Effect Of Intramedullary Nailing Vs Plate Fixation On Bone Union Time In Distal Tibial Fractures, Madeline Wasmund

The PA Department Journal of Medical Science

Distal tibia fractures are complex fractures due to the intricate anatomy and minimal soft-tissue protection. There are currently two techniques that are mainstays for repairing a distal tibia fracture: intramedullary nailing and plate fixation. This study explores the bone union time between these two different techniques. PubMed was searched with a specific search strategy using the terms “intramedullary rod”, “plate/screw fixation”, “tibial fractures”, and “time to bone union.” Filters were applied to find articles that were most relevant, which resulted in 4 articles, each of which was appraised. Three articles were systematic reviews/meta-analyses comparing intramedullary nail fixation and plate fixation …

The Impact Of Glucose Exposure On Organic Cation Transporters (Oct) Function In A Corneal Epithelial Cell Line, David A. Garza

Theses & Dissertations

Organic cation transporters (OCT) facilitate the movement of neurochemicals and medications, contribute to the removal of cellular waste, and facilitate neuronal communication. Three subtypes of these high-capacity, low-affinity transporters (OCT1, OCT2, and OCT3) are differently expressed in peripheral tissues such as the liver, kidneys, as well as the central nervous system. OCTs are also expressed in ocular tissues. Chronic hyperglycemia is a complication commonly associated with diabetes that can lead to ocular diseases such as diabetic keratopathy, which affects the cornea. In this project, we expose immortalized human corneal epithelial cells (HCE-S) to various glucose concentrations to study their impact …

Expanding The Role Of Muscle Stem Cell Fusion In Muscle Under Hypertrophic Stimulus, Jensen Goh Zhong Sheng

Theses and Dissertations--Physiology

Muscle stem cells (MuSCs) are a unique stem cell population that can activate in response to both injury and growth stimuli. Studies on muscle regeneration have shown MuSC activation follows a uniform progression through proliferation, differentiation, and fusion. Therefore, to determine whether MuSC replication is a prerequisite for differentiation under hypertrophic stimulus, I used a lineage-tracking mouse model (Pax7^rtTA; TRE-H2B-GFP) to label MuSC nuclei and simultaneously tracked DNA synthesis via EdU incorporation. This dual-labeling approach allowed us to not only distinguish MuSC-derived nuclei but also demarcate which MuSC had proliferated prior to fusion. I then employed a mechanical …

The Fascia Iliaca Regional Nerve Block Using Ultrasound And Landmark Technique: An Objective Structured Clinical Examination For Nurse Anesthetists, Braxton T. Beech, Parker F. Rigby

Doctoral Projects

The fascia iliaca block (FIB) is an effective regional anesthesia technique used in various clinical settings, including operating rooms, emergency departments, and pain management clinics. Despite its advantages in reducing postoperative complications and minimizing opioid use, FIB remains underutilized among Certified Registered Nurse Anesthetists (CRNAs), primarily due to limited exposure and training. This doctoral project examines the implementation of an Objective Structured Clinical Examination (OSCE) as an educational intervention to enhance CRNA proficiency in performing FIB using both ultrasound-guided and landmark techniques.

A pre- and post-test study design was conducted with 18 CRNA participants attending a continuing education workshop. Demographic …

Advanced Interactions Of Directed Energy With Retinal Pigment Epithelial Cells And Their Photochemical And Photothermal Responses, Jin B. Ha

Theses & Dissertations

Excess optical radiation can injure the retina through either rapid heat deposition (photothermal damage) or cumulative photo‑oxidative stress (photochemical damage), yet current laser‑safety limits treat these mechanisms as independent. To test that assumption, this dissertation integrated systematic wavelength, duration and temperature‑controlled laser exposures with live/dead fluorescence imaging in a melanin‑loaded hTERT‑RPE1 monolayer model. First, concurrent 447 nm (blue) and 2 µm (infra‑red) beams delivered for 200 s demonstrated a strong thermal–photochemical synergy: each beam alone was sub‑threshold (≤25 % lethality) but together produced 100 % RPE death without exceeding 50 °C, proving that modest heating markedly lowers the photon dose …

Machine Learning Based Medical Ultrasound Image Classification And Grad-Cam Interpretation, Victoria C. Hemphill

All Theses

This work takes a step in creating a diagnostic tool for the classification decision process of Achilles tendinopathy using ultrasound images. An attention-based multiple instance learning model is developed to classify the images. Typically, doctors capture multiple ultrasound images of the Achilles tendon during a study to determine a complete diagnosis. Multiple instance models adopt this behavior by providing a single label for a set of instances (images). The images are grouped into ”bags” at the study level and passed into the model. The MIL model then uses its attention property to assign an importance score to each image to …

Peripheral Neuroimmune Mechanisms Of Chronic Back Pain, Aleyah Esther Goins

Biomedical Sciences ETDs

Chronic back pain (CBP) affects 1 in 10 people worldwide, reducing mobility, productivity, and quality of life. Despite its prevalence, non-addictive treatments remain limited due to an incomplete understanding of chronic pain mechanisms. This dissertation examines peripheral neuroimmune interactions in CBP using a urokinase-type plasminogen activator (uPA)-induced mouse model (uPA-CBP). uPA, a pro-inflammatory serine protease, was injected into the L2/L3 lumbar spinous ligament, inducing prolonged mechanical and cold hypersensitivity. Flow cytometry of dorsal root ganglia (DRG) showed increased CD45+CD11b+ myeloid cells in males and CD45+CD3+CD4+ lymphocytes in females. DRG neurons from male uPA-CBP mice exhibited heightened action potential firing. Pharmacological …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

The Effectiveness Of Botulinum Toxin Injections In The Management Of Chronic Neck And Shoulder Myofascial Pain: A Nursing Perspective, Jia Zhou

Nursing | Senior Theses

Abstract

Background

Chronic neck and shoulder myofascial pain has long been challenging patients and medical professionals due to its limited response to traditional therapies on top of high recurrence. Physical therapy, oral analgesics, and trigger point injections have only provided partial or short-term relief. As a result, botulinum toxin type A injections have been explored as an alternative treatment. Previous studies have shown promising short-term outcomes, but concerns regarding long-term safety, cost-effectiveness, and potential adverse effects, particularly in older adults, have remained unresolved. These gaps have highlighted the need for comprehensive evaluation from both clinical and nursing perspectives.

Objective

The …

Fabricating Silver-Ceria Polymer Nanocomposite Scaffolds For Biomedical Therapeutic Applications, Shreya S. Pawar

Honors Undergraduate Theses

Improper healing of bone fractures and limited regeneration of bone following bone tumor resection remain a prevalent complication worldwide. Long-term effects of this include joint instability, limited movement, and arthritis. Bone infections (osteomyelitis), reactive oxygen species (ROS) generation via excessive inflammation, and underlying conditions such as osteoporosis can contribute to suboptimal bone tissue regeneration. ROS accumulation stimulates osteoblast apoptosis, while promoting osteoclast differentiation. These processes inhibit mineralization and osteogenesis. Conventional therapeutics involve the utilization of drugs and bone grafts. However, these approaches pose limitations and can result in subsequent complications. Microbial infections, ROS accumulation, and excessive inflammations are factors that …

Stargardt’S: Trends In Treatment Modalities, Dallas Myers

Theses and Graduate Projects

Background: This review is aimed at furthering understanding of Stargardt’s, including disease pathophysiology, treatment methods, and the future of vision restoration.

Purpose: Stargardt’s (STGD) was initially discovered in 1909, but it was not fully understood until 1997. It is the most common form of inherited macular degeneration. There are few resources for patients and providers regarding treatment options and lifestyle recommendations.

Methods: A comprehensive literature review was conducted using NIH, UpToDate, and Google Scholar. Specific terms are further detailed in the review. Inclusion criteria were studies focused on STGD patients. Exclusion criteria for were those that only …

Evaluation Of Myogenic Differentiation Potential Of Bmd Ipscs In Vitro And The Effect Of Ubiquitination Inhibitors On Dystrophin Stability In Vivo, Muchen Liu

Dissertations and Theses (Open Access)

Background: Muscular dystrophies are heterogeneous groups of inherited diseases leading to progressive muscular weakness and degeneration. In the case of Becker muscular dystrophy (BMD), non-disrupting mutations of the DMD gene reading frame is the causative defect. By the age of 30s, about 60 to 70% of BMD patients develop cardiomyopathy, which is often lethal. Unfortunately, there is currently no cure for BMD. Meanwhile, improvement of dystrophin stability by repressing polyubiquitination is a promising strategy. The application of human iPSCs in tissue regeneration also serves as a potential therapeutic strategy. This study aims to test the efficacy of selected drugs interfering …

Examining The Impact Of Firearm Recoil During A Round Of Trap Shooting On Neurometabolic Changes Associated With Traumatic Brain Injury, Lakota Jones

Theses, Dissertations and Capstones

The CDC identifies concussion as a blunt, blow, or jolt to the head resulting in brain injury. Shooting sports do not impose a direct blow to the head but instead inflict rapid acceleration to the brain via recoil transfer. Exposure to rapid, repetitive recoil may cause physiological disturbances in the brain, therefore resulting in mild traumatic brain injury (TBI). Chronic recoil transfer and overpressure exposure influencing neurometabolic changes of TBI have yet to be measured. The objective of this study was to examine kinetic energy experienced in trap and skeet shooters following one round of shooting in comparison to neurometabolic …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

The Validity And Reliability Of Ultrasound As A Tool For Assessing Skeletal Muscle Characteristics In The Pediatric Population, Elizabeth Seewer

Theses and Dissertations (ETD)

Annually, around 5 million people in the U.S. are admitted to Intensive Care Units (ICU) due to critical conditions, with pediatric patients comprising 21% of these admissions. Approximately 40% of pediatric ICU (PICU) patients require mechanical ventilation and extended stays, and about 6% result in death. Survivors often face long-term disabilities, including loss of skeletal muscle mass (SMM), a risk factor for morbidity and mortality. Abdominal computed tomography (CT) scans, often performed during PICU admissions, can assess muscle mass but pose risks of increased cost and radiation exposure. While CT and Magnetic Resonance Imaging (MRI) are gold standards for muscle …

Anatomy Of The Ankle And Ankle Injuries In Athletes, Isabelle G. West

Honors Capstones

The purpose of this project was to learn about the anatomy of the ankle joint, explore common ankle injuries in athletes, and research how they are treated overall and in a physical therapy setting. To do so, a dissection of the ankle joint was completed with Mrs. Kara Coffman-Rea in the cadaver lab as well as an exploration of plastinated models. Additionally, a literature review of current research on the ankle was completed. Though many structures of the ankle joint were identified through dissection, the focus of the literature review is on the structures of the lateral ankle and the …

Pectoralis Nerve Block Compared To Thoracic Paravertebral Nerve Block In The Mastectomy Patient: Evidence-Based Practice Recommendations, Eric Boyer

Doctor of Nursing Practice Scholarly Projects

Patients undergoing a mastectomy are at increased risk of becoming opioid dependent. Most patients undergoing a mastectomy are diagnosed with breast cancer, and the use of opioids is known to aid in cancer metastasizing due to the suppression of the body's natural killer cells. In addition, regional anesthesia, also known as a nerve block, has long provided a reduction in sensation by blocking the nerve pathway, thus numbing the feeling of pain in the operative area. The Pectoralis nerve block (PECS) and the Thoracic Paravertebral block (TPVB) are used in patients undergoing a mastectomy to help reduce the severity of …

Myod Functions As An Oncogene In Rhabdomyosarcoma By Promoting Survival Through Differentiation And Cyld, Alexander Oles

MUSC Theses and Dissertations

Rhabdomyosarcoma (RMS) is the most common soft tissue cancer among

children, characterized by a skeletal muscle lineage that is impaired from

undergoing terminal differentiation. NF-κB is constitutively active in cancer cells

and plays a critical role in cell survival. Although NF-κB is also activated in RMS,

surprisingly we find that these tumors are less dependent on NF-κB to overcome

stress-induced cell death. Instead, RMS cells survive by being partially

differentiated under the control of the myogenic transcription factor MyoD. Loss of

MyoD or cellular reprogramming dedifferentiates RMS tumor cells and promotes

cell death when exposed to stress. Further, use of …

Sexually-Divergent Differentiation And Inflammatory Response To Osteoclasts, Lilijanna L. Cummings

EWU Masters Thesis Collection

No abstract provided.

Mitochondria As Causes Of And Therapeutic Targets In Chronic Post-Sepsis Skeletal Muscle Weakness, Meagan Scott Kingren

Theses and Dissertations--Pharmacology and Nutritional Sciences

Sepsis, or the organ damage that ensues after the body fails to properly contain a local infection, is the leading cause of in-patient hospitalization in the United States. Advances in critical care medicine over the last 20 years have enabled most sepsis patients to survive the life-threatening dysregulated immune response. However, a majority of survivors report chronic weakness and fatigue years after sepsis, and the cause of this weakness remains largely unknown. This dissertation work focused first on elucidating the major causes of post-sepsis muscle weakness (Aim 1). This aim involved a time-course study to determine when muscle weakness was …

Effects Of Expiratory Muscle Strength Training On Oropharyngeal Swallow Physiology In Persons With Obstructive Sleep Apnea (Osa): A Pilot Study, Ankita Murlidhar Bhutada

Graduate Theses and Dissertations (2019 - present)

Obstructive sleep apnea (OSA) is characterized by frequent narrowing of the upper airway during sleep. The estimated prevalence of swallowing impairments (dysphagia) in OSA patients ranges up to 80% and comprises approximately 50% of the caseload of practicing speech-language pathologists in the United States. Despite the high prevalence of dysphagia, there is a paucity of evidence supporting behavioral intervention(s) for ameliorating swallowing impairments in OSA. This pilot study assessed oropharyngeal swallowing physiology in persons with OSA and the feasibility and acceptability of a behavioral dysphagia intervention that specifically targets upper airway musculature – Expiratory Muscle Strength Training (EMST). A total …

Tourniquet-Induced Ischemia-Reperfusion Injury, Junliang Qian

Theses & Dissertations

Ischemia-reperfusion (IR) is a pathological condition characterized by an initial restriction of blood supply to an organ followed by subsequent restoration of reperfusion associated with exacerbation of tissue damage. For pre-hospital emergency situations and surgical procedures, tourniquet or femoral artery ligation are widely used to stop extremity hemorrhage or create a bloodless operating field. To fully evaluate the underlying mechanisms in IR pathophysiology and potential therapeutic options, we compared tourniquet- and femoral artery ligation-induced IR injuries in the hindlimb of mice. We found that tourniquet/IR-induced acute hindlimb injuries are more severe than those induced by femoral artery ligation/IR, including alteration …

Effects Of Exercise On Parkinson's Symptom Relief, Brooke Burnett

The Eleanor Mann School of Nursing Undergraduate Honors Theses

In this review of twenty research articles, the effects of moderate exercise therapy on the symptoms of Parkinson’s Disease will be explored. Appropriate literature was located using the research question, “In older adults with a Parkinson’s Disease Diagnosis, how does moderate exercise influence the symptoms of this disease?” Twenty peer-reviewed research articles were examined for the impact of different forms of exercise on various symptoms associated with Parkinson’s. Nineteen of the articles reviewed provide substantial evidence in support of exercise therapy as a treatment option for people with Parkinson’s, and one of the articles found inconclusive evidence neither in support …

A Neurophysiological Investigation Of Listening Effort In Normal Hearing Adults Using Fnirs And Pupillometry, Jessica Defenderfer

Theses and Dissertations (ETD)

Real-world conversations are often accompanied by some sort of interference that challenges the clarity of the speaker’s message, causing listeners to exert more effort to understand speech. Previous research has demonstrated that when listening to speech becomes difficult, various regions of the brain are recruited beyond those which engage during optimal listening conditions. However, the neural correlates that underly listening effort are not fully understood. Importantly, the pupillary response can be used to index listening effort, such that pupil size increases with increasing cognitive demand. I proposed that pupillometry can be used to characterize the cortical response, such that changes …

Automatic Posture Correction Utilizing Electrical Muscle Stimulation, Ravi Kiran Kattoju

Electronic Theses and Dissertations, 2020-2023

Habitually poor posture can lead to repetitive strain injuries that lower an individual's quality of life and productivity. Slouching over computer screens and smart phones, asymmetric weight distribution due to uneven leg loading, and improper loading posture are some of the common examples that lead to postural problems and health ramifications. To help cultivate good postural habits, researchers have proposed slouching, balance, and improper loading posture detection systems that alert users through traditional visual, auditory or vibro-tactile feedbacks when posture requires attention. However, such notifications are disruptive and can be easily ignored. We address these issues with a new physiological …

How Exercise Affects The Musculoskeletal System In The Biological Sexes: A Literature Review, Lauren Connolly

Honors Program Theses

Exercise has countless benefits for the human body. Physical activity increases overall health and reduces the risk of developing many chronic diseases. While the entire body is impacted by exercise, the musculoskeletal system is perhaps targeted most directly. Muscle contraction is required to complete any form of exercise, which helps build muscle mass and consequently strengthens bones. The physiology of musculoskeletal growth after exercise is the same for all individuals. However, the magnitude of this growth is not the same for men and women. Men have a profound ability to gain muscle mass that most women are not capable of …

The Effect Of Cancer Cachexia Progression On The Feeding Regulation Of Skeletal Muscle Protein Turnover, Brittany R. Franch

Theses and Dissertations (ETD)

Cancer cachexia is defined as the unintentional loss of skeletal muscle mass with or without fat loss that cannot be reversed by conventional nutritional support. Cachexia occurs in ~20% of cancer patients. More specifically, 50% of lung cancer patients, the most common cancer worldwide, develop cachexia. Cachexia occurs most often in lung and gastrointestinal cancers, whereas breast and prostate have the lowest rate of cachexia. Cancer-induced cachexia disrupts skeletal muscle protein turnover (decreasing protein synthesis and increasing protein degradation). Skeletal muscle’s capacity for protein synthesis is highly sensitive to local and systemic stimuli that are controlled by mTORC1 and AMPK …

The Impact Of High Intensity Interval Training On Neurogenesis And Angiogenesis In The Dentate Gyrus, Darrin Lenhart

Seton Hall University Dissertations and Theses (ETDs)

BACKGROUND: Exercise is associated with improved neuronal health and longevity, synaptic plasticity, cerebral blood volume, overall brain volume, and neurogenesis which collectively may have the power to forestall neurodegenerative disease.

PURPOSE: This study aims to explore the impact of high intensity interval training on individuals with mild cognitive impairment using a range of cognitive, physiological, and biomechanical measures. Specifically, this study seeks to assess the impact of high intensity interval training on neurogenesis and angiogenesis in the dentate gyrus of individuals with mild cognitive impairment versus healthy age-matched controls, as assessed by urinalysis of BDNF levels, performance on the Rey …

Multiple Sclerosis And Its Symptom Management Through Supplementation And Dietary Planning, Lindsey J. Davis

Selected Honors Theses

Multiple Sclerosis (MS) is an autoimmune, neuroinflammatory disorder that is characterized by the breakdown of myelinated axons in the Central and Peripheral Nervous Systems. It is a potentially debilitating autoimmune disease that affects almost 1 million people in the United States, and nearly 2.5 million people worldwide. The precise etiology of MS is still being researched, but much progress has been made towards understanding the molecular mechanisms and impactful ways to treat this disease. While there is still no cure, new treatment plans are constantly being orchestrated in effort to alleviate the burden that MS carries. Combination treatment plans have …

Roles And Regulation Of Satellite Cells In Skeletal Muscle Regeneration, Sydney Vlasman

University Honors Theses

Skeletal muscle has an innate ability to self-regenerate in response to certain stimuli. In the case of trauma, muscle resident stem cells are required to meet the regenerative needs of the tissue. These resident stem cells, called satellite cells (SCs), are crucial in the regenerative process following injury; understanding the major factors which regulate satellite cell activity can provide valuable insight for regenerative medicine. The ability to implement and properly activate satellite cells has immense potential in the treatment of conditions including trauma, degenerative disorders, and age-related sarcopenia. This review will discuss the current understanding of satellite cell-mediated regeneration and …