Doctor of Healthcare Administration (D.H.A.), Franklin University, 2023, Health Programs

Massive bleeding remains one of the leading potentially preventable causes of death in the United States, accounting for more than 50% of mortality rates (Marietta, Marco et al., 2011). Massive transfusion protocol (MTP) is a rapid transfusion of a large amount of blood and blood products (more than ten units of red blood cells in twenty-four hours, or four units of red blood cells in an hour, or any four blood components in 30 minutes) in a short period of time (Thurn et al., 2019). The blood products' ratios included in the massive transfusion protocol are distinct and composed of red blood cells, fresh frozen plasma, and platelets. Developing and establishing electronic records for massive transfusion protocols may improve patient outcomes (Broxton et al., 2017). Using liquid plasma during a massive transfusion protocol may improve patient survival rate by decreasing the blood product delivery time to the patient's bedside and reducing healthcare costs by lowering blood product waste (Beckermann et al., 2022). In this quantitative study, the researcher analyzed retrospective medical records from a Level One Medical Trauma Center in the Southwest United States to answer the research question. Data regarding using liquid plasma in massive blood transfusion outcomes were collected from the hospital records for pre- and post-liquid plasma usage implementation. The study investigated the following research question: For patients who require emergency and massive transfusion, what is the impact of using liquid plasma compared to fresh frozen plasma on blood product wastage and plasma-saving cost one year before and after using liquid plasma?

Master of Science (MS), Ohio University, 2018, Mechanical Engineering (Engineering and Technology)

Cell rolling onto vascular endothelium under hydrodynamic blood flow is an important mechanism in many physiological and pathological processes, such as inflammatory response and tumor metastasis. The blood-borne cells are in direct contact with the most inner layer of endothelium formed by a highly compliant layer of endothelial cells. The effect of substrate stiffness on the adhesive dynamics of rolling cells is poorly understood. The goal of this thesis is to develop a modeling framework to understand the physics underlying the specific adhesion of a rolling cell to a soft bio-adhesive substrate subjected to a viscous shear flow. Of particular importance is to predict the effect of substrate stiffness on stable adhesion and rolling velocity of the cell. The developed models show a direct correlation between the state of adhesion and the substrate compliance. The results of this Thesis are anticipated to enhance our understanding of cellular arrest by endothelium and provide a quantitative basis to rational design of the nano-particles for vascular drug delivery.

Doctor of Philosophy (PhD), Ohio University, 2015, Clinical Psychology (Arts and Sciences)

Background: Individuals who donate blood are presented with unique challenges to continuing their donation career such as managing existing fears, perceived lifestyle barriers (such as work or family commitments), and even moving past prior negative donation experiences. Donors must persist through several donations and gain experience throughout the process to internalize the role and expectations of being a blood donor. As such, donors may benefit from interventions which not only increase their ability to overcome perceived barriers to repeat donation but which also enhance their identity as a blood donor. The current research project examined the effect of a post-donation motivational interviewing intervention with implementation intentions on blood donor identity, and donation related intention, as well as actual repeat donation behavior. Study Design and Methods: 142 females and 53 males who ranged in age from 18 to 72 years (Mean = 37.2; SD = 13.5) were recruited from Hoxworth Blood Center in the Cincinnati, Ohio region between October 2013 and January 2015. Following completion of baseline questionnaires, participants were randomly assigned to a postdonation motivational interview with implementation intentions (MI+II) or a nointerview control group and received a telephone call. Participants in the MI+II group completed a brief telephone (<18 minute) interview designed to promote and clarify intrinsic motivations for donating, explore how donating blood fits in with their goals and values, address barriers that may prevent future donation and develop individualized implementation action plans to promote repeat donation. They were then asked to complete follow-up questionnaires regarding blood donor identity, donation intention, attitudes, subjective norms, perceived behavioral control, anxiety, and personal moral norms. Participants in the no-interview control group were simply asked to complete the same series of follow-up questionnaires one month later (open full item for complete abstract)

Doctor of Philosophy (PhD), Wright State University, 2014, Biomedical Sciences PhD

We studied the 3 dimensional structure of LC and cNTS neurons from neonatal rats. Neurons were identified as either chemosensitive or nonchemosensitive based on their firing rate response to hypercapnia, using whole-cell patch clamping and were passively loaded with Lucifer Yellow. The identified, loaded neurons were reconstructed and analyzed using Neurolucida Neuron Tracing Software. Chemosensitive LC neurons have less rounded soma than nonchemosensitive neurons, and they have dendrites arising from two poles to produce a fusiform appearance. The dendritic branches extend a greater distance from the soma of chemosensitive than nonchemosensitive neurons. Conversely, chemosensitive cNTS neurons were found to have ovoid multipolar somas with compact, complex arborization while nonchemosensitive neurons had bipolar somas with projections arising from opposite poles separated by ~ 180º. Chemosensitive LC neurons and cNTS neurons have at least one projection that makes a closer approach to the floor of the 4th ventricle than do nonchemosensitive neurons from both regions, but on average this closest approach is still greater than 50 microns. These data indicate that projection to the surface of the brainstem is not necessary for the chemosensitive response in the LC and the cNTS. To evaluate regional vascularity and neuronal populations, neurons and blood vessels were labeled using immunohistochemical techniques. Neurons were labeled with NeuN and blood vessels with Isolectin-GS-IB4 (a marker for endothelial cells). Confocal microscopy was used to collect images through 50 µm sections. Image J analysis of the confocal projections revealed that in the LC there is a higher density of blood vessels in the chemosensitive dorsal and intermediate regions compared to the nonchemosensitive ventral region of the LC. Interestingly, the dorsal and intermediate zones of the LC have a very high percentage of chemosensitive neurons while the ventral zone has mostly nonchemosensitive (open full item for complete abstract)

Master of Science in Exercise and Health Studies, Miami University, 2014, Exercise and Health Studies

The purposes of this investigation were to determine if proxies for muscle fiber composition and anthropometric measurements can predict systolic (SBP) and diastolic blood pressure (DBP), pulse pressure(PP), and mean arterial pressure (MAP). We studied 370 Division I Male and Female Athletes from various sports. Multiple regressions were run to predict blood pressure from anthropometric variables and proxies for fiber type. SBP included Neck circumference, Arm span, and MaxVi (.663;43.4%); DBP included BMI, Arm Length, and Neck Circumference (.298;8.9%); PP included peak force, height, MaxVi, and Neck Circumference (.639;40.2%); and MAP included BMI and Neck Circumference (.458;20.5%). Blood pressure exists on a normal curve, and because natural characteristics like fiber type and anthropometric-characteristics affect blood pressure, their influence on normal homeostatic blood pressure should be considered in the determination of pathology from normal physiology and the evaluation of treatment options.

Doctor of Philosophy (PhD), Ohio University, 2013, Experimental Psychology (Arts and Sciences)

To expand our prior research and address the limitation of full reliance on self-report measures within the blood donation literature, the present study examined the ability of three novel blood donation implicit measures to predict reported intention to donate blood, immediate decision to sign-up to donate blood, and confirmation of actual behavior among a sample of nondonors. A total of 225 undergraduate Psychology students with no history of blood donation agreed to participate in a 60-minute testing session, in which they sat at a computer to complete three implicit measures (image and word versions of implicit attitudes and implicit social-identity) followed by a series of explicit measures (donation attitudes, donation anxiety, self-efficacy, anticipated regret, subjective norm, descriptive norm, personal moral norm, and donation intention). After completing the computerized portion of the experiment, participants were given an opportunity to sign-up for a local blood drive that took place one to three weeks after the testing session. Finally, participants were contacted 30 days post session to confirm whether or not they donated blood. Results revealed that the image and word implicit measures demonstrated stronger internal consistency and construct validity than the social-identity implicit measure. Further, only the image implicit measure significantly predicted donation intention, explaining 1.7% of the variability. None of the implicit measures was shown to contribute variance over and above their explicit counterparts. Likewise, level of decisiveness and consideration did not moderate the relationship between implicit measures and donation intention, sign-up behavior, or 30-day behavior. These findings suggest that, while the implicit attitude measures may be valid in this context, they appear to be weak predictors of nondonor intentions and behavior, especially when tested alongside their explicit counterparts.

MS, University of Cincinnati, 2009, Allied Health Sciences : Nutrition

Purpose: To assess the change in the glycemic index of the diets of teenagers with hypertension or pre-hypertension who received formal nutrition counseling as part of a 3-month intervention to lower blood pressure. Subjects: A sub-set of the participants' data as reported by Couch et al. (12) was used. Participants were adolescents between the ages of 11-19 years with diagnosed pre-hypertension and Stage 1 hypertension (n=45). Study Design: Participants were randomly assigned to a behavioral nutrition intervention focused on the DASH diet (n=23) or Routine Care (RC) (n=23). Methods: Dietary glycemic index (DGI) and dietary glycemic load (DGL) were calculated for each treatment group for food items obtained from three 24-hour recalls collected at baseline and 3 months (post-intervention). Change scores for dietary glycemic index, dietary glycemic load, systolic blood pressure and diastolic blood pressure were calculated by subtracting baseline values from post-treatment values. Results: Neither the DASH nor the RC treatment significantly reduced DGI or DGL. There was no detectable association between change in DGI or DGL for all participants or by intervention group and change in systolic blood pressure or diastolic blood pressure. Conclusion: Based on these findings, counseling on a DASH type diet did not significantly modify DGI or DGL. Further, change in DGI and DGL was not associated with change in blood pressure in this study. These results suggest that the effects of the DASH intervention on blood pressure in this study were mediated by some component of the DASH diet other than DGI or DGL.

DNP, Walsh University, 2024, Nursing

Hypertension (HTN) is one of the most diagnosed conditions and is increasing in prevalence at an extreme rate. Although evidence-based recommendations include self-measured blood pressure (SMBP) twice daily, many older adults do not monitor their blood pressure outside of the clinic setting. Consistent education from healthcare professionals to patients on how to correctly measure blood pressure and address other risk factors of hypertension is lacking. This research study was designed to implement and evaluate the effectiveness of an SMBP training program for registered nurses (RNs) providing case management support to community-based older adults with essential hypertension in a Managed Care Organization (MCO) across Wisconsin. RN case managers completed a learning module and their hypertension management knowledge was measured at three points, pre-intervention, immediately post-intervention, and one-month post-intervention. Results were then compared via RM-ANOVA. A retrospective review of patient charts was also completed to determine if there was an increase in the patient recorded frequency of SMBP following the RN case manager training and compared via independent t-tests. The RN case managers' hypertension management knowledge increased significantly following education, with a slight decrease in scores over time. Retrospective chart reviews revealed that the frequency of documented patient blood pressure self-measurements increased significantly following RN case manager education. Implementing an evidence-based SMBP training program for RN case managers is a successful intervention to support the management of essential hypertension in community-based older adults.

Master of Fine Arts, The Ohio State University, 2024, Theatre

The subconscious mind gathers a lot about a person based on visuals alone. In the world of live theatre, this initial impression is highly controlled by the costume designer. Each element of live theatre combines to create a story that captures the attention of the audience; the actor walks onto the stage, their mind and heart completely in their performance, surrounded by an involved environment and adorned with skillfully detailed garments. Together with my professors and associates at The Ohio State University, we produced a surreal yet modern telling of Blood Wedding by early 20th century playwright Federico Garcia Lorca. We dove into the text, found our balance between poetry and realism, and created a world of bittersweet love. This thesis documents the costume design process from that production. The five chapters will discuss the producing situation, concept and design scheme, character analyses, production, and self-evaluation of the project.

Doctor of Philosophy (PhD), Wright State University, 2023, Engineering PhD

Blood flow dynamics plays a critical role in maintaining tissue health, as it delivers nutrients and oxygen while removing waste products. It is especially important when there is a disruption in cerebral autoregulation due to trauma, which can induce ischemia or hyperemia and can lead to secondary brain injury. Thus, there is a need for noninvasive techniques that can allow continuous monitoring of blood flow during intervention. Optical techniques have become increasingly practical for measuring blood flow due to their non-invasive, continuous, and relatively lower-cost nature. This research focused on developing a low-cost, scalable optical technique for measuring blood flow by implementing speckle contrast optical spectroscopy using a fiber-camera-based approach. This technique is particularly well-suited for measuring blood flow in deep tissues, such as the brain, which is challenging to access using traditional optical methods. A two-channel continuous wave speckle contrast optical spectroscopy device was developed, and the device was rigorously tested using phantoms. Then, it is applied to monitor blood flow changes in the brain following traumatic brain injury (TBI) in mice. The results indicate that trauma-induced significant blood flow decreases consistent with the recent literature. Overall, this approach provides noninvasive continuous measurements of blood flow in preclinical models such as traumatic brain injury.

Master of Science (M.S.), University of Dayton, 2022, Electrical and Computer Engineering

Vascular network of human eye plays an important diagnostic role in ophthalmology. Various size of the vessels, relatively low contrast and the presence of potential retinal diseases or pathologies complicate the segmentation process in fundus imaging. It is impossible to segment the vascular ends of thin retina vessels with the existing computational methods due to their high inefficiency and precision. Deep learning provides superior performance in semantic segmentation, especially for biomedical applications. One of the popular deep learning architectures for semantic segmentation is U-Net, which is specifically tailored for feature cascading to perform effective pixel classification. Advanced versions of U-Net such as Recurrent U-Net (RU-Net) and Recurrent Residual U-Net (R2U-Net) had been proposed for improved performance. The studies state that learning from a significant depth and extensive network with residual units is more accurate and can extract more discriminative feature representation for segmentation than learning from a shallow network without the residual units. In other words, residual learning reinforces the features in the previous layers to extract more versatile characteristics. It is observed that the reinforcement of features in successive layers would provide a relatively faster and efficient performance in image segmentation. In this thesis, we propose a modified U- Net architecture incorporating the residues from successive layers for the extraction of features in subsequent layers. The new model, named as Residues in Succession U-Net, is optimized for better overall performance exhibiting qualitative and quantitative results with the same number of parameters. 4 The Residues in Succession U-Net is evaluated for blood vessel segmentation in retinal images on a benchmark expert-annotated dataset viz. Structured Analysis of Retina (STARE). The testing and evaluation results show that the new model provides improved perf (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2022, Chemistry

The objective of this dissertation is to physically and chemically characterize a hydrophobic paper-based microsampling platform and to apply it to various applications including drug testing and the development of a three-dimensional (3D)-embossed hydrophobic paper platform that enables field collection, storage, and direct analysis of biological samples through ambient ionization mass spectrometry (MS). Conventional microsampling platforms have several advantages when compared to traditional collection methods; however, several notable disadvantages are commonly associated with these platforms, such as cold storage requirements and laborious sample pre-treatment and clean-up steps prior to analysis. Ambient ionization techniques have been developed to overcome these challenges to enable rapid, direct analysis of samples in situ by coupling the microsampling platform (e.g., paper spray, PS) to MS, a powerful analytical tool that allows for quantitative and qualitative studies to be performed. Chapter 2 describes the process by which a protective barrier forms on the exterior surface of dried blood spheroids on hydrophobic paper substrate. This was achieved through chemical characterization of cocaine spiked in blood using PS-MS and physical characterization of red blood cell (RBC) morphology through scanning electron microscopy (SEM). It was determined that the self-assembly of RBCs during the initial evaporation stages of drying ultimately leads to an external protective barrier that passivates the interior bulk, protecting it from environmental stressors. Chapter 3 describes the utilization of an exogenous polymer, xanthan gum, to help stabilize dried blood spheroids that dry under non-optimal drying conditions which leads to severe cracking and cratering, subjecting the interior bulk to potential degradation due to exposure to the environmental elements. This insight led to the fortification of a less viscous b (open full item for complete abstract)

Doctor of Philosophy (PhD), Wright State University, 2021, Engineering PhD

The research presented in this dissertation focused on the application of optical imaging techniques to establish blood flow and oxygen saturation as effective biomarkers for two disease cases, Autism Spectrum Disorder (ASD) and Huntington's Disease (HD). The BTBR mouse model of ASD was utilized to validate measurements of cerebral blood flow and oxygenation as biomarkers for autism. The R6/2 mouse model of juvenile HD was utilized to validate measurements of skeletal muscle blood flow following tetanic muscle contractions induced by electrical nerve stimulation. Next, a noncontact, camera-based system to measure blood flow and oxygen saturation maps was implemented to improve upon the previous HD mouse results by providing spatial heterogeneity in a wild-type mouse model. Finally, translational research was performed to validate a research design conducting concurrent grip strength force and skeletal muscle blood flow and oxygenation measurements in a healthy human population that will be used to establish HD biomarkers in humans in future clinical applications.

Master of Arts (M.A.), University of Dayton, 2021, English

Women are oftentimes forgotten in history due to the pursuit of their male colleagues. Much is the case for Lady Colin Campbell, nee Gertrude Elizabeth Blood (b. 3 May 1857), as she was left behind in history. However, unlike other similar stories, Blood was subject to the thoughts and opinions of a nation when she and her husband went through the longest and nastiest - dismissed - divorce trial in UK history. After the trial, she engaged in journalistic writing, submitting over a period of time to the periodical The World which would eventually turn into her essays A Woman's Walks. Despite her popularity at the time Blood and her writing faded out of the public sphere. What this project intends to accomplish is to reintroduce Gertrude Elizabeth Blood back into society not for her scandal, but for how her work can be considered part of the Flaneur genre. As a woman born to a family capable of social climbing and then eventually a shunned member of the upper class, Blood's work can shed unique light on the machinations of the Flaneur and the effects of class and gender. This proposed project will perform an analysis to (a) engage in understanding of the flaneur, working the flaneuse into the definition of the flaneur using Blood's writing and (b) a reintroduction of Blood as a woman worthy of analysis, and appreciation for her work as a woman who went against the grain of society.

Doctor of Nursing Practice, Mount St. Joseph University , 2021, Department of Nursing

Remote home blood pressure (BP) monitoring has the potential to improve patient engagement and adherence with the prescribed treatment plan for managing hypertension. This DNP project examined the effects of daily remote BP measurement using transmission of biometric data through a Bluetooth-equipped device paired to participants' smartphones. Twelve adults, with an age range of 37 to 69 years, completed four weeks of daily BP measurements and communicated via text, telephone call, or video visit with care team members to discuss the plan of care and address any concerns. A Wilcoxon signed-ranks test was performed to determine the magnitude of difference between the week 1 and week 4 systolic and diastolic BP measurements. The results revealed Week 4 systolic BPs (M = 127, SD = 12.48) were significantly lower than the Week 1 systolic BPs (M = 136, SD = 12.48), W = -2, p = .004 and the Week 4 diastolic BPs (M = 82, SD = 10.97) were significantly lower than the Week 1 diastolic BPs (M = 89, SD = 9.92), W = -4, p = .006. This average systolic decrease of 9 mmHg and average diastolic decrease of 7 mmHg indicated success in lowering BP within a four-week timeframe. The clinical management of a chronic condition such as hypertension is a long-term process, but the findings of this DNP project supported the empirical evidence showing that remote BP monitoring improves patient outcomes.

Master of Science (MS), Ohio University, 2018, Exercise Physiology-Research (Health Sciences and Professions)

Blood flow restricted (BFR) exercise is an alternative to “traditional” exercise that, by partially occluding pressure to working extremities during low-to-moderate exercise intensities, produces greater physiological stress. To that end, chronic BFR exercise training at low-to-moderate intensities has been demonstrated to yield greater physiological adaptations. However, most of the research to date has applied BFR in resistance exercise and focused on muscular strength and hypertrophy. The purpose of this investigation was to determine if the addition of BFR to low-to- oderate intensity treadmill walking could alter energy substrate utilization compared to a non-BFR condition. Nine healthy, college-aged men performed treadmill walking at a relative intensity of 50 ± 5% of the participant's maximal oxygen consumption (VO2max) during the application of (BFR) or without (CON) restriction. The absolute and relative oxygen consumption (VO2) and carbon dioxide production (VCO2) were continuously measured during exercise; while respiratory exchange ratio (RER), the absolute amount and the relative contribution of carbohydrate and fat oxidation were calculated. Blood lactate concentrations were measured before and at 2 min after exercise. Analysis of the data demonstrated that at the same physiological intensity, BFR did not alter substrate utilization indicated by RER (CON: 0.88 ± 0.04, BFR: 0.90 ± 0.05, p = 0.247). However, 4 post-exercise lactate concentration was significantly higher in the BFR trial (CON: 1.27 ± 0.32 mg/dL, BFR: 2.01 ± 0.47 mg/dL, p = 0.003). This result indicates that BFR exercise alters local but not whole-body level metabolism.

Master of Science in Biomedical Engineering, Cleveland State University, 2018, Washkewicz College of Engineering

The rubber hand illusion (RHI) is a visual-tactile perceptual illusion commonly used to study body ownership. In this paradigm, a rubber hand is positioned in front of a participant, and the person's real hand is hidden from sight behind a barrier. When the real hand and the rubber hand are stroked synchronously, individuals perceive the rubber hand as if it were their own; it becomes “embodied.” This illusory experience of body ownership is associated with multimodal integration of touch and vision. From these visual-tactile-cognitive mechanisms, we establish that our hands belong to us when what we see matches what we feel. Recently, studies have established a correlation between the induction of the RHI and temperature changes at the skin surface. Interestingly, when the brain perceives its real limb to be “disembodied” during the cognitive illusion, the temperature of that real limb drops. The central hypothesis for the proposed study is that cognitive limb embodiment directly affects blood flow patterns; blood flow in a specific limb can be disrupted by altering the sense of the limb's embodiment. Our rationale is that understanding the mechanisms underlying thermal-vascular regulation in healthy and diseased populations is clinically significant because blood flow can be used as a physiological marker of cognitive limb embodiment and may also be particularly important in identifying and understanding disease states. Physiological correlates of embodiment, such as temperature and blood flow changes, may have significant potential for quantitatively assessing various diseases. The first aim was to develop a modified ultrasound method to measure blood flow under the conditions of the RHI. In addition, the Doppler waveform indices were examined as physiological markers for cognitive embodiment. The second aim was to investigate the link between temperature changes and blood flow during cognitive limb embodiment. Taken together, this work seeks to provide a (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2017, Chemistry

Metal complexes that catalyze inactivation and degradation of biomolecular targets can be developed into novel therapeutics (catalytic metallodrugs) against a variety of diseases and molecular tools to study biology. Despite recent advances in the field, a lack of substrate selectivity is a major hindrance to the development of metal catalysts for biological application. Improved targeting can enhance catalytic efficiency and minimize nonselective activity and the potential for side effects in clinical practice. We employed the strategy of substrate-selective catalytic metallodrugs and designed selective copper catalysts that target disease-associated biomolecules including G-quadruplex telomeric DNA and L-fucose. In the first part of this work, we report small-molecule Cu complexes as membrane-permeable nucleases that promote selective DNA cleavage of G-quadruplex telomeric DNA. Despite recent advances in nuclease technology, targeting nucleic acids with protein-based nucleases in live cells remains a challenge due to low membrane permeability of proteins. Telomeric DNA determines the replicative capacity of cells, while successive shortening of telomeric DNA leads to cellular senescence. Fine tuning of nuclease activity has resulted in rapid reduction of telomere length promoted by these Cu complexes in cancer cells. Low non-specific DNA damage confirms the cleavage selectivity of Cu complexes under cellular context. Furthermore, we also show these Cu complexes promote more rapid telomere reduction in S-phase specific than G1/G0 phase, which should be associated with increase of G-quadruplex formation during DNA replication. Our results implicate a strategy for the development of artificial nucleases that can degrade therapeutically relevant nucleic acids in cells. In the second part of this work, we highlight the design of synthetic agents that mimic natural fucosidases for biological application. Catalysts that promote carbohydrate degradation are of wide (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 1964, Graduate School

Doctor of Philosophy, The Ohio State University, 1960, Graduate School