Medicine and Health Sciences Commons^™

Opioid Tolerance And Withdrawal In The Mouse Colon, James Fune

Theses and Dissertations

Constipation is a major clinical obstacle associated with opioids, prompting patients to discontinue treatment due to pain, discomfort, and psychosocial stressors. Moreover, chronic users become tolerant to the analgesic effects of opioids, but not to their constipating effects. Upon cessation of long-term treatment, serious diarrhea–among other somatic signs of withdrawal–may ensue. These symptoms become a driving factor for relapse, causing patients to restart opioid treatment. In this study, we aim to understand mechanisms that contribute to opioid tolerance and withdrawal in the colon. Previous findings suggest that constipation occurs partly due to the colon’s lack of tolerance to opioids’ inhibitory …

Establishing A Conventional Linac-Based Electron Flash Beam, Justin Defrancisco

Theses and Dissertations

Problems: A rediscovered radiotherapy technique, FLASH, involves increasing the dose rate to >40 Gy/s. For a given dose, FLASH is shown to decrease the normal tissue complication probability without affecting the tumor control probability. More preclinical studies are necessary to confirm and enable these desirable properties on humans. Current preclinical investigations have diverse constraints, requiring FLASH apparatuses with flexible parameters and accurate control. However, there are limited FLASH platforms available, the existing ones are costly. Our institution is not in possession of any such infrastructure. Even if available, dosimetry and beam control in FLASH are extremely lacking. There is …

Rethinking Parkinson's Disease Genetics In The Precision Medicine Era: Why Genomic Diversity Matters?, Camilla Teixeira Pinheiro Gusmão, Giselli Scaini, Everton Ferreira De Souza, Rafael Antônio Vicente Lacerda, Matheus De Almeida Costa, Raja Mehanna, João Quevedo, Howard Lopes Ribeiro Junior

Faculty, Staff and Student Publications

No abstract provided.

Topss: Tolerability Of Transcranial Direct Current Stimulation In Pediatric Stroke Survivors, Stuart Fraser, Anna Clearman, Melika Abrahams, Bernadette Gillick, Tia Lal, Sean Savitz, Nuray Yozbatiran

Faculty, Staff and Student Publications

Background: Transcranial direct current stimulation is a non-invasive neuromodulation technique with emerging therapeutic potential in neurodevelopmental conditions. While childhood-onset stroke survivors frequently experience long-term motor impairment, there are very few studies examining the safety and feasibility of transcranial direct current stimulation in this population.

Objective: To evaluate the safety, feasibility, and tolerability of bihemispheric transcranial direct current stimulation paired with occupational therapy in children and adolescents with chronic hemiparesis following childhood-onset arterial ischemic stroke or intracranial hemorrhage.

Methods: In this single-arm, open-label pilot study, five participants aged 6-19 years of age received five daily sessions of transcranial direct current stimulation …

Smoking Habit And Long-Term Colorectal Cancer Incidence By Exome-Wide Mutational And Neoantigen Loads: Evidence Based On The Prospective Cohort Incident-Tumour Biobank Method, Tsuyoshi Hamada, Tomotaka Ugai, Carino Gurjao, Satoko Ugai, Xuehong Zhang, Koichiro Haruki, Yasutoshi Takashima, Naohiko Akimoto, Mai Chan Lau, Kosuke Matsuda, Nobuhiro Nakazawa, Mayu Higashioka, Satoshi Miyahara, Keisuke Kosumi, Yohei Masugi, Li Liu, Yin Cao, Daniel Nevo, Molin Wang, Reiko Nishihara, Sachet A Shukla, Catherine J Wu, Levi A Garraway, Jeffrey A Meyerhardt, Edward L Giovannucci, Jonathan A Nowak, Charles S Fuchs, Andrew T Chan, Mingyang Song, Marios Giannakis, Shuji Ogino

Faculty, Staff and Student Publications

Objective: To test the hypothesis that the association of smoking with long-term colorectal cancer incidence may be stronger for tumours with higher mutational and neoantigen loads.

Methods and analysis: In the Nurses' Health Study (1980-2012) and the Health Professionals Follow-up Study (1986-2012), our novel prospective cohort incident-tumour biobank method (PCIBM) used 3053 incident colorectal carcinoma cases including 752 cases with whole-exome sequencing data. Using the multivariable duplication-method Cox regression model with the inverse probability weighting to adjust for the selection bias due to tissue availability, we assessed a differential association of cigarette smoking with colorectal carcinoma incidence by an exome-wide …

The Effects Of Ph And Oncometabolites On Dna Repair Mediated By Alkb Family Enzymes, Quentin Mylie

Open Access Dissertations

Modifications of DNA and RNA, in particular methylations - such as N⁶-methyladenine (m6A), 5-methylcytosine (m5C), 1-methyladenine (m1A), and 3-methylcytosine (m3C) are crucial for gene regulation, genome integrity, and cellular adaptation. This dissertation investigates the role of the ALKB family of alpha-ketoglutarate (αKG) and iron-dependent dioxygenases in modulating these modifications, with a focus on how their activity is influenced by pH and metabolic factors, underscoring the connection between environmental conditions and epigenetic and genetic stability.

Chapter 1 provides a comprehensive literature review on the epigenetic and genetic regulation of DNA and RNA modifications, with a particular focus on methylation …

Hypnosis And Mindfulness Audio Recordings For Reducing Fatigue In Individuals With Multiple Sclerosis: A Randomized Controlled Study, Mark P. Jensen, Susan Robles, Michael G. Nash, Susanne May, Dwan M. Ehde, Melissa A. Day, Owen Gottlieb, Laurence I. Sugarman, Kevin N. Alschuler

Articles

Background

Fatigue is a common problem in individuals with multiple sclerosis (MS).

Objective

The objective was to evaluate the effects on fatigue of having 4 weeks of

access to audio recordings of therapeutic hypnosis (HYP) and mindfulness meditation

(MM) practices.

Methods

A total of 333 individuals with MS and fatigue were randomly assigned to

one of the three treatment conditions for 28 weeks: (1) access to therapeutic HYP audio

recordings, (2) access to MM audio recordings, or (3) no access to recordings

(treatment as usual or TAU). Fatigue impact (primary outcome) and other outcomes

were assessed at 4, 16, and …

Starting The Conversation: Patient Perceptions Of Self-Assessed Type-2 Diabetes Risk., Bennett Collis, Huda Kutmah, Peyton Couch, Neelima J Kale, Karen L Roper

Ambulatory and Primary Care Articles

INTRODUCTION: Little is known about patients' perceptions of their risk for type-2 diabetes (T2D), or if knowledge of risk could facilitate weight and diabetes prevention discussions with health care professionals.

METHODS: In our academic family medicine practice, 25 patients completed a previsit T2D risk assessment on their phone and answered interview and survey questions to assess their understanding of their risk for developing T2D.

RESULTS: Interest in their T2D risk was high, but self-estimation of risk before obtaining their score was low (21/25 reported ≤30% chance of developing diabetes). All patients perceived T2D to be very serious, most remembered their …

Obesity, Metabolic Health, And Diabetic Complications In People With Type 1 Diabetes., Yuanjie Mao, Jen-Tzer Gau, Ning Jiang

Ambulatory and Primary Care Articles

AIM: The concept of metabolically healthy obesity (MHO) has not been studied in type 1 diabetes (T1D). By analysing datasets from the DCCT/EDIC study, we compared the development of diabetic complications by obesity and metabolic health over 30 years of follow up.

MATERIALS AND METHODS: Insulin resistance was calculated by estimated glucose disposal rate (eGDR). The participants (n = 1127) were then divided into four groups based on time-weighted mean body mass index and mean eGDR: metabolically healthy non-obesity (MHN, n = 874), metabolically unhealthy non-obesity (MUN, n = 66), MHO (n = 146) and metabolically unhealthy obesity (MUO, n …

Therapeutic Potential Of Brassica Carinata Microgreens Extract In Alleviating Symptoms Of Type 2 Diabetes In Wistar Rats, Lilian Nakakaawa, Ifeoluwa D. Gbala, Joel L. Bargul, Xavier Cheseto, John M. Wesonga

All Peer-Reviewed Publications

Microgreens of Brassica plants have attracted increasing research interest in the management of the prevailing epidemic of Type 2 diabetes mellitus (T2DM) because of their high nutritional value. This study evaluated the antidiabetic effects of Brassica carinata Microgreens Ethanolic Extract (BMEE) in type-2 diabetic rats. For the normoglycemic assay, rats were divided into five groups and received a single oral dose of 100, 250, and 500 mg/kg of BMEE while the control groups received distilled water and Glibenclamide. Fasting blood glucose (FBG) levels were determined on a weekly basis for 28 days in diabetic rats after treatment with BMEE at …

Comparing Patency Of Pulmonary Stent Implantation And Balloon Angioplasty In Pulmonary Vein Stenosis: A Systematic Review And Meta-Analysis, Izza Batool, Muhammad K. Khan, Muhammad Zohaib, Ibrahim A. Khan, Syed A. A. Bukhari, Shreeja Shah, Khaled Harmouch, Hussam Al Hennawi, Bruce D. Klugherz

Abington Jefferson Health Papers

Pulmonary vein stenosis (PVS) is an insidious diagnosis associated with morbidity and mortality. Pharmacologic therapy may suffice initially, but advanced stages demand mechanical intervention. Pulmonary stent implantation (PSI) and pulmonary balloon angioplasty (PBA) are common strategies, both carrying restenosis risks. This meta‐analysis compares PSI and PBA to determine the superior revascularization strategy. We systematically searched databases until November 2023, identifying 11 studies with 780 patients. Studies, including those involving patients undergoing balloon angioplasty (BA) or stent angioplasty (SA) for PVS, were selected. Case reports, editorials, and cross‐sectional studies were omitted. Primary outcomes included restenosis requiring reintervention, 5‐year freedom from restenosis, …

Revascularization Strategies For Multivessel Disease In Acute Coronary Syndrome: Network Meta-Analysis, Khaled M. Harmouch, Mohammad Hamza, Nomesh Kumar, Zarghoona Wajid, Neel Patel, Masooma Naseem, Jawad Basit, Prakash Upreti, Manoj Kumar, Waqas Ullah, Yasar Sattar, Timir K. Paul, Emmanouil Brilakis, M. Chadi Alraies

Abington Jefferson Health Papers

BACKGROUND: The optimal revascularization strategy for patients with acute coronary syndrome (ACS) and multivessel disease (MVD) remains debated. This study compares the efficacy and safety of different revascularization strategies in these patients.

METHODS: We included 20 studies comparing staged, complete, and culprit-only (CO) revascularization strategies in patients with ACS and MVD. We divided the revascularization strategies into 3 distinct strategies: CO, complete index procedure (CIP), and complete staged procedure (CSP). We then compared CIP and CSP with CO. Outcomes studied are all-cause mortality, cardiac death, recurrent myocardial infarction (MI), need for revascularization, bleeding, contrast-induced nephropathy (CIN), stroke, bleeding, and stent …

Neighbourhood Resilience Planning With Renters In Hamilton, Ontario, Canada, Anna Do

Theses and Dissertations (Comprehensive)

This sequential mixed-methods study demonstrates the co-production of knowledge between academic researchers and local communities. Guided by the resilience planning framework, the study engaged 48 renters from the Beasley neighbourhood of Hamilton, Ontario, Canada in identifying stressful and supportive locations using a participatory mapping tool called the “Place Report.” A total of 74 Place Reports were submitted, with most reporting supportive places in or near Beasley. Thematic analysis revealed three overarching domains, and 13 themes related to the use and function of these locations. Places pertaining to food, housing, and physical activity emerged as the most frequently discussed topics. The …

Limiting H1n1 Replication Via The Dsrnai Pathway Using Sequence-Specific Ldsrna, Shawn Marie Sharon Carr, Stephanie Dewitte-Orr

Theses and Dissertations (Comprehensive)

The seasonal influenza virus causes a common respiratory illness that can be life threatening to the immunocompromised, the very young, and the elderly. The current strategies for avoiding a serious influenza virus infection are good hygiene practices and the annual influenza vaccine. Unfortunately, last year’s influenza virus vaccine effectiveness ranged between 32-60% for children and adolescents and 46-54% for adults. These low efficacy rates are due to the vaccine often targeting hemagglutinin, a highly variable surface protein. This thesis seeks to create a prophylactic treatment via the RNA interference (RNAi) response that targets the virus’s conserved genes that are integral …

Immune Pathway Modulation In Melanoma Using Chitosan Nanoparticle-Mediated Dsrna Delivery, Bethel C. Iwuji

Theses and Dissertations (Comprehensive)

Cancer is a group of diseases characterized by abnormal and uncontrolled cell division, which typically results in the formation of tumours. Even with advances in treatments, cancer remains one of the leading causes of death globally. Melanoma is an aggressive form of skin cancer which is highly malignant, develops in the pigment-producing cells of the skin, melanocytes, and in the late stages of the disease poses a significant challenge for therapeutic intervention due to its multidrug resistance. The innate immune system is the first line of defence against invading pathogens, including viruses, bacteria, and fungi, and can recognize and destroy …

“It Is Tiny And It Is Everything”: Exploring The Effects Of Arts-Integrated Gardening On Experiences Of Ecological Grief Through Autoethnographic Research, Christina Kingsbury

Theses and Dissertations (Comprehensive)

This study explores how arts-integrated gardening affects experiences of ecological grief through autoethnography and draws on my personal experiences as a survivor of environmentally linked cancer and artist working with gardens through social practice. My research builds on two areas of emergent scholarship—investigations of ecological grief and gardens as sites for social work practice—to explore how social work may address ecological grief through arts-integrated gardening. I use a quilting autoethnography as a method of inquiry to foreground my subjective knowledge and analyze it through intersectional feminist, disability and decolonizing theories. By incorporating narrative analysis and arts-based inquiry—writing in place, poetic …

Evaluation Of The Dnazyme Gr5 For The Determination Of Lead Speciation In Natural Waters, Gaganprit Gill

Theses and Dissertations (Comprehensive)

This thesis explores the development and application of a DNAzyme-based biosensor designed to detect labile metal species in environmental samples. Real time and on-site monitoring of labile metal fractions would make a valuable contribution to environmental management, as these fractions are the most bioavailable and pose significant toxicity risks to aquatic organisms. Conventional methods for detecting labile metals, while effective, are often burdened by high costs, complexity, and lengthy processing times, making them less ideal for rapid and widespread environmental assessments.

The first manuscript of this thesis (chapter 2) establishes the fundamental capabilities of the Pb²⁺-specific DNAzyme GR5 …

Nuclear Intron Sequence Variation Of The Bulinus Globosus Complex (Mollusca: Planorbidae): Implications For Molecular Systematic Analyses, Chairat Tantrawatpan, Kotchaphon Vaisusuk, Chrysantus M. Tanga, Warayutt Pilap, Naruemon Bunchom, Ross H. Andrews, Tongjit Thanchomnang, Wanchai Maleewong, Weerachai Saijuntha

All Peer-Reviewed Publications

Urinary schistosomiasis is caused by the blood fluke Schistosoma haematobium, which is predominantly found in Africa. The freshwater snail Bulinus globosus is its main intermediate host. The species that make up the B. globosus group are genetically complex, and their taxonomic status remains controversial. Genetic variation, heterozygosity, and DNA recombination in B. globosus were examined using the mitochondrial cytochrome c oxidase subunit 1 (COI) and the intron 3 region of the arginine kinase gene (AkInt3). A total of 81 B. globosus snails were collected from three different localities in Kwale County, Kenya. Genomic diversity, heterozygosity, DNA recombination, and haplotype network …

From Misinformation To Policy Solutions: Teaching Herd Immunity And Vaccine Hesitancy Through Real-World Case Studies Of Measles Outbreaks, Laurieann Klockow

Biomedical Sciences Faculty Research and Publications

Vaccine hesitancy threatens herd immunity, contributing to the resurgence of measles outbreaks. This lesson engages upper-level biomedical science students in analyzing the complex interplay between vaccination rates, herd immunity and vaccine exemption policies through examination of the 2019 New York measles outbreak that threatened the United States’ measles elimination status. Students critically evaluate anti-vaccine misinformation, analyze epidemiological data and develop evidence-based policy recommendations to increase vaccination rates. The lesson combines team-based learning with authentic assessment through vaccine policy development, moving beyond knowledge acquisition and content to building scientific literacy and evidence-based reasoning skills essential for scientifically literate citizens and future …

Design Thinking For Health Environments: Case Study Research On Innovation, Design Leadership, And Healthcare Complexity, Diana S. Nicholas

Antioch University Dissertations & Theses

As healthcare costs are skyrocketing, of the 6,093 hospitals in America, 53% will lose money in the current year (Coleman-Lochner, 2022). Design health innovation centers (DHICs) are formed in Europe and the United States to create efficiencies in healthcare related to budget challenges. DHICs exist in unique contexts both in America and Europe that are not yet well understood. These efforts are difficult to lead due to the lack of understanding of their worth and how their process is valuable to healthcare settings (Bhattacharyya et al., 2022). The specific problem examined here is that little is known about how DHIC …

Black Birth Work As Radical Praxis: A Hermeneutic Phenomenological Inquiry Of Leadership Among Black Birth Workers, Lesa C. Clark

Antioch University Dissertations & Theses

This hermeneutic phenomenological study explores the leadership experiences of Black birth workers (BBWs), revealing critical insights into leadership dynamics within maternal healthcare. Through a theoretical framework integrating African feminism, Black feminism, and anti-racist feminism, the research examines how BBWs conceptualize and enact leadership through embodied, relational, and liberatory approaches. This study addresses a significant gap in leadership literature, particularly regarding generational knowledge and practices of BBWs, which remain understudied despite their vital role in Black maternal healthcare. This study reveals distinct leadership perspectives and methodologies through in-depth interviews with eight BBWs and a detailed interpretive analysis. The findings contribute to …

The Role Of Floodplain Complexity In Wood Turtle Habitat Use, Laura S. Deming

Antioch University Dissertations & Theses

Wood turtles occupy cold, low-gradient riverine habitat throughout the northeastern United State and southeastern Canada. Stream alterations, such as dams, channel straightening, and floodplain development have diminished the natural hydrologic and sedimentation regimes that result in complex channel and floodplain geomorphology. Studies throughout the species’ range have quantified many aspects of their habitat, but none have quantified components of geomorphology of wood turtle sites. The goal of this study was to explore the role of stream channel and floodplain geomorphology in wood turtle habitat use, with specific objectives to (1) quantify components of stream channel and floodplain geomorphic complexity, (2) …

The Importance Of Accessibility, Self-Advocacy, And Affirming Care: An Interpretive Phenomenological Analysis Of Transgender And Gender Diverse Older Adults’ Primary Care Experiences, Jason Vaught

Antioch University Dissertations & Theses

The present study explored the lived experiences of Transgender and Gender Diverse (TGD) older adults when receiving primary care. The methodology utilized for this study was Interpretive Phenomenological Analysis (IPA). Three participants completed individual, semi-structured interviews. The themes that emerged included “Lack of Accessibility to Services,” “Need for Self-Advocacy,” and “Value of Affirming Care from Providers.” These results illustrated the multifarious needs that arise for TGD older adults when accessing primary care. The findings provided recommendations for healthcare organizations, primary care physicians, and other healthcare professionals. Specifically, the recommendations emphasized two key practices for physicians treating TGD older adults: (1) …

Experiences Of Dissertating Students: What Works?, Laura Durkin

Antioch University Dissertations & Theses

This study explores the experiences of doctoral graduates from Council for Accreditation of Counseling and Related Educational Programs (CACREP)-accredited Counselor Education and Supervision (CES) programs. Guided by theoretical frameworks on student attrition and institutional racism, the research investigates three primary questions: (1) What dissertation- specific programmatic factors influence time to completion for CES doctoral students? (2) What interventions most strongly promote a sense of social integration and belonging? and (3) What interventions most strongly promote academic integration and confidence in students’ ability to succeed? Data were collected anonymously through an online survey, which included demographic and open-ended questions. Twelve participants …

Outside Of The Counseling Room: Whiteness And Antiracism, Carlee D. Smith

Antioch University Dissertations & Theses

This dissertation explores the lived experiences of white counselors as they integrate antiracism practices into their non-clinical lives. Rooted in the Multicultural and Social Justice Counseling Competencies (MSJCC) framework, this study addresses the gap in literature surrounding how white counselors embody antiracist ideologies outside of the counseling room. Through narrative qualitative methods, the research examines the challenges, strategies, and reflections of white counselors committed to antiracist practices; practical integration into personal life often encounters barriers related to internal biases, social resistance, and limited educational support. Insights from this research highlight the critical need for ongoing self-reflection, community accountability, and structural …

Beyond Strong: A Phenomenology Of Women Executives And The Connection Between Leadership And Fitness, Nozomi Bullock

Antioch University Dissertations & Theses

Senior-level executive leaders’ work in a dynamic, competitive, 24/7 business environment can be physically rigorous, mentally demanding, and emotionally isolating. The same holds true for women pursuing senior-level leadership roles in corporate America. Women who achieve and succeed in such roles remain the minority: Outsiders in elite spaces who are held to higher standards and overly scrutinized. Among senior-level executive women leaders, those committed to a fitness and training regimen including weightlifting constitute an even smaller minority. Senior-level executive roles require stamina, resilience, and courage—qualities that make up the foundation of the mindset of fitness and strength training (Foyster et …

My Body My Choice: A Qualitative Study Of Volitional Female Sterilization In The U. S. Latina And Hispanic Female Population, Heather Morris Tuip

Antioch University Dissertations & Theses

This qualitative study, utilizing an interpretative phenomenological analysis methodology, elucidates the experience of Latina and Hispanic women living in the United States who have volitionally undergone sterilization or have sought the procedure out for birth control. Understanding the rich, contextual, lived experience of Latina and Hispanic women through an intersectional framework highlights how cultural influences and contemporary policies on reproductive rights informed their personal choice to undergo a female sterilization procedure. The participants of this study shared how they made meaning of their experiences. Within a homogenous sampling of study participants who share ethnicities and genders, six group experiential themes …

Childhood Aggression: A New Conceptualization, Hannah G. Harrison

Antioch University Dissertations & Theses

Childhood aggression is a frequently observed behavioral phenomenon, yet lacks a precise
definition in both the DSM-5-TR and current research literature. Definitional ambiguity and
construct enmeshment continue to create construct confusion for researchers, clinicians, and
informants. This empirical review of the current literature and diagnostic criteria examines how
childhood aggression has been historically conceptualized, defined, and described. The primary
aim was to identify and clarify inconsistencies in current definitions and to address knowledge
gaps to improve diagnostic clarity. Through a thematic synthesis of recent literature, several key
issues emerged: the absence of a precise definition of childhood aggression; reliance on …

Embracing The Suck: Overcoming Moral Injury-Related Attachment Trauma Through Outdoor Adventure, Emerald D. Ralston

Antioch University Dissertations & Theses

Moral injury is increasingly recognized as a distinct and debilitating consequence of military service, arising when individuals engage in, witness, or are unable to prevent actions that transgress their deeply held moral beliefs. In this dissertation, I argue that this form of trauma can be experienced as an attachment rupture, particularly when the military—functioning as an institutional attachment figure—betrays the servicemember’s trust. Such experiences compromise internal working models (IWMs) of self, others, and the world, and may result in complex trauma symptoms, including dissociation, depersonalization, and profound relational disconnection. These injuries are frequently stored in the body, rendering traditional cognitive …

Stigma Of Obesity And Healthcare Utilization, Moya A. O'Leary

Antioch University Dissertations & Theses

The impact of personal factors on healthcare utilization is an essential area of research to improve overall health outcomes among the population. This study explored the relationship between perceived stigma and healthcare avoidance among men and evaluated the relationship between self-reported body mass index (BMI) and avoidance of healthcare appointments due to weight-related stigma and other reasons. This study found no significant relationship between BMI and avoidance of preventive medical appointments due to perceived stigma. However, men from all weight categories endorsed avoiding preventive healthcare appointments due to weight-related reasons and for other reasons. This study explored the reported reasons …