly diagnosed cases of MDI-OA decreased and plateaued. New research suggests that dermal exposures to MDI may explain this …

Improving Patient Self-Advocacy And Communication With Providers Through Diabetes Self-Management Education: Analyses From A Randomized Controlled Trial, Brenna Owens Kirk

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: West Virginia (WV), a rural state in Appalachia, has the highest type 2 diabetes mellitus (T2DM) prevalence in the United States. Open communication in the patient-provider relationship is an integral part of comprehensive chronic disease management. This is especially true for patients living with T2DM, a disease that requires many complex, daily self-management activities and is associated with increased emotional distress. However, patients living with T2DM are often reluctant to openly share their concerns regarding self-care with their provider. This study aimed to test the effectiveness of the Diabetes and Hypertension Self-Management Program (DHSMP), a 12-week group lifestyle …

Examination Of The Time Course Effects Of Electronic Cigarettes On The Thoracic Aorta, Madison Robinson

Graduate Theses, Dissertations, and Problem Reports (ETD)

Endothelial dysfunction is a critical early marker of the pathogenesis of cardiovascular disease and a pathological biomarker in cigarette smokers. Emerging evidence finds similar cardiovascular risks resulting from electronic cigarettes (E-cig) as that seen from smoking. Logically, the time or length of exposure to E-cigs will likely influence the development of vascular dysfunction, however, the length of exposure that causes permanent damage is unknown. The goal of this study was to determine the potential window of chronic E-cig exposure that results in vascular dysfunction, which is marked by endothelial dysfunction, microvascular dysfunction, and stiffening of arteries. Based on prior chronic …

Regulation Of Diabetic Cardiomyopathy Through Mitochondrial Import Of Long Non-Coding Rnas, Andrew Dodge Taylor

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: The leading cause of mortality in patients with diabetes mellitus is heart failure. When mitochondrial health and function is disrupted, cardiac contractile function is compromised. Therefore, understanding mitochondrial regulation may benefit predicting and countering diabetic cardiomyopathy. MicroRNAs (miRNAs) play a crucial role in diabetic cardiac mitochondrial protein expression. Long noncoding RNAs (lncRNAs) have been shown to regulate miRNAs, but not in the mitochondrion. Additionally, it has yet to be confirmed if lncRNAs utilize the same mechanisms for mitochondrial import that miRNAs use, or if lncRNA presence in the mitochondrion fluctuates in diabetic mitochondria like miRNA presence does. The …

Multidisciplinary Approach To Injury Rehabilitation: The D1 College Athlete Perspective, Lindsey Leatherman

Graduate Theses, Dissertations, and Problem Reports (ETD)

Sport injuries continue to be unavoidable disruptions in student-athletes’ athletic careers with over 200,000 injuries estimated to be reported each year in college sport (Kerr et al., 2015). Researchers continue to emphasize the importance of an interprofessional approach to rehabilitation to help athletes manage the adverse psychological and emotional reactions to injury (Appaneal et al., 2009; Gervis et al., 2020; Putukian, 2016). The purpose of this study was to extend and replicate the research of Clement and Arvinen-Barrow (2021) by incorporating perspectives of Division I US student-athletes. The current study describes 321 NCAA Division I collegiate athletes’ experiences of receiving …

Demonstrating The Need For Intergenerational Trauma-Specific Substance Use Treatment For Mothers Receiving Substance Use Treatment And Their Children, Brittany Ti-Esha Smith

Graduate Theses, Dissertations, and Problem Reports (ETD)

For decades the United States has faced substance use epidemics that have devastating public health consequences, with the most recent epidemic being the opioid epidemic. While the substance that is the center of the epidemic’s changes over time, one factor that has been found to be positively related to substance use has remained consistent, that preventable risk factor is adverse childhood experiences (ACEs). Those who experience ACEs are at elevated risk for developing SUD. If the trauma that is a result of experiencing ACE is not treated it can complicate recovery and impact the individuals’ families. The children of individuals …

Standardizing Nasogastric Tube Securement: A Quality Improvement Initiative, Shannon Lee Thompkins

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem: At a large academic medical center located in the northeastern United States, nasogastric tubes (NGT) were traditionally secured with tape. The institutional policy was nonspecific with no written procedure. The inconsistent use of nasal bridle securement devices (NBSD) and predominant use of tape has the potential to lead to a high rate of NGT dislodgement.

Background: NGT complication and dislodgement rates range from 2%-36% (Gimenes et al., 2019). Stabler et al. (2018) report 29%-63% NGT dislodgement rates in critically ill patients. Patients with intracranial hemorrhage dislodge NGTs in 25% of patients (Rahman et al., 2022)

Available Knowledge: Based on …

Translational Approaches To Address The Metastatic/Resistant (Mr) Phenotype Of Non-Small Cell Lung Cancer Brain Metastases, Kent L. Marshall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Lung cancer remains the most frequently diagnosed malignant neoplasm shared in men and women worldwide, second only to the sexually dimorphic prostate cancer in men and breast cancer in women. Overall, lung cancer was responsible for 12.5% of new cancer cases globally in the year 2022. Of these cases, 80-85% are non-small cell lung cancer (NSCLC), a highly genotypically diverse sub-type of lung cancer. Over the past three decades, extraordinary improvement in screening, smoking cessation, early diagnosis and targeted therapy have been made, improving NSCLC survival markedly. However, as patients are surviving their primary disease better, there is a temporal …

Changes In Psychiatric Diagnosis Associated With Sars-Cov-2 Infection And Predicting The Development Of New Psychiatric Illness In Covid Patients By Using Machine Learning Approach: A Study Using The Us National Covid Cohort Collaborative (N3c), Asif Rahman

Graduate Theses, Dissertations, and Problem Reports (ETD)

The enduring impact of COVID-19 extends beyond acute illness, with potential long-term psychiatric consequences raising significant concern among healthcare professionals and researchers alike. Emerging evidence suggests a multifaceted relationship between COVID-19 and the development of different psychiatric illnesses like Schizophrenia Spectrum and Psychotic Disorders (SSPD), Depression, Bipolar disorder, Personality disorder, Trauma, and a range of other mental health conditions. Considering these emerging connections, our study endeavors to rigorously assess the associations between COVID-19 and various psychiatric illnesses while simultaneously employing machine learning techniques to predict the development of new psychiatric disorders in individuals affected by the virus. Leveraging the extensive …

Spiral Wave Teleportation And Multiplex Network Synchronization In Light Sensitive Belousov-Zhabotinsky Systems, Shannyn Alicia Tyler

Graduate Theses, Dissertations, and Problem Reports (ETD)

We experimentally and computationally investigate dynamical behaviors in excitable and oscillatory media using light sensitive Belousov-Zhabotinsky (BZ) systems. These systems are not in a state of thermodynamic equilibrium, and have been proven to show various interesting phenomena including spatiotemporal patterns, self-organization, and chaos. We utilize the BZ reaction, a nonlinear chemical reaction, known for its relaxation-type oscillations, to explore the dynamics of these systems.

We examine spiral wave teleportation in an excitable media as an effective alternate defibrillation method. Spiral waves have emerged as a key phenomenon associated with the initiation and persistence of cardiac arrhythmias. Using a light sensitive …

An Examination Of Coping Resources And Strategies Among Appalachian Transgender And Gender Nonconforming Adults And Youth, Zachary Ramsey

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background. The body of literature shows that TGNC adults and youth face a multitude of health disparities (e.g., depression, anxiety, suicidal ideation, eating disorders, body dysmorphia) due to their marginalization. Neither Meyer’s Minority Stress Model nor Testa’s Gender Minority Stress and Resilience Model sufficiently examines coping and the ways it interacts with other concepts within the model. Aims. The objective of this dissertation was to examine the coping resources and strategies of Appalachian transgender and gender nonconforming individuals. The three aims of this study were to: 1) evaluate the relationship of coping resources and strategies between TGNC Youth and cisgender …