PhD, University of Cincinnati, 2023, Medicine: Molecular, Cellular and Biochemical Pharmacology

Inflammatory low back pain (LBP) is an extremely common and debilitating condition that is often treated with corticosteroids, which activate the glucocorticoid receptor (GR) in sensory neurons of the dorsal root ganglion (DRG) to reduce inflammation. However, many clinically used corticosteroids administered for LBP can also activate the mineralocorticoid receptor (MR) with similar or even greater potency. In rodent inflammatory pain models, MR antagonists reduce pain behavior, neuronal excitability, and inflammatory mediators. In this work (Chapter 2), we have compared human and mouse DRG expression of the GR and MR transcripts, finding that these receptors are almost ubiquitously expressed and colocalized in sensory neurons. The GR is predominant in nociceptors, while the MR is predominant in Aβ mechanoreceptors across species. This finding bodes well for translation of rodent corticosteroid research to clinical pain treatments, and suggests important roles for GR & MR in specific neuronal subpopulations. We have also shown (Chapter 3) that MR antagonism reduces mechanical hypersensitivity in rodents in an inflammatory LBP model, but MR KO in sensory neurons does not. While sensory neuronal MR KO does not change pain behaviors, it does change neuronal excitability and GR expression. These findings support the use of MR antagonists clinically, but show that sensory neuronal MR KO is not having the same effect. We learned through the MR KO model that MR has opposing roles in A- and C- neuronal excitability, and directly or indirectly regulates GR expression before and during inflammatory LBP. This research is the first to use mice as a model for corticosteroid receptor regulation in pain, shows translational possibility, and furthers mechanistic insights into corticosteroid receptor action at the DRG using genetic manipulation techniques.

Committee: Jun-Ming Zhang M.D. M.Sc. (Committee Chair); Temugin Berta Ph.D. (Committee Member); Yvonne Ulrich-Lai Ph.D. (Committee Member); Terry Kirley Ph.D. (Committee Member); Judith Strong Ph.D. (Committee Member); James Herman Ph.D. (Committee Member) Subjects: Neurology

Doctor of Philosophy, The Ohio State University, 2023, Biomedical Engineering

Low back pain (LBP) is a leading cause of disability worldwide, affecting approximately 80% of adults at some point in their lifetime, and has large associated socioeconomic burdens. Intervertebral disc (IVD) degeneration is a major cause of LBP, accounting for approximately 40% of all LBP cases, yet current clinical therapies do not target the underlying pathology that IVD cells experience in degeneration. While cell therapies and viral gene delivery have been of interest in IVD regeneration, their clinical application is limited due to caveats such as cell survivability, mutagenesis, and unwarranted immune response. Thus, a method of non-viral delivery of prominent developmental transcription factors into diseased patient cells may serve as a novel, minimally invasive, and non-addictive therapy for IVD degeneration utilizing the patient's own cells. The first chapter of this dissertation covers the background on the clinical relevance of LBP and IVD in its healthy and diseased states along with detailed background on current therapies for IVD degeneration. This then leads into the advantages of cellular reprogramming via non-viral delivery and developmental transcription factors of interest (FOXF1, Brachyury, Mohawk, Scleraxis) along with a brief review of animal models relevant to IVD degeneration. Chapter 2 explores the non-viral delivery of Brachyury, a transcription factor critical to the development of the nucleus pulposus (NP) region of the IVD, in diseased human NP within a physiologically relevant 3D culture model. Similarly, Chapter 3 assesses the non-viral delivery of FOXF1, a key phenotypic marker of healthy NP cells, into diseased NP cells via electroporation and engineered extracellular vesicles (EVs) in both human cells in vitro and mice IVDs in vivo. Chapter 4 explores the outer annulus fibrosus (AF) region of the IVD via non-viral transfection of Mohawk or Scleraxis into diseased human AF cells. These chapters are then summarized in the final concl (open full item for complete abstract)

Committee: Devina Purmessur (Advisor); Natalia Higuita-Castro (Committee Member); Benjamin Walter (Committee Member); Paul Stoodley (Other) Subjects: Biomedical Engineering

Master of Science, Miami University, 2023, Computer Science and Software Engineering

It is a well-established fact that the performance of Machine Translation (MT) techniques largely depends on the quantity and quality of data available. The lack of a large well-curated dataset is especially a challenge for low-resource languages. The Myaamia language, also known as the Miami-Illinois language, is an endangered Native American language, and there are active efforts being made toward its revitalization. As a part of the revitalization process, the recorded texts are currently being manually translated, which might take up to a decade to translate at the current rate, according to some expert assessments. To speed up the translation process, we developed Myaamia Translator, a Neural Machine Translation (NMT) based machine translation approach, which leverages the state-of-the-art transformer architecture to translate text from Myaamia to English. The contributions of this work are two-fold: first, we use a combination of rule-based augmentation and back-translation augmentation to address the data limitation; and second, we train the model using the large dataset to test its effectiveness in translating a religious Myaamia textbook to English.

Committee: Christopher Vendome (Advisor); David Costa (Committee Member); Hakam Alomari (Committee Member); Douglas Troy (Committee Member) Subjects: Artificial Intelligence; Computer Engineering; Computer Science; Language; Linguistics; Native American Studies

Master of Science, The Ohio State University, 2022, Industrial and Systems Engineering

While biomechanical models can be insightful to potential mechanisms that can contribute to low back pain, they require significant computing power and various technologies that are not readily available in settings such as clinics. On the other hand, lightweight sensing systems such as inertial measurement unit sensors (IMUs) can be integrated in wearable technologies to easily capture high level spine kinematics. While kinematics can be useful for identifying pain populations or tracking motion metrics for patients, they do not provide a look at the internal structures of the spine during dynamic motions. Several studies have attempted to bridge this disparity. Specifically, muscle coactivity of the trunk muscle groups can greatly impact the overall loading and shear forces on the spine, and several studies have attempted to only use kinematics to predict the trunk muscle forces during static exertions. The goal of this study was to present a methodology that can predict trunk muscle forces as a time series, during dynamic motions, which does not require electromyographic (EMG) signals. This was achieved by first, collecting a new dataset with motions that capture key spine kinematics using an EMG-assisted biomechanical model. Second, to use kinematic-derived variables from this data with deep learning methodologies to predict the trunk muscle forces. 30 healthy subjects performed a series of unloaded, bending, and twisting, during a standardized spine motion assessment while wearing EMG sensors on ten trunk muscles. Several variables were extracted from the time series, including velocities, muscle lengths, height, weight, and torso angles. Using several deep learning architectures, these variables were trained to map these variables to the ten muscle forces produced during the dynamic motions. Various deep learning architectures were investigated, however only three main architectures were reported and pursued. Assessed on an independent test set, the architec (open full item for complete abstract)

Committee: William S. Marras (Advisor); Samantha Krening (Committee Member) Subjects: Industrial Engineering

Master of Science (MS), Ohio University, 2022, Experimental Psychology (Arts and Sciences)

Chronic low back pain (CLBP) is a burdensome chronic pain condition. Emotion regulation (ER) and insecure adult attachment dimensions are psychosocial variables of great importance to individual differences observed across different chronic pain populations. However, few studies to date have examined ER and insecure adult attachment dimensions in tandem among individuals with CLBP. The aims of the present study are to examine the independent and joint influences of insecure adult attachment dimensions and ER strategies, including emotional expression, cognitive reappraisal, and expressive suppression, on patients' CLBP severity and CLBP interference (N = 242). Results showed that anxious attachment, but not avoidant attachment, positively and significantly correlated with CLBP interference; neither anxious attachment nor avoidant attachment was associated with CLBP severity. Emotional expression and expressive suppression positively and significantly correlated with CLBP severity, but not CLBP interference. Cognitive reappraisal did not correlate with CLBP severity or CLBP interference. Furthermore, emotional expression exacerbated the influence of avoidant attachment on CLBP severity or CLBP interference, while expressive suppression and cognitive reappraisal did not moderate the attachment – CLBP relation. In line with existing research, the present study shows that anxious attachment may be a risk factor related to more CLBP interference. Interestingly, expressing emotions was associated with more CLBP severity or CLBP interference among avoidant people.

Committee: Dominik Mischkowski (Advisor) Subjects: Psychology

Doctor of Philosophy, The Ohio State University, 2022, Industrial and Systems Engineering

Low back pain (LBP) and neck pain (NP) arise from complex interactions among physical, psychological, and social stressors. One psychological stressor that may play a role in the etiology of low back and neck pain but has not yet been studied relative to spinal injury is cognitive dissonance. Originally introduced by Leon Festinger in 1957, Cognitive Dissonance Theory (CDT) posits that humans strive for psychological consistency and experience both psychological discomfort and physiological arousal when their beliefs, values, or behaviors are placed at odds with the world around them. These psychological and physiological effects, known as the cognitive dissonance state (CDS), may also yield biomechanical changes that increase the risk of experiencing spinal injury. Thus, the objective of the study was to explore the potential association between cognitive dissonance and low back/neck pain injury risk. A laboratory study was conducted to examine the effects of the CDS on psychological, physiological, and biomechanical factors associated with LBP and NP injury risk. Seventeen healthy subjects (ages 19-44) participated in the experiment, which involved a precision lowering task. To elicit the CDS, subjects were provided negative feedback on their task performance that ran counter to a pre-established expectation that their performance on the task was excellent. Dependent measures included changes to positively and negatively oriented psychological affect, changes to blood pressure, changes to heart rate variability (HRV), and changes to spinal loads in the cervical and lumbar spines (calculated via two electromyography-assisted biomechanical models). Providing subjects with negative feedback inconsistent with their expectations yielded changes to positively and negatively oriented affect and blood pressure consistent with the CDS, but main effects of the CDS condition on HRV were opposite of expected. However, there was substantial variability in the psychologic (open full item for complete abstract)

Committee: William S. Marras (Advisor); Afton L. Hassett (Committee Member); Tristan E. Weaver (Committee Member); Carolyn M. Sommerich (Committee Member) Subjects: Biomechanics; Industrial Engineering; Social Psychology

Doctor of Philosophy, The Ohio State University, 2020, Biomedical Engineering

Degeneration/calcification of the cartilage endplate (CEP) has been linked to the onset and progression of intervertebral disc (IVD) degeneration yet the CEP remains under characterized and understudied. The aims of this dissertation were to evaluate the effect of in vitro cell culture conditions, including biochemical hypertrophic stimuli (10% fetal bovine serum (FBS) and Wnt agonist), oxygen tension (Aim 1), and substrate stiffness (Aim 2), on hypertrophic differentiation, a possible mechanism of degeneration/calcification, in human CEP cells and to characterize the human CEP on the molecular, cell and tissue level (Aim 3) and compare it to the CEP of animal models commonly used to study IVD degeneration, specifically bovine and canine species (Aim 4). For Aim 1, isolated human CEP cells were cultured as pellets for 21 days at either 5% or 20.7% O2 and treated with 10% FBS or Wnt agonist, two biochemical stimuli known to induce hypertrophy in articular chondrocytes. CEP cells did not exhibit a hypertrophic morphology in response to hypertrophic stimuli but did display other hallmarks of chondrocyte hypertrophy and degeneration including hypertrophic gene and protein expression, and a decrease in healthy proteoglycans (glycosaminoglycan (GAG)) and increase in fibrous collagen accumulation. For Aim 2, human CEP cells were cultured in either 2% (soft) or 4.5% (stiff) agarose gels at 5% O2 for 11 days. No significant differences in cell morphology, or protein expression of hypertrophic cell markers were observed between substrate stiffnesses. For Aims 3 and 4, isolated human, bovine and canine CEP, nucleus pulposus (NP), annulus fibrosus (AF) and articular cartilage (AC) tissue and cells were evaluated for cell morphology, matrix composition/structure, GAG content, and gene and protein expression. Significant differences in matrix and cell marker gene expression were observed between human CEP and NP or AF, with greatest differences between the human CEP and AC. W (open full item for complete abstract)

Committee: Devina Purmessur (Advisor); Alan Litsky (Committee Member); Sarah Moore (Committee Member); Gregory Lafyatis (Committee Member) Subjects: Biomedical Engineering

Master of Science, The Ohio State University, 2019, Comparative and Veterinary Medicine

Intervertebral disc (IVD) degeneration (IVDD) is an important cause of low back pain in people, but can be difficult to treat, either surgically or medically, with current available therapies. Thus, understanding the pathological mechanisms of IVDD and developing novel treatments are critical for improving outcome and quality of life in people living with LBP. The chondrodystrophic (CD) canine clinical model of IVDD is a promising spontaneous model through which to assess IVD-associated spinal pain and translational therapeutic strategies for LBP. The canine IVD is larger than most other small animal IVDD models and undergoes maturational changes similar to those of the human IVD. Furthermore, both dogs and people develop painful IVDD as a spontaneous process, resulting in similar characteristic pathologies and clinical signs. Future exploration of the canine as a model of IVD-associated spinal pain and biological treatments using the canine clinical model will further demonstrate its translational capabilities with the added ethical benefit of treating an existing veterinary patient population with IVDD. The goal of this study was to explore the pathological differences between herniated surgical (n=16) and healthy autopsy (n=6) CD canine nucleus pulposus (NP) samples using histology and immunohistochemistry for CD31, tryptase, and CD163 to assess blood vessel, MC, and MØ presence, respectively. Histology revealed that, compared to healthy autopsy NP, surgical NP contained smaller dispersions of NP cell clusters with large amounts of granulation tissue. While healthy NP extracellular matrix is mainly composed of aggrecan, surgical NP matrix is primarily collagen. 11/15 (73.3%) surgical samples stained positive with CD31 for blood vessels in granulation tissue, with 14/15 (93.3%) samples containing CD31-positive cells within NP tissue, versus 0/4 autopsy NP tissue samples. 12/15 (80%) of surgical samples stained positive for tryptase, with 14/15 (93.3%) contain (open full item for complete abstract)

Committee: Sarah Moore (Advisor); Devina Purmessur (Advisor); Alan Litsky (Committee Member) Subjects: Veterinary Services

Master of Science (MS), Ohio University, 2019, Athletic Training (Health Sciences and Professions)

Chronic low back pain is a difficult condition to treat due to its ambiguous nature. The pain that many people experience often does not correlate to a structural problem. Sufferers tend to experience different trunk and core muscle activation patterns, which leads researchers to believe that the brain creates adaptations to compensate for pain. Little research has been compiled on the motor activation patterns in the brain to look into this theory. This study uses functional magnetic resonance imaging (fMRI) to establish a novel motor neuroimaging paradigm for trunk and core musculature in healthy subjects during a trunk isometric task. Six healthy young adults (male, n=3; female, n=3)(age = 22.67 ± 3.14) with no significant history of low back pain within 8 weeks were recruited as participants. Participants were asked to perform a sustained, isometric trunk motor task while lying supine in an fMRI scanner. The total, mean, and maximum blood oxygen level dependent (BOLD) signals were assessed in the motor cortex. An intraclass correlation coefficient (ICC) and one sample t-test were conducted to assess if there were significant differences during the first and second scanning sessions between each participant and between all participants. The ICC(3,k)=0.873 for 30% MVIC target intensity indicates strong test-re-test reliability, and the 40% and 50% target intensities also demonstrated excellent test-re-test reliability. However, associated 95% confidence intervals were wide. The one sample t-test determined there was no significant change between sessions for all participants (p>0.05). The ICC and one sample t-test indicated that the methods have good test-re-test reliability and no significant difference between scanning sessions, however, the small sample size makes it difficult to confidently say the methods are reliable.

Committee: Dustin Grooms (Committee Chair); Janet Simon (Committee Member); Brian Clark (Committee Member) Subjects: Neurology; Sports Medicine

Doctor of Philosophy, University of Toledo, 2017, Physics

Thin film solar cells based on hybrid organic-inorganic perovskites (HOIPs) have become highly attractive over the past several years due to a high solar to electric power conversion efficiencies (PCEs). Perovskite materials based on methylammonium lead iodide (CH3NH3PbI3, MAPbI3) possess high optical absorption coefficients, long minority carrier lifetimes and diffusion lengths, and desirable optical band gaps, and carrier collection in these materials can be highly efficient when they are paired with appropriate electron and hole transport materials (ETMs and HTMs), respectively. Additionally, perovskite solar cells (PSCs) can be fabricated via a variety of solution-based routes, which are suitable for low-cost, large area manufacturing. The combination of these attributes gives PSCs an advantage over currently available commercial photovoltaic (PV) technologies. Understanding the nucleation and growth mechanisms, and controlling the grain size and crystallinity in the solution-processed fabrication of perovskite thin films are important to prepare electronic-quality materials for PV applications. We investigated the nucleation and growth mechanisms of MAPbI3 formed in a two-step solution process. To prepare the MAPbI3 films, PbI2 films were spin-coated and then were reacted with methylammonium iodide (MAI) in the isopropanol (IPA) solution at various concentrations. We showed that the conversion rate, grain size, and morphology of MAPbI3 perovskite films depend on the concentration of the MAI solution. Three distinct perovskite formation behaviors were observed at various MAI concentrations, and a tentative model was proposed to explain the reaction mechanisms. The nucleation and growth process of MAPbI3 can be significantly changed by adding divalent metal salts into the MAI solution. We showed that the incorporation of Cd2+ ions significantly improved the grain size, crystallinity, and photoexcited carrier lifetime of MAPbI3. Formation of ( (open full item for complete abstract)

Committee: Michael J. Heben Ph.D. (Committee Chair); Randy J. Ellingson Ph.D. (Committee Member); Yanfa Yan Ph.D. (Committee Member); Song Cheng Ph.D. (Committee Member); Terry P. Bigioni Ph.D. (Committee Member) Subjects: Materials Science; Physics

Master of Science, The Ohio State University, 2017, Biomedical Engineering

Low back pain is a widespread debilitating disorder of significant socio-economic importance and intervertebral disc (IVD) degeneration has been implicated in its pathogenesis. Despite its high prevalence the underlying causes of LBP and IVD degeneration are not well understood, contributing to the difficulty in identifying relevant treatment strategies that specifically target this disease. Recent work in musculoskeletal degenerative diseases such as rheumatoid arthritis and osteoarthritis have revealed a critical role for immune cells, specifically mast cells in their pathophysiology, eluding to a potential role for these cells in the pathogenesis of IVD degeneration. This study sought to characterize the presence and role of mast cells within the IVD, focusing on chemo-attractants (CCL2/MCP-1 and stem cell factor) which may recruitment mast cells to the IVD and mast cell-IVD cell interactions using immunohistochemistry and 3D in-vitro culture methods. Mast cells were upregulated in painful human intervertebral disc tissue and were able to induce an inflammatory, catabolic and pro-angiogenic phenotype in bovine nucleus pulposus and cartilage endplate cells at the gene level. Bovine annulus fibrosus cells in particular from the healthy IVD however, demonstrated a protective role against key inflammatory (IL-1ß and TNFa) and pro-angiogenic (VEGFA) genes expressed by mast cells, and mitigated neo-angiogenesis formation in vitro. In conclusion, mast cells can infiltrate and elicit a degenerate phenotype in IVD cells, enhancing key disease processes in the degenerate IVD and making them a potential target for low back pain therapeutics.

Committee: Devina Purmessur (Advisor); Christopher Breuer (Committee Member); Safdar Khan (Committee Member) Subjects: Biomedical Engineering

Doctor of Philosophy, The Ohio State University, 2016, Industrial and Systems Engineering

The literature was reviewed to identify inflammatory markers found in the blood of subjects suffering from LBP. This information was then used to design an experiment intended to determine the contribution of repetitive lifting, mental load and subject personality to inflammatory responses after exposure. Twenty male subjects were exposed to repetitive lifting combined with a high or low mental workload task for two hours. Plasma, WBC counts, IL-1ß, TNF-a, IL-6, IL-8, IL-10, Substance P, Creatine Kinase, and salivary cortisol were sampled before, immediately post, 2 hours post and 20 hours post exposure. A well-regulated inflammatory response was observed following exposure. There was an initial elevation of IL-6, TNF-a, IL-8 and CK while the composition of plasma WBCs shifted in favor of granulocytes. 20 hours post exposure, CK concentrations have peaked and circulating granulocytes returned to normal. However, granulocytes are expected to live longer than 20 hours and therefore may still be active at sites of tissue trauma. In an industrial setting, 20 hours post lifting exposure would correspond to a worker returning to work the next day and creates conditions for cumulative lifting and inflammatory exposures. Interactions were noted between subject personality, mental load and inflammatory responses. Interactions were also noted between mental load, personality and spinal loading. However, these changes in spinal load did not correspond to changes in inflammatory responses.

Committee: William Marras Ph.D. (Advisor); Thomas Best MD, Ph.D. (Committee Member); Devina Purmessur Ph.D. (Committee Member); Safdar Khan MD (Committee Member) Subjects: Biochemistry; Engineering; Industrial Engineering

Doctor of Philosophy (PhD), Ohio University, 2016, Biological Sciences (Arts and Sciences)

Low back pain (LBP) is the leading cause of disability worldwide with more than eight hundred billion dollars of direct and indirect costs associated with LBP being incurred annually in the US alone. About 80-90% of all LBP patients do not have a definitive diagnosis of the etiology of pain, and are grouped under the non-specific LBP cohort. A group of such patients with unspecified etiology for their back pain are believed to have their LBP due to un-controlled and often, more than normal segmental motion involving one or more of their lumbar vertebrae. As such, many surgical treatments for LBP are directed at reducing inter-vertebral motion at and around an affected segment. The most common approaches for quantifying vertebral motion are based on radiographic assessments, which in many cases preclude scientific inquiry (e.g., use of high radiation equipment is not permitted for scientific investigations in some states, and, even when permitted, presents a major roadblock for serial assessments). This project was undertaken to develop and examine the feasibility, reliability and accuracy of a technique that used magnetic resonance (MR) images, custom built 3-D models and animations of spine-segment motion to quantify displacements in a calibrated imaging space. Experiment 1 explored the feasibility of developing an MRI-based spine kinematics quantification technique that involved (i) creating MRI compatible solid-body objects, (ii) scanning axial images of the objects in the MRI machine to create static 3-D virtual models of the solid-bodies, (iii) scanning the solid bodies as they were displaced within the MR imaging space through pre-determined magnitudes, and (iv) using images from the displacement trials to create background 'scenes' in an animation software where the user performed an image-to-model matching. This process called `rotoscoping', resulted in reliable quantification of the displacements achieved with the technique developed in this aim (see Cha (open full item for complete abstract)

Committee: Brian Clark Ph.D. (Committee Chair); Susan Williams Ph.D. (Committee Member); Robert Staron Ph.D (Committee Member) Subjects: Anatomy and Physiology; Biomedical Research; Medical Imaging

Master of Arts, The Ohio State University, 2015, Linguistics

This thesis compares the English spoken by a Beachy Amish-Mennonite church in Coshocton County Ohio with the English of Non-Mennonites in the same region. Although there is no previous research on this or any nearby Mennonite communities, previous research on the dialects of English spoken by Amish communities in the US suggests that differences from the regional standard are influenced by deliberate border maintenance, primacy of language in expressing ethnic identity, and interference from Pennsylvania German, known to speakers as “Dutchified English”. However, the wealth of diversity in related ethnic minority groups has not been tapped, and very little research has examined the English of Mennonites who generally choose a less conservative, and consequently more complex, balance between separation from and engagement with the outside world. The variables I focus on are initial th-stopping, final obstruent devoicing, and the low back vowel merger. The first two variables are documented for Amish English and various German bilingual communities. Th-stopping is also socially salient, and is associated with the more religiously orthodox groups in Holmes County, from which the Coshocton community distinguishes itself. I collected production and perception data from ten speakers in the Mennonite Church community and five non-Mennonite speakers from the same region, and I present here my findings of the use of th-stopping and final consonant devoicing, both of which are attested although neither are used categorically, and the low back merger, which is attested categorically in all Non-Mennonites, but in only one Mennonite speaker. This research is the first step in the description of Mennonite English in Ohio, and opens several avenues for further comparison. The perceptual data also has theoretical implications for the role of community identity and border maintenance in the way these Mennonites position themselves between their non-plain neighbors and the mor (open full item for complete abstract)

Committee: Brian Joseph (Advisor) Subjects: Linguistics

Doctor of Philosophy in Urban Education, Cleveland State University, 2014, College of Education and Human Services

The study utilized an individual change model to investigate the effectiveness of a chronic pain rehabilitation program at treating pain, mood (depression, anxiety, and stress), and function for chronic low back pain patients. This retrospective study consisted of a sample of 621 patients with a chronic low back pain diagnosis who completed an interdisciplinary rehabilitation program. The outcomes of pain, mood and function were assessed at four waves including admission, discharge, 6-month, and 12-month follow-ups using established instruments. The Depression, Anxiety, Stress Scale (DASS) by Lovibond and Lovibond (1995a) was used to assess patients' self-reported levels of depression, anxiety and stress during the time period. The Pain Disability Index (PDI; Tait, Chibnall & Krause, 1990) assessed pain-related disability in several areas of functioning including: family/home functioning, recreational functioning, social functioning, occupational functioning, sexual functioning, self-care functioning, and life support functioning. Finally, a self-report Likert scale was used to determine patients' self-reported levels of pain on a 0-10 point scale. Individual characteristics including age, gender, support, working status, and disability compensation status were also used as predictor variables. The study found that, regardless of patient characteristics or circumstance, treatment in an interdisciplinary chronic pain rehabilitation program was effective at improving patients' moods, increasing their levels of functioning, and improving their perceptions of pain. Patients entered the program with pain conditions significantly different from zero, suggesting discomfort at admission. In addition, patients' rates of change were statistically significant, showing improvements in pain mood and functioning during the period under study. The results from this dissertation study support the extant literature that interdisciplinary treatment is effective. Specifica (open full item for complete abstract)

Committee: Sarah Toman PhD (Committee Chair); Joshua Bagaka's PhD (Committee Member); Kathryn MacCluskie EdD (Committee Member); Judith Scheman PhD (Committee Member) Subjects: Counseling Psychology

Doctor of Philosophy, The Ohio State University, 2013, Industrial and Systems Engineering

Repetitive manual lifting and whole body vibration (WBV) exposure encountered in manual handling and delivery type jobs lead to muscle fatigue and are documented risk factors for low back disorder (LBD). In order to compensate for muscle fatigue, people in these occupations may adapt their working strategy to prevent an injury. The goal of this dissertation research was to identify the interactive effects of WBV and repetitive lifting exposures on muscle fatigue and changes in lifting mechanics. Study 1 investigated the effects of prolonged repetitive asymmetric lifting task on behavioral adaptations, measures of tissue oxygenation, and spine kinematics during a controlled flexion-extension motion task. Seventeen healthy volunteers repeatedly lifted a box (15% of the participant's lifting capacity) positioned in front of them at ankle level to a location on their left side at waist level at the rate of 10 lifts/minute for 60 minutes. The results showed that this prolonged lifting task lead to decrease in tissue oxygenation measures and an increase in the level of perceived exertion over time. Behavioral changes with repetitive lifting task included an increase in forward bending motions and velocities in the sagittal and coronal plane. Behavioral measures that increased over time have also been documented to increase the risk of back injury. Study 2 investigated the interactive effects of seated vibration exposure and lifting task precision demands on behavioral and physiological changes experienced during a repetitive lifting task. This study was a 2 x 2 repeated measures design with two levels of vibration exposure and two levels of lifting task precision demands. The initial analyses showed no significant interaction between WBV exposure and task precision demands during the repetitive lifting task. Thus, the data was separately analyzed to understand changes in the physiological and behavioral responses associated with each of these physical factors. (open full item for complete abstract)

Committee: Steven Lavender PhD (Advisor); Carolyn Sommerich PhD (Committee Member); Richard Jagacinski PhD (Committee Member) Subjects: Industrial Engineering

MS, University of Cincinnati, 2013, Medicine: Occupational Safety and Ergonomics

Musculoskeletal disorders (MSDs) have the potential to impact a tremendous number of the waitresses and waiters in the United States, yet very little is known about the ergonomic risk factors that these workers routinely encounter. Many of the traditional risk factors for MSDs can be commonly found for wait staff such as lifting and transferring heavy loads, reaching for items (e.g. horizontal trunk moment arm), repetitious tasks, and standing for long periods of time on their feet. The objective of the study was to document the potential risk factors that restaurant servers are commonly exposed to on a typical shift. Twenty servers from three different restaurants within the Midwest metropolitan area were observed by direct observation methods including direct measurement of weight lifted on trays; observation of postures when transferring trays, quantification of sitting and walking by an ActivPal, and workload perception and current body region symptom through a simple survey. The results show that servers carried 16.4 kg per hour or 6.3 kg per tray, which is relatively low compared to other industries. There were more than 90% of the servers who reported standing more than 5 hours, but less than 8 hours during their shift. Objective measures by the ActivPal confirmed a large amount of time on their feet (76% of time standing or walking). The body region with the greatest increase in discomfort at the end of the shift was the upper back (increasing by 55%). The next highest changes in discomfort were in the neck (at 45%) and lower back (at 50%) regions. Also, almost 70% of the servers carried a tray of food in front of themselves, potentially resulting in poor and awkward postures. In all, the current study provides a glimpse into the demands on the servers. Generally, while the number of trays served was not particularly high, the average load represents a risk, especially when peak times could require many more trays served. All indications from the perceptions (open full item for complete abstract)

Committee: Kermit Davis Ph.D. (Committee Chair); Susan Kotowski Ph.D. (Committee Member) Subjects: Occupational Safety

PhD, University of Cincinnati, 2009, Medicine : Environmental Health

Low back pain (LBP) has been described as one of the most prevalent and significant musculoskeletal problems, with upwards of 85% of the population experiencing LBP at some point in their life. Of those experiencing LBP, up to 85% will not receive a definitive diagnoses as to the cause of the pain. Although a number of known injury sites exist within the low back, because of the ongoing occurrence of LBP, other injury mechanisms must still exist. Complicating pain is the fact that there are several pain pathways as well as there are no objective measures of pain. Recently, it has been shown that exercise induced muscle inflammation, which causes pain, can be analyzed using magnetic resonance imaging (MRI). In addition, magnetic resonance spectroscopy (MRS) has been shown to be able to detect changes in the chemicals in the brain, which are known to respond to painful stimuli. Given these two factors, the goal of this study was to identify whether inflammation in the low back musculature (measured using MRI) could be linked with metabolite changes in the brain known to respond to pain (measured with MRS). Ten healthy subjects (5 males and 5 females) underwent baseline lumbar and brain scans and then completed a lifting and lowering designed to produce inflammation in the erector spinae muscles. Subjects were asked to lift a 9.1 kg carton 8 times per minute until they could no longer do so. Following completion of the lifting task, subjects underwent another lumbar and brain scan. Twenty-four hours later a final lumbar and brain scan series was completed. Subjective ratings of perceived exertion and pain levels were also collected at baseline, immediately following the lifting task, and 24-hours after completing the task. T2 maps were used to analyze muscle inflammation. In an unexpected finding, T2 relaxation times actually decreased significantly following the completion of the lifting task. Glutamate and glutamine, pain markers, were not elevated based on the MRS a (open full item for complete abstract)

Committee: Kermit Davis PhD (Committee Chair); Lisa Lemen PhD (Committee Member); Kim Cecil PhD (Committee Member) Subjects: Biomedical Research; Occupational Safety; Public Health

MS, University of Cincinnati, 2008, Medicine : Occupational Safety and Ergonomics

Millions of youth work on farms and routinely undertake physically demanding tasks. While a high percentage of youth report musculoskeletal pain, research has not been conducted on what interventions could reduce the risk of pain/injury. Therefore, the purpose of this study was to test several interventions for shovels (add-on handles) and wheelbarrows (additional wheels or adjustable handles) during common farm tasks. Based on the results, the add-on handles may not be completely effective in reducing risk of low back injuries during shoveling tasks. While add-on handles reduced sagittal trunk motion, there was a trade-off with increased twist motion compared to a regular handle scoop shovel. For the wheelbarrows, a large reduction in sagittal flexion and velocity was achieved using the wheelbarrow with three wheels or the adjustable handle. However, for both types of equipment, none of the interventions showed any significant change in the predicted low back disorder risk level.

Committee: Kermit Davis PhD (Committee Chair); Amit Bhattacharya PhD (Committee Member); Thomas Waters PhD (Committee Member) Subjects: Agriculture; Engineering; Occupational Safety

MS, University of Cincinnati, 2004, Engineering : Industrial Engineering

Hypotheses: 1)Increased weight without posture adaptation will increase strength requirements measured by percent capable values in joint moment strengths. 2)The Recommended Weight Limit predicted by the NIOSH lifting equation does not guarantee that the L5/S1 compression force stays below the 3400 N recommended maximum for obese individuals in certain lifting postures. Methods: Data was input for a series of lifting postures. The percent capable at the ankle, knee, hip, torso, shoulder, and elbow as well as the compression force at the L5/S1 vertebrae were recorded for a variety of body weights and hand loads. Results: The results of the current pilot study indicate a relationship between increased body mass and a decrease in percent capable values. The study also demonstrates that for certain obese individuals, the NIOSH Revised Lifting Equation does not limit L5-S1 compression forces to below the 3400 N recommended threshold.

Committee: Dr. Woojin Park (Advisor) Subjects: Engineering, Industrial