Medicine and Health Sciences Commons^™

Expression Of 5-Lo In Chronic Wounds In A Preclinical Murine Model Of Obesity And Type 2 Diabetes, Joshua Wu, Ramiro Cisneros, Nathaniel Primous, Estephania Garcia, Bhuvana Lakkasetter, Claudia Biguetti

School of Podiatric Medicine - Student Research

Introduction: Diabetes is associated with impaired wound healing and a high incidence of chronic, non-healing ulcers, largely driven by persistent low-grade inflammation. Leukotriene B4 (LTB4), a product of the 5-lipoxygenase (5-LO) pathway, has emerged as a key mediator of this chronic inflammatory state. Hence, this study investigated the role of the 5-LO pathway in cutaneous wound healing under normoglycemic and diabetic conditions using a murine model.

Methods: Twelve 8-week-old male C57BL/6J mice were fed with high-fat diet (HFD; 60% kcal fat) or low-fat diet (LFD; 10% kcal fat) for 12 weeks (IACUC 22-33). Body weight (BW) and fasting blood glucose …

Family- And Cultural-Level Influences For Latine Adolescent Nicotine Use: A Qualitative Study Informing Prevention, Cindy M. Hernandez Castro

Theses and Dissertations

Early tobacco use among Latine adolescents represents a critical public health concern, with 23.8% reporting current use and exceeding rates among other racial/ethnic groups (Birdsey et al., 2023; Gaddy et al., 2022). This early initiation elevates risks for nicotine dependence and related morbidity in adulthood (Tsao et al., 2023). Guided by Structural Ecosystems Theory (Szapocznik & Coatsworth, 1999) and contemporary grounded theory analysis (Braun & Clarke, 2006; Charmaz, 2006; Noble & Mitchell, 2016), this study examined multilevel influences on nicotine-related attitudes among Latine youth, including: (1) familial factors (i.e., parental monitoring, caregiver-youth communication), (2) cultural dynamics (i.e., cultural values and …

Absolute Quantification And Identification Of Rna From Rna-Lipid Nanoparticles Using High Resolution Mass Spectrometry, Jason C. Funderburk

Theses and Dissertations

RNA therapeutics are a rising drug category with potential use for a range of conditions encompassing infectious diseases to therapies for cancer, diseases, and genetic disorders. RNA-lipid nanoparticles (RNA-LNPs) are the prominent delivery method for these therapeutics approved products include mRNA vaccines and polyneuropathy treatments. The emergency use authorizations and orphan drug status of current RNA-LNP drugs has allowed approval without finalization of the regulatory analytical procedures for quality monitoring. The objective of the study was to develop an LC-MS assay to simultaneously measure identity and concentration of two therapeutically relevant intact RNA constructs extracted from RNA-LNPs to enhance quality …

A Framework For Digital Energy Modulation And Translation In Projectional X-Ray Imaging, Richard R. Wargo

Theses and Dissertations

In projectional X-ray imaging, acquisition energy fundamentally influences subject contrast, image noise, and radiation dose. While dual-energy techniques exploit spectral differences to optimize contrast and enable material separation, acquiring multiple images of the same anatomy often requires additional exposures and increased system complexity.

This dissertation presents a framework for digital energy modulation (DEM), in which computational models are trained to translate projection images between energy domains without requiring additional X-ray acquisitions. DEM is conceived as a generalizable strategy for controlled contrast modulation in projection imaging, with potential applications in image optimization, radiation therapy alignment, and dual-energy applications.

The framework was …

Generating Synthetic Ct From Mri Data, Foysal Ahmed

Theses and Dissertations

Magnetic resonance imaging (MRI) provides excellent soft tissue contrast without ionizing radiation, making it a strong alternative to computed tomography (CT) in medical imaging workflows. However, CT remains essential for applications requiring electron density information, such as radiation therapy treatment planning. This study investigated the feasibility of generating synthetic CT (sCT) images from MRI using a deep learning-based U-Net architecture. A two-dimensional U-Net was trained on paired MRI-CT data from the SynthRAD 2025 dataset, consisting of 120 T1-weighted (T1W) and 60 T2-weighted (T2W) axial cases, including deformed CT (dCT) aligned to MRI. Model testing used an independent dataset of 30 …

Magnetic Resonance Only Planning Validation Using Synthetic Ct By Mvision, Eric D. Brass Sr

Theses and Dissertations

Problems: Adaptive radiotherapy requires clinically practical methods for responding to patient-anatomy changes that occur between the original planning images and the day of treatment delivery. Registering a previously acquired computed tomography scan to a newly acquired magnetic resonance image can introduce cross-modality uncertainty and may delay replanning. This thesis evaluates whether synthetic computed tomography generated from same-day magnetic resonance imaging can reduce registration-related uncertainty while supporting rapid dose recalculation for fraction-level adaptation.

Procedure: Magnetic resonance imaging DICOM data were exported from the ViewRay MRIdian treatment planning system and uploaded to MVision for synthetic computed tomography generation. The synthetic computed tomography …

Development Of A Practical Lu-177 Activity Calibration Protocol For Clinical Nuclear Medicine: Dosimetric Impact Analysis And Implementation Tools, Azam Almolaiki

Theses and Dissertations

Lutetium-177 (Lu-177) is widely used in radionuclide therapy, where accurate activity measurement prior to administration is essential for safe and effective treatment delivery. However, variability in dose calibrator response due to measurement conditions and source geometry remains a practical challenge in routine clinical settings. This study presents a practical clinical calibration strategy under real-world constraints for Lu-177 activity measurement using standard nuclear medicine instrumentation. A vial-based approach was implemented using a well-type ionization chamber (Capintec CRC-15R) to evaluate measurement repeatability, temporal stability, and geometry dependence. All measurements were performed under consistent conditions with appropriate decay correction applied using the physical …

Commissioning & Daily Qa Of Converted Linac For Electron Flash, Tomaj Javidtash

Theses and Dissertations

Ultra-high dose rate (FLASH) radiotherapy has demonstrated promising normal tissue sparing in preclinical studies; however, the lack of standardized dosimetry, commissioning, and quality assurance (QA) methodologies remains a major barrier to its reproducible and safe implementation. In particular, conventional clinical commissioning and QA protocols are not directly applicable at FLASH dose rates due to challenges associated with detector response, dose-per-pulse effects, and beam control limitations.

This thesis presents the commissioning of a converted Varian 21EX linear accelerator for electron FLASH operation within the Division of Medical Physics at the Virginia Commonwealth University (VCU) Department of Radiation Oncology. Comprehensive beam characterization …

Embracing Imperfection And Stress As The Foundation For Growth, Excellence, And Well-Being In Dentistry, John W. Claytor Jr., Dds, Magd-Llsr, Facd

Journal of the American College of Dentists

Studies reveal that stress in dentistry begins early in training and may progress throughout a dentist’s career. Fear of managing patient dissatisfaction, demanding schedules, time constraints, staff issues, and the stressors of clinical dentistry all contribute to professional strain. Difficulties associated with perfectionistic tendencies, burnout, and mental health concerns remain ever-present challenges within the profession. This article discusses evidence-based strategies, coping skills, organizational approaches, and professional resources that may help mitigate the effects of stress in dentistry. Particular emphasis is placed on reducing stigma surrounding mental health care and supporting initiatives such as the Lorna Breen Heroes Foundation’s “Safe Haven” …

Revisiting Nasal Polyp Scoring In Clinical Trials: Interpretive Variability And The Need For Standardization, Leigh J. Sowerby, Babak Pourmomenarabi, Antonino Maniaci, Olivia Ginty, Joseph Khristian Han

Department of Otolaryngology (ENT) Faculty Publications

[Introduction] Borish et al. provided an excellent review highlighting methodological variability among the six pivotal Phase III trials [1]. One critical yet overlooked issue is the inconsistent application of the endoscopic nasal polyp score (NPS), a primary outcome measure in all trials.

Oropharyngeal Syphilis Presenting As Tongue Based Ulcer With Lymphadenopathy, Serena F. Pu, Kevin J. Carlson, Jonathan R. Mark, Benjamin J. Rubinstein

Department of Otolaryngology (ENT) Faculty Publications

Within the aerodigestive tract, syphilis presents with varied signs and symptoms, some of which may mimic malignancy or other disease processes. We present the case of a 29-year-old man with otalgia and odynophagia who was found on physical examination and office laryngoscopy to have a 4-cm ulcerative mass of the tongue base and cervical lymphadenopathy. While planning for tissue diagnosis, the patient’s serologies revealed positive treponemal antibody testing and elevated rapid plasma reagin (RPR) titers, confirming syphilitic infection, likely representing secondary syphilis. While awaiting operative biopsy, the patient received intramuscular penicillin with complete resolution of the mass and symptoms, and …

Depemokimab: A Twice Yearly Anti-Il 5 Biologic For Chronic Rhinosinusitis With Nasal Polyps (Crswnp) - A Narrative Review, Marn Joon Park, Joseph K. Han, Kent K. Lam

Department of Otolaryngology (ENT) Faculty Publications

Depemokimab is a monoclonal antibody that targets interleukin-5 with enhanced binding affinity and an extended terminal elimination half‑life of 6-8 weeks. The unique pharmacodynamic features of depemokimab enable sustained suppression of type 2 inflammation with twice‑yearly subcutaneous dosing. This narrative review provides details of depemokimab's molecular profile, pharmacokinetics, and pharmacodynamics and results regarding the clinical efficacy and safety of depemokimab from recently published Phase 3 clinical trials for the treatment of chronic rhinosinusitis with nasal polyposis (CRSwNP). In 528 severe adult CRSwNP patients (ANCHOR‑1/‑2 trials), depemokimab achieved Δ total endoscopic nasal polyp score by -0.70 (p <  .001) and Δ nasal obstruction verbal response scale by -0.24 (p = .003) at week 52, compared to placebo. Twice‑yearly 100 mg depemokimab provides durable eosinophil suppression and with a safety profile comparable to placebo in Phase 3 trials for CRSwNP. Future work should refine biomarkers and assess comparative cost‑effectiveness and long‑term adherence, safety, and effectiveness.

Dupilumab In Chronic Rhinosinusitis Without Nasal Polyps: Randomized Phase 2 Trial (Orion), Stella E. Lee, Anju T. Peters, Philippe Gevaert, Joseph K. Han, Claus Bachert, Francisco Moreira Da Silva, Andrés Rosenblüt, Chih-Chi Hu, Jennifer Maloney, Paolo Caferra, Adrianna Michalak, Andrew P. Fontenot, Lacey B. Robinson, Neelam A. Phadke

Department of Otolaryngology (ENT) Faculty Publications

BACKGROUND: Chronic rhinosinusitis (CRS) is often driven by type 2 inflammation and is characterized by nasal obstruction/ discharge, facial pain/pressure, and/or reduced smell, either with or without nasal polyps (CRSwNP or CRSsNP).

OBJECTIVE: To test whether dupilumab improves radiographic features in CRSsNP. Methods: ORION (NCT04678856), a phase 2, randomized, multicenter, double blind, placebo-controlled study, assessed dupilumab efficacy and safety in adults with uncontrolled CRSsNP. Patients were randomized 1:1 to dupilumab or placebo for 24 to 52 weeks. Endpoints included changes from baseline at week 24 in Lund–Mackay computed tomography (LMK-CT) score (dupilumab only [primary] and vs placebo [secondary]), sinus Total …

Indirect Treatment Comparison Of Tezepelumab Versus Other Biologics In Severe Chronic Rhinosinusitis With Nasal Polyps: A Systematic Literature Review And Network Meta-Analysis, Joseph K. Han, Joaquim Mullol, Claire Hopkins, Oliver Pfaar, Martin Desrosiers, Jason Steenkamp, Danny Gibson, Santiago Zuluaga Sanchez, Andrew Foster, Christopher S. Ambrose

Department of Otolaryngology (ENT) Faculty Publications

Introduction

This study compared the efficacy of tezepelumab with other approved biologics and endoscopic sinus surgery (ESS) using indirect treatment comparisons (ITCs) in adults with severe, uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP).

Methods

Randomized controlled trials (RCTs) identified via a systematic literature review (SLR) were synthesized in a network meta-analysis (NMA). Outcomes included change from baseline in nasal polyp score (NPS), nasal congestion/obstruction score (NCS/NOS), difficulty with sense of smell (DSS), Sino-Nasal Outcome Test-22 (SNOT-22) score, Lund Mackay score (LMS), time to nasal polyposis (NP) surgery decision, proportions requiring NP surgery or systemic corticosteroids (SCS), time to SCS use, …

New Therapies, New Challenges: Cystic Lung Disease After Cancer Immunotherapy, Ananya Venkatesh, David Camacho, Ross Summer, Michael Dong

Division of Internal Medicine Faculty Papers & Presentations

Immunotherapies have reduced reliance on cytotoxic strategies with their associated high toxicity levels, revolutionizing cancer care. However, these targeted therapies have also increased prevalence of previously rare sequelae, impacting patients experiencing longer survival. We describe a case of endometrial adenocarcinoma with lung metastases, in which tumor resolution following immunotherapy created cystic airspaces, leading to a pneumothorax complication. A 49-year-old female with advanced stage endometrial adenocarcinoma and lung metastasis developed cystic lung lesions in areas of previous metastatic lesions after treatment with Pembrolizumab and Bevacizumab. She developed a pneumothorax secondary to the rupture of one of the large lung cysts, leading …

Socialization Interventions For Older Adults In Assisted Living Facilities: A Systematic Review, Anoop S. Muvva

Honors Undergraduate Theses

Older adults, defined as individuals over the age of 65, are a growing population in the United States, with projections estimating this group will reach approximately 80 million persons by 2050. Over 90% of older adults are diagnosed with a chronic condition, which can make it difficult to carry out the activities of daily living. As a result, some older adults reside in assisted living facilities, where dedicated staff provide daily support. However, issues in the delivery of care within these settings, including unmet socialization needs and complications among care staff, may contribute to social isolation. Programs designed to address …

Perceptions, Expectations, And Attitudes About Adolescent Telepsychiatry Among Indian American Family Caregivers, Udayvir Jalf

Honors Undergraduate Theses

Adolescent mental health concerns have risen sharply in the United States. The COVID-19 pandemic marked a significant turning point in mental health care access, with telehealth having become a central mode of care delivery. With adolescent telehealth, caregiver involvement has shown to improve treatment adherence and outcomes. Little is known, however, about how Indian American caregivers experience and navigate their adolescent’s virtual mental health care. This qualitative study investigated the perceptions, expectations, and attitudes of Indian American family caregivers regarding adolescent telepsychiatry and caregivers’ involvement. In depth semi-structured interviews were conducted with Indian American caregivers of adolescents who completed at …

Comparative Spatial Biology: A Cross-Species Analysis Of Canine Oral Cancers As Models For Human Disease, Ram Pradhyumnan

Honors Undergraduate Theses

Oral squamous cell carcinoma (OSCC), one of the most common malignancies of the oral cavity, remains a clinically challenging disease due to its aggressive behavior, late-stage diagnosis, and limited improvements in therapeutic outcomes over recent decades. A significant barrier to progress in OSCC research and treatment is the lack of suitable preclinical models that recapitulate the complexity and natural progression of the disease. Most current models—including cell lines, xenografts, and genetically engineered mice—fail to capture key features such as the spatial organization of tumor epithelium, interactions with an intact immune system, and the stepwise evolution from normal mucosa to invasive …

Invasion Of Microplastics Into The Reproductive Tissues Of Feral And Domestic Felines, Emma K. Quade

Honors Undergraduate Theses

Although plastics have many useful properties in modern society, once these materials are introduced into the environment, they can cause extensive damage. Following degradation into microplastics (MP), plastic particles less than 5 mm in size, these contaminants can make their way into a variety of different environments and organisms. There are many studies that have investigated the prevalence of MP in marine environments, but fewer studies have looked into terrestrial systems, and even less that have focused on contamination in companion animals. This study sought to investigate the invasion of MP into the reproductive tissues of felines, Felis catus, …

The Relationship Between Physical Behaviors, Perceived Stress, Oral Hygiene Awareness, And Periodontal Disease Among College Students, Gustavo Quilula

Honors Undergraduate Theses

Periodontal disease (PD) is a preventable inflammatory disease that targets the supporting tissues that surround teeth. PD is extensively studied among older adults, but there is limited evidence of the prevalence of PD and potential modifiable risk factors among young adults. The purpose of this study is to assess the prevalence and severity of PD among U.S. college students and (2) examine the association between objectively measured physical activity (PA), oral hygiene awareness, perceived stress, and PD symptoms. College students from a large metropolitan university were enrolled in this cross-sectional study. Oral hygiene knowledge, PD symptoms, and perceived stress were …

Examining The Barriers To Healthcare Among Native Hawaiian And Pacific Islander Populations Living In Hawaii, Gracie L. Kaye

Honors Undergraduate Theses

The state of Hawaii was annexed by the United States in 1898, and served as a starting point from which the U.S. influenced Hawaii's socioeconomic conditions and healthcare access. The literature review examines healthcare views and outcomes among Native Hawaiian and Pacific Islander residents, utilizing various tools and resources to investigate how these factors have impacted overall health statistics and the reasons behind these trends. Results found that the western colonization of the island and the disease outbreaks led to an initial mistrust of “western ideas.” Additionally, due to long-standing cultural beliefs, there is a natural preference for traditional cultural …

How Does The Frequency Of Visits Impact The Quality Of Life For Nursing Home Residents?, Sophie M. Carlton

Honors Undergraduate Theses

This integrative literature review examines the relationship between quantity of visitation and quality of life (QOL) of nursing home residents. The purpose of this review is to examine existing research to determine whether an optimal “dosage” of visitation exists that meaningfully enhances QOL for this vulnerable population. Establishing an evidence based- guideline may help reduce uncertainty for families and promote more consistent improvements in resident well-being. Nursing home residents are the focus of this work because their limited ability to leave the facility makes visitation one of their primary sources of non-occupational social interaction. The COVID19 pandemic further heightened the …

Analyzing Early Medieval Perspectives Of Fetal Development, Nivedha Srinivasan

Honors Undergraduate Theses

This thesis examines early medieval perspectives of fetal development by analyzing two manuscripts: British Library, Cotton Tiberius A III and Leiden University, Vossianus lat. Q69. This study will investigate how knowledge of pregnancy was shared throughout England before the establishment of universities. Interest in medieval reproductive language has piqued in importance in recent years, especially due to modern legal debates surrounding reproductive rights. By examining descriptions of the nine months of fetal development in these two manuscripts, as well as in widely known earlier medical texts like Pliny’s Natural History and Vindicianus’ Gynaecia, this research explores how monastic writers in …

The Knowledge, Experiences, And Attitudes Of Nurses Regarding Trauma-Informed Care For Sexually Abused Intrapartum Patients, Kayleigh Mcgraw

Honors Undergraduate Theses

Labor and delivery nurses care for women from diverse backgrounds who are preparing for a life-changing event, often marked by fear, excitement, sadness, and joy. However, 1 in 5 women in the United States have experienced rape or attempted rape, and for these survivors, labor can become re-traumatizing. Many report flashbacks, dissociation, and a sense of “being back in the rape” during childbirth. Research further links prior sexual assault to unplanned cesareans, traumatic births, and childbirth-related PTSD. Trauma-informed care (TIC) provides a framework to reduce these risks by encouraging providers to understand trauma, recognize signs of distress, and act to …

Timelines Of Care: Analyzing Treatment Access For Women With Ongoing Reproductive Health Needs, Nyla M. Keith

Honors Undergraduate Theses

Mandates in the United States created pressure on an already strained healthcare system post-COVID-19 pandemic. With new regulations placed upon abortion care forcing the closing of low-cost health clinics such as Planned Parenthood, legislation that has made health insurance more expensive, and rising pharmaceutical prices, women’s OB/GYN care in America has struggled to meet patient needs. A cross-sectional survey was developed and distributed to four clinics in the Orlando area to assess patients' perceived access to care and identify barriers to receiving OB/GYN care. The survey took approximately 10 – 15 minutes to complete, was available in print and online …

Evaluating The Efficacy And Safety Of Inactivated Dengue Vaccines In Vulnerable Populations, Alaa Daghash

Honors Undergraduate Theses

Dengue virus is a mosquito-borne flavivirus responsible for over 390 million annual cases worldwide. While there are live-attenuated vaccines available to prevent dengue, none are currently approved for use in the United States, and existing platforms pose significant risks of viral reactivation and antibody-dependent enhancement in vulnerable populations, such as pregnant women, children under the age of nine, and the immunocompromised. This widespread exclusion of vulnerable populations exposes a significant vaccine equity gap in dengue prevention, as the populations most at risk for severe dengue are the same ones who are currently excluded from vaccination. In this study, I conducted …

Studying Chronotypes And Their Role In Sleep And Mental Health: A Scoping Review, Evan Nguyen

Honors Undergraduate Theses

Sleep patterns remain a significant public health concern globally, impacting several aspects of life, including mental health. This scoping review examined how chronotype and circadian typology predict mental health, with sleep quality serving as a crucial mediator. While the importance of sleep is widely acknowledged, there is a lack of studies specifically investigating chronotype-aligned interventions to reduce psychological distress. To address the shortage, a comprehensive review of the peer-reviewed literature was conducted, identifying six papers for analysis. These studies mostly utilized cross-sectional designs to assess diverse global groups, including university students, healthcare workers, and military personnel. The results indicate that …

The Role Of Resistance Training In Managing Menopause-Related Changes, Alyson K. Strauss

Honors Undergraduate Theses

Resistance training serves as a critical non-pharmacological strategy for mitigating the physiological and psychological declines associated with the menopausal transition. This natural biological phase, marked by declining estrogen levels, typically leads to accelerated bone mineral density loss, sarcopenia, metabolic regulation disturbance, and heightened mood disturbances. To evaluate the efficacy of targeted exercise interventions, a systematic review was conducted following PRISMA guidelines. From an initial pool of 60 relevant articles, 13 studies met the specific inclusion criteria, focusing on structured resistance training protocols for perimenopausal, menopausal, and postmenopausal cohorts.

The synthesis of these studies indicates that resistance training is a highly …

Life In Laughter: Comedy’S Impact On Student Health And Success, Julia Weinstein

Honors Undergraduate Theses

College students face rising rates of anxiety, depression, and stress, highlighting the need for accessible, stigma-free wellness interventions. While comedy is often seen as entertainment, research indicates laughter produces measurable psychological and physiological benefits, including reduced cortisol and increased endorphins. Life in Laughter, a creative-research hybrid project, investigates how live and digital comedy experiences affect college students’ mood, stress, and sense of belonging. Using mixed methods, data were collected through anonymous audience surveys, app-based reflections via JoyScroll, and interviews, supplemented by a mini-documentary. Findings suggest humor functions as both an emotional regulation tool and a means of fostering …

Oral Health Access Among Ethnic Minority Older Adults In The United States, Jasleen K. Sodhi

Honors Undergraduate Theses

Oral healthcare is a critical yet often overlooked component of overall health among U.S. adults. Ethnic minorities for older adults face heightened risks of poor oral health and related health conditions, while experiencing disparities in access to care. This study aimed to systematically examine and synthesize existing literature to assess the extent to which oral health disparities exist among ethnic minority older adults in the U.S. and explore the roles of socioeconomic factors on these disparities. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, we conducted a systematic review of peer-reviewed articles published in English …