Medicine and Health Sciences Commons^™

Synthetic Interbody Devices And Traditional Bone Graft Are Associated With A Similar Rate Of Surgical Complications After 1-2 Level Anterior Cervical Discectomy And Fusions, Geet Shukla, Abhijith V. Matur, Xu Tao, Syed Khalid, Rebecca Garner, Justin Gibson, Daryn Cass, Andrew Wu, Seth Street, Julia Garcia-Vargas, Jay P. Mehta, Kelly Childress, Henry Ofori Duah, Benjamin Motley, Joseph Cheng, Owoicho Adogwa

College of Nursing Faculty Research and Publications

Study Design:  Retrospective cohort. Objective:  To compare the rates of all-cause surgical complications of synthetic interbody devices versus allograft or autograft in patients undergoing 1-2 levels anterior cervical discectomy and fusion (ACDF) procedures. Summary of Background Data:  Cervical degenerative disorders affect up to 60% of older adults in the United States. Both traditional allograft or autograft and synthetic interbody devices (polyetheretherketone or titanium) are used for decompression and arthrodesis, with increasing utilization of the latter. However, the differences in their postsurgical complication profiles are not well-characterized. Patients and Methods:  Patients who underwent 1-2 level ACDFs for cervical radiculopathy or myelopathy …

Rare Case Of Open Comminuted Scaphoid Fracture Dislocation: Treatment With Free Bone Graft And Locking Plate, Makoto Fukuda, Masahiro Miyashita, Masataka Yasuda

Children’s Nutrition Research Center Staff Publications

To the best of our knowledge, there are no reports in the literature of an open comminuted scaphoid fracture dislocation. We present such a rare case. The case report illustrates the case of a 58-year-old right-handed press operator who injured his left wrist when his hand got caught in a press machine. He received initial treatment at another hospital and was subsequently referred to our hospital. Eight days after the injury, surgery was performed under the brachial plexus block. Successful bone fusion was achieved through volar locking plate fixation, primary free bone grafting from the radius, and Kirschner wire fixation. …

Prevalence Of Distal Symmetrical Polyneuropathy By Diabetes Prevention Program Treatment Group, Diabetes Status, Duration Of Diabetes, And Cumulative Glycemic Exposure, Christine G Lee, Adam Ciarleglio, Sharon L Edelstein, Jill P Crandall, Dana Dabelea, Ronald B Goldberg, Steven E Kahn, William C Knowler, Maxwell T Ma, Neil H White, William H Herman, Diabetes Prevention Program Research Group

Children’s Nutrition Research Center Staff Publications

Objective: To assess associations between distal symmetric polyneuropathy (DSPN) and Diabetes Prevention Program (DPP) treatment groups, diabetes status or duration, and cumulative glycemic exposure approximately 21 years after DPP randomization.

Research design and methods: In the DPP, 3,234 adults ≥25 years old at high risk for diabetes were randomized to an intensive lifestyle (ILS), metformin, or placebo intervention to prevent diabetes. After the DPP ended, 2,779 joined the Diabetes Prevention Program Outcomes Study (DPPOS). Open-label metformin was continued, placebo was discontinued, ILS was provided in the form of semiannual group-based classes, and all participants were offered quarterly lifestyle classes. Symptoms …

Avoidant/Restrictive Food Intake Disorder Prevalence Is High In Children With Gastroparesis And Functional Dyspepsia, Isha Kaul, Helen Burton-Murray, Salma Musaad, Yiming Mirabile, Danita Czyzewski, Miranda A L Van Tilburg, Andrew C Sher, Bruno P Chumpitazi, Robert J Shulman

Children’s Nutrition Research Center Staff Publications

BACKGROUND: Avoidant/restrictive food intake disorder (ARFID) prevalence in children with gastroparesis (Gp) and/or functional dyspepsia (FD) is unknown. We aimed to identify ARFID prevalence and trajectory over 2 months in children with Gp, FD, and healthy children (HC) using two screening questionnaires. We also explored the frequency of a positive ARFID screen between those with/without delayed gastric emptying or abnormal fundic accommodation.

METHODS: In this prospective longitudinal study conducted at an urban tertiary care hospital, patients ages 10-17 years with Gp or FD and age- and gender-matched HC completed two validated ARFID screening tools at baseline and 2-month follow-up: the …

Impact Of Sustained Calorie Restriction And Weight Cycling On Body Composition In High-Fat Diet-Fed Male And Female C57bl/6j Mice, Daniel L Smith, Yongbin Yang, Luis M Mestre, Beate Henschel, Erik Parker, Stephanie Dickinson, Amit Patki, David B Allison, Tim R Nagy

Children’s Nutrition Research Center Staff Publications

Objective: The objective of this study was to investigate body composition changes with weight cycling (WC) among adult C57BL/6J mice with diet-induced obesity.

Methods: A total of 555 single-housed mice were fed a high-fat diet ad libitum (AL) from 8 to 43 weeks of age. The 200 heaviest mice of each sex were randomized to the following four groups: ever obese (EO, continued AL feeding); obese weight loser (OWL, calorie-restricted); obese weight loser moderate (OWLM, body weight halfway between EO and OWL); and WC (diet restricted to OWL followed by AL refeeding cycles). Body weight and composition data were collected. …

Relationship Between Food Security, Nutrition Security, And Diabetes: The Role Of Supplemental Nutrition Assistance Program Participation, Maha Almohamad, Jayna M Dave, Eric E Calloway, Ruosha Li, Shreela Sharma

Faculty, Staff and Student Publications

BACKGROUND: Inadequate nutrition and poor diet quality are associated with a heightened risk of diabetes. The connection between food insecurity measures and diabetes has been established, with evidence indicating that Supplemental Nutrition Assistance Program (SNAP) participation contributes to reductions in food insecurity. Recently developed nutrition security measures, defined as the ability to acquire healthful foods to prevent diseases, and their association with diabetes and SNAP participation are not yet understood.

OBJECTIVES: This study aimed to assess the relationship between food security and nutrition security in relation to diabetes overall and by SNAP participation and nutrition security as potential modifiers.

METHODS: …

Dementia Of The Alzheimer’S Type In Adults With Down Syndrome: Knowledge Among Graduate Students In Physical Therapy, Occupational Therapy, And Speech-Language Pathology., Abigail Regan Donaway

Electronic Theses and Dissertations

This non-experimental study utilized a convenience sample (N = 322) to investigate graduate students in physical therapy (PT), occupational therapy (OT), and speech-language pathology’ s (SLP) knowledge of the connection between Down syndrome and dementia of the Alzheimer's type (DAT). Ninety-two-point-five percent of participants were female, and 79.80% were white. All participants completed a survey comprised of items relating to information about general knowledge (i.e. facts) of the association between DS and DAT, the signs/symptoms that occur in each stage of dementia of the Alzheimer’s type for people with Down syndrome, and familiarity regarding the diagnosis and care. Descriptive and …

Tongue-Tie: Impact On Oropharyngeal Function During Swallow., Kolbie A. Vincent

Electronic Theses and Dissertations

Swallowing is an intricate process involving over 50 muscle pairs and numerous nerves, with dysphagia resulting from deficits in various stages (Hennessy & Goldenberg, 2016). Lingual restriction may adversely impact swallowing function, affecting bolus preparation, size, and overall efficiency. Tongue-tie can pose challenges to speech, chewing, and swallowing (Becker & Mendez, 2022; Chaubal et al, 2011; García-Pola, M. J., et al., 2002). This pilot study seeks to determine how tongue-tie affects swallowing function in an adult male, and whether surgical revision of a submucosal lingual tether leads to measurable changes in oropharyngeal swallow function. Results showed inconsistent changes in diameter …

Exploring Influencing Factors On The Adoption Of Non-Pharmaceutical Interventions During Pandemics: Covid-19 As An Example., Ahmed Abdulmohsen I Alobaydullah

Electronic Theses and Dissertations

Background: Pandemics are associated with loss of life, hospitalizations, and disruption to people’s social and economic lives. As the 2019 pandemic illustrates, COVID-19 can be prevented by pharmaceutical and non-pharmaceutical interventions (NPIs). Recommended measures such as wearing a mask, washing hands, social distancing, and self-quarantine have been proven to curb the spread of the coronavirus. Identifying the factors associated with adherence to NPIs is the first step in understanding which levers of change to pull when designing health promotion interventions such as health communication campaigns. This dissertation explores these factors and proposes a health communication framework during pandemics. Research Questions: …

Control Of Muscle Activation In The Lower Limbs During Leg Cycling After A Motor Complete Spinal Cord Injury., Jae Fish

Electronic Theses and Dissertations

Spinal cord injury (SCI) affects the central nervous system (CNS) causing muscle paralysis and autonomic dysfunctions throughout the body. Muscle activation after SCI is essential to facilitate functional recovery and may be produced via remaining input from supraspinal centers, the central pattern generators (CPG), or muscle stretch reflex responses. In this study, assisted leg cycling is evaluated as a tool to identify the neural structure control of muscle activation after motor complete SCI. Eight individuals with a complete or sensory incomplete SCI between C2 and T5 participated in the study. Participants completed leg cycling trials with and without supraspinal intention …

Modifiers Of The Effects Of Different Dimensions Of Social Support On Cardiac Rehabilitation Adherence., Melissa Amraotkar

Electronic Theses and Dissertations

Introduction: Cardiovascular disease (CVD) is a leading cause of mortality worldwide. Cardiac Rehabilitation (CR) is a Class I, level A indication for treatment and prevention further complications of CVD. The attendance rate for CR in the U.S. is very low, especially among female patients. Dimensions of social support, sex of the support provider, and the quality of primary intimate relationship are associated with health-promoting behavior and may influence CR adherence in patients. Purpose: The purpose of this study was to examine the relationship between dimensions of social support and CR adherence, and whether these relationships were moderated by factors such …

Investigation Of Avaren-Fc's Therapeutic Potential Against Ovarian Cancer., Katarina Lee Mayer

Electronic Theses and Dissertations

This thesis describes the investigation of Avaren-Fc (AvFc), a novel lectin-based therapeutic fusion protein consisting of the recombinant Avaren lectin and the Fc region of human IgG1, against ovarian cancer. AvFc possesses selectivity toward tumor associated N-linked high-mannose-type glycans. The present study demonstrates AvFc’s in vitro activity against OVCA cell lines via antibody-dependent cell-mediated cytotoxicity and its ability to extend the survival of mice challenged with murine ID8 OVCA cells after repeated systemic administration. Furthermore, AvFc treatment in this model was found to increase the presence of peritoneal leukocytes, suggesting a shift toward an improved antitumor immune response. Another key …

Electrochemical Modulation Of Surface Plasmon Wave To Investigate Dna-Based Sensing Platforms And Detection Of Sars-Cov2., Anil Sharma

Electronic Theses and Dissertations

This study offers a thorough comparative analysis of optical and electrical signaling strategies for assessing the electrochemical properties of different redox-labeled DNA-based biosensing platforms. In addition, it illustrates the development of an optical interrogation technique with electrochemical modulation of surface plasmon waves (ECM-SPW) as a route for analyzing and implementing DNA-based hybridization sensors. For those quantitative analyses, we chose a model sensing platform composed of a methylene blue (MB)-modified single-stranded DNA (ssDNA) signaling probe and an unlabeled capture ssDNA probe that complements the signaling probe. Two types of signaling probes were employed in this work: one with MB attached to …

Preclinical Stability Assessment Of Epicertin, A Biotherapeutic Candidate For Ulcerative Colitis Mucosal Healing., Wendy Michelle Kittle

Electronic Theses and Dissertations

EPICERTIN is a biotherapeutic candidate for mucosal healing in ulcerative colitis (UC), a major type of inflammatory bowel disease (IBD). Despite the critical role of mucosal healing in achieving successful remission of UC, there are currently no targeted mucosal healing agents available. EPICERTIN has previously demonstrated epithelial repair and mucosal healing activity in colon epithelial cells, murine colitis models, and tissue explants from IBD patients, highlighting its therapeutic potential to meet this unmet need for UC patients. The development of appropriate chemistry, manufacturing, and controls (CMC) data will facilitate our ultimate goal to bring EPICERTIN to the clinic for a …

Socioecological Factors Associated With The Timing Of Prenatal Care Initiation In Kentucky And Beyond: An Exploratory Study., Melissa B. Eggen

Electronic Theses and Dissertations

Objectives: Early prenatal care is initiated in the first twelve weeks of pregnancy and is a known contributor to improved short- and long-term outcomes for women and infants. Despite its known benefits, many women do not initiate early prenatal care. The purpose of this dissertation was to explore the socioecological factors associated with the timing of prenatal care initiation in the United States and in Kentucky. Methods: Chapter Two of this dissertation used a scoping review methodology to identify barriers and facilitators related to first-trimester prenatal care initiation among women in the United States. Chapter Three of this dissertation used …

Examining The Relationship Between Mass Incarceration, Gender Norms, And Hiv Vulnerability For Formerly-Incarcerated Black Men Who Have Sex With Men And Women., Adrienne B. Smith

Electronic Theses and Dissertations

In 2018, Black Americans represented 42% of new HIV diagnoses, despite comprising only 13% of the population. Moreover, Black men accounted for three-quarters of new HIV cases in 2016, with Black gay/bisexual men contributing to the majority of incidence among Black Americans. Existing literature suggests that individual behavior alone cannot explain these racial inequities in HIV rates. This study aims to explore the role of the criminal legal system (CLS) as a structural determinant of health, given its historical racial implications that disproportionately affect Black Americans. Additionally, the study examines masculinity’s influence as a predictor of risky sexual behavior. This …

A Mixed Methods Investigation Of First-Year Medical Students' Competency Development In The Gross Anatomy Laboratory Context., Emily M. Porta-Miller

Electronic Theses and Dissertations

Competency-based medical education and competency assessment are common in the clerkship years of undergraduate medical education and in graduate medical education; however, they are less commonly included in the preclinical, or basic science, years of medical education. This study investigated the effects of a novel competency-based curricular thread which assessed Communication, Teamwork, and Professionalism competency development of first-year medical students in the gross anatomy lab context. The study employed a convergent parallel mixed methods approach. The quantitative phase used a pretest/posttest design with paired dependent t-tests to determine if students’ exhibited growth, stagnancy, or decline within any of the …

Assessing The Relationship Between Racism In Medicine, Medical Mistrust And Cardiovascular Disease Among Black American Adults., Osayande Agbonlahor

Electronic Theses and Dissertations

Cardiovascular disease (CVD) persists as the leading preventable cause of death and disability among Black Americans in the United States. Structural and psychosocial factors such as racism have been highlighted as a fundamental cause of persistent cardiovascular health disparities in the U.S. This study examined the associations between racism in medicine, medical mistrust and CVD among Black Americans using the Minority Stress Theory as a theoretical framework. This study evaluates the sociodemographic differences in the quality of care received among Black Americans. Data from the Health Information National Trends Survey, 2022 and the Consumer Assessment of Healthcare Provider and Systems …

Reimaging Safety After Sexual Violence: A Qualitative Exploration Of Survivors' Experiences With Formal And Informal Crisis Response Networks., Hallie Ruth Decker

Electronic Theses and Dissertations

Sexual violence (SV) is a highly prevalent public health and human rights concern impacting communities across the United States. SV is associated with a myriad of adverse physical, reproductive, sexual, mental, behavioral, financial, and social health outcomes which may be acute or chronic. Health challenges associated with post-traumatic stress and post-traumatic stress disorder are particularly common among victims and survivors of SV. Engagement in early psychological/psychosocial intervention strategies may prevent or reduce PTSD-related symptomatology after experiencing an SV encounter. Despite the availability of crisis response and support options to support individuals who have experienced SV, significant barriers exist across social …

"They Are Who We Thought They Were": The Influence Of White Supremacist Discourse On Voter Suppression And Black Health., Tanisha Howard Lewis

Electronic Theses and Dissertations

Political systems in the United States have contributed to health outcomes in the through the historic and legal doctrine related to race and racism, segregation, housing, employment, and education. In recent years, significant attention has been given to theorizing the political determinants of health and what it means in the overall conversation about health equity. The equity implications of the political determinants of health are innumerable because they are the origin point of the structural determinants of health and the primary drivers of the social determinants of health, which span from environmental conditions to food security. The focal determinant of …

Comparison Of Specific Jaw Position Measurements On A Static And Dynamic Virtual Patient., Payton Lofton

Electronic Theses and Dissertations

This study aimed to compared the differences in jaw position measurements in protrusive and open/close positions on a static virtual patient created using 3dMD System to those from a dynamic articulation of a virtual patient (MODJAW) as well as measurements between the Cadiax and MODJAW. Six fiducial surface markers were placed on a volunteer subject’s face and dynamic facial scans of protrusive and open/close jaw movement acquired and exported. A CBCT scan was also acquired. The mandible and maxilla were segmented and loaded into Vultus and aligned to the facial scan using the fiducial markers. Results were compared using a …

Rockin’ Rehab: Novel Rocking Chair For Children With Spinal Cord Injury To Enable Trunk Muscle Activation And Detect Muscle Activation Patterns., Johnathan Jay George

Electronic Theses and Dissertations

Introduction: Activity-based locomotor training improves trunk control in children with spinal cord injury (SCI), and there is need for additional activities to allow these children to activate trunk muscles. The purpose of this research was to design, fabricate, and evaluate a rocking chair for children with SCI, and to investigate the activation of muscles during use. Sensorization of the chair to confirm muscle activation is also explored. Methods: Quality Function Deployment (QFD) design methodologies identified and ranked needs and features for the rocking chair. A design was developed and evaluated via finite element analysis. The chair was fabricated and tested …

Biofeedback Using Virtual Reality, Conscious Interoception, And Breathing Exercises Modulates Blood Pressure And Heart Rate Variability In People With And Without Cervical Spinal Cord Injuries., Rachel Torres

Electronic Theses and Dissertations

There is an immediate need for fast-acting blood pressure (BP) modification without the side effects of pharmaceutical interventions for people with cervical spinal cord injuries (SCI), who often suffer from dangerous increases and decreases in BP.^1,2 First, we compared mental to virtual reality (VR) imagery with the addition of breathing exercises and guided interoceptive attention, investigating participants’ ability to volitionally change their BP and heart rate variability (HRV), alternating three-minute stimulating and relaxing training cycles in 17 noninjured (NI) participants and 14 participants with SCI. Second, we trained 13 people with SCI and seven NI control participants for one …

Acute Mechanical Circulatory Support In The Cardiovascular Icu: Investigating The Effects Of An Interactive Cardiovascular Dynamics Simulation Program On Nursing Clinical Judgment., Casey Saulman

Electronic Theses and Dissertations

Introduction: Education on acute mechanical circulatory support (AMCS), a therapy used in the cardiovascular intensive care unit (CICU) to manage cardiogenic shock (CGS) is limited for CICU nurses. There is a need to explore clinical judgment in CICU nurses and provide innovative learning experiences that foster judgment when managing AMCS. Methods: This mixed methods feasibility study investigated the effects of an interactive cardiovascular dynamics simulation program on CICU nurses’ knowledge, clinical reasoning, and clinical judgment. Semi-structured interviews explored the participants’ perceptions of the learning experience. Results: Twenty-one nurses completed the cardiovascular dynamics simulation program. The majority were white (85.7%), female …

An Interpretable Framework To Identify Responsive Subgroups From Clinical Trials Regarding Treatment Effects: Application To Treatment Of Intracerebral Hemorrhage, Yaobin Ling, Muhammad Bilal Tariq, Kaichen Tang, Jaroslaw Aronowski, Yang Fann, Sean I Savitz, Xiaoqian Jiang, Yejin Kim

Faculty, Staff and Student Publications

Randomized Clinical trials (RCT) suffer from a high failure rate which could be caused by heterogeneous responses to treatment. Despite many models being developed to estimate heterogeneous treatment effects (HTE), there remains a lack of interpretable methods to identify responsive subgroups. This work aims to develop a framework to identify subgroups based on treatment effects that prioritize model interpretability. The proposed framework leverages an ensemble uplift tree method to generate descriptive decision rules that separate samples given estimated responses to the treatment. Subsequently, we select a complementary set of these decision rules and rank them using a sparse linear model. …

Barriers And Facilitators To Kinship Care In Texas: A Multi-Stakeholder, Mixed Methods Perspective, Lauren Malthaner, Jill Mcleigh, Hilda Loria, Erinne Conner, Mike Henson-Garcia

Caregiver Needs and Supports

Kinship caregivers face numerous barriers to providing care for children placed with them and limited facilitators to help ensure successful placements. Although the needs of kinship caregivers are being examined and prioritized in the legislature, operational and policy-level interventions are needed. Results from this study allow for interventions tailored to the needs of kinship caregivers in the State of Texas as identified by a multitude of stakeholder groups.

For questions about this study or others, please email [email protected]

childrens.com/fostercare

Comparing Ait And Eft In Reduction Of Negative Emotions Associated With A Past Memory: A Randomized Control Study, Gregory Brown, Kavita Batra, Emily Dorin, Raveena Bakhru, Andrew Han, Arianna Palermini, Robert Sottile, Sherine Khanbijian

Psychiatry & Behavioral Health Faculty Research

PURPOSE: To assess whether Quick AIT was statistically equivalent to Basic Recipe Clinical EFT for the reduction of negative emotion associated with a past event.

Optimization Of Vagus Nerve Stimulation (Vns) And The Use Of Cervical Vns As A Treatment For Heart Failure With Reduced Ejection Fraction, Misty Owens

Electronic Theses and Dissertations

Vagus nerve stimulation (VNS) is a promising neuromodulatory therapy under investigation for a range of disorders, including heart failure, gastric dysmotility, and migraine. Two primary forms of VNS are currently investigated: cervical VNS (cVNS), involving surgically implantation to activate vagal afferents in the cervical branch in the neck and transcutaneous auricular VNS (taVNS) which subcutaneously stimulates the auricular branch in the outer ear. The nucleus of the solitary tract (NTS) serves as a relay-station receiving 90% of vagal afferents, enabling connections with higher-order brain regions and other brainstem nuclei like the spinal trigeminal nucleus (Sp5) and locus coeruleus (LC), facilitating …

An Analysis Of Strength Training Implementation In Ballet, Claire Hoover

Senior Honors Theses

Ballet, a style of dance that is known for its 180-degree external rotation, extreme precision, discipline, and aesthetics, is an athletic activity that is undertaken by many young people, particularly females. Although ballet has many athletic components, recent studies have shown there are a variety of weaknesses that impact its participants, including the female athlete triad, lack of lower extremity muscular strength, risk of injury, and overtraining. According to recent research, strength training, although not historically paired with ballet, could minimize ballet dancers’ deficiencies by increasing muscular strength and reducing risk of injury and incidence of the female athlete triad. …

Detection And Extraction Of Pfoa And Pfos Via Mips, Joseph Redding

Senior Honors Theses

Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) are utilized as surfactants in many different materials. With an immensely stable structure due to the presence of carbon-fluorine bonds, PFOA and PFOS are resistant to degradation. Known to persist in water resources, these compounds tend to bioaccumulate and impute toxic effects on human health, such as decreased fertility and immune function. To date, there exists no effective approach to the removal of these lingering compounds. Because of the health risks, there is increasing urgency to devise a means by which to detect and withdraw PFOA and PFOS from the environment. In …