Doctor of Philosophy, Case Western Reserve University, 2021, Anthropology

In an effort to combat the staggeringly high rates of opioid overdose deaths in the US, Overdose Education and Naloxone Distribution (OEND) clinics were established. This study was a collaborative partnership with a local urban hospital committed to harm reduction through their community-based OEND clinic. This study's purpose was twofold. First, to understand who utilized OEND clinics and the factors affecting their HSB (i.e. number of Naloxone kits). Second, to understand how OEND clients framed their understanding of their SUD and if their model of addiction affected HSB. The study was comprised of three distinct phases. Phase 1 Quantitative assessment examined the demographic characteristics (i.e., gender, race, education, SES, occupation), mental health concerns (i.e., anxiety, depression & general distress), breadth and satisfaction of social support, and addiction beliefs in 235 clients from a local OEND clinic in Cleveland, Ohio. Since all participants in this study were already a part the OEND clinic, the number of naloxone kits will serve as a proxy for HSB. Phase 2 Qualitative Assessment explored how 61 of the enrolled clients framed their understanding of their substance use disorder (SUD). Qualitative interviews were coded for themes related to SUD beliefs, the type of stigma experienced by clients as a function of their drug use, and their motivation behind the decisions to seek out Naloxone. Phase 3 involved informal clinic observations to understand clients' experiences and interactions with OEND clinic staff. Gaining a better understanding of patients' health-seeking behaviors (HSB) at OEND clinics is a critical first step along the road to combatting the opioid epidemic. Phase 1 data revealed that clients who chose to engage in the HSB of OEND clinic were primarily unemployed, Caucasian males who were approximately 38 years of age. They were highly anxious, depressed, and in need of more social support to assist in their recovery. The majorit (open full item for complete abstract)

Committee: Lee Hoffer (Committee Chair); Janet McGrath (Committee Member); Jill Korbin (Committee Member); Brian Gran (Committee Member) Subjects: Behavioral Sciences; Cultural Anthropology; Health; Mental Health; Public Health; Social Research

Master of Science, The Ohio State University, 2020, Public Health

The United States is experiencing an opioid overdose epidemic over the past two decades. Ohio, ranked second for the highest overdose death rate involving opioids in 2017, is especially troubled in this crisis. To combat the epidemic, researchers have used public health surveillance data to identify clusters of overdose incidents and develop prevention programs. In this thesis, we obtain data from three different surveillance sources in Dayton, OH to explore the quality and consistency of the stories behind these data sets: ZIP code level naloxone administration by Ohio Emergency Medical Services (EMS) Providers 2017 - 2019, individual-level Dayton Police Department non-fatal and fatal overdose encounters from April 2017 to March 2019, and 2017 Montgomery County Coroner's office death records. We first aggregate all three data sources into ZIP code level and compare their spatial distribution using map visualizations and Spearman's correlation test. We then use descriptive statistics and record linkage on the individual-level data from the police and the coroner to understand the demographic characteristics of fatal overdose events. Our correlation test results show a close similarity between the police and the coroner on their reports of fatal overdose locations (p-value < 0.001) in 2017. We find inconsistent location reporting between the police and EMS providers (p-value = 0.68). The demographic information of individual-level data matches closely between the police and the coroner. However, the police encounter data report a much higher proportion of heroin that is not indicated in the coroner's death records. These findings suggest that researchers should be aware of the limitations of these data sets and use them with appropriate caution.

Committee: David Kline (Advisor); William Miller C. (Committee Member); Lai Wei (Committee Member) Subjects: Biostatistics; Epidemiology; Health Sciences; Information Science; Public Health

DNP, Otterbein University, 2017, Nursing

The opioid overdose epidemic continues to escalate in the United States. Some of the morbidity and mortality associated with opioid overdose can be prevented with the timely administration of naloxone, an opioid reversal agent. The literature emphasized that the emergency department (ED) venue and registered nurses are well positioned to screen and identify high risk individuals whether they present as a result of an overdose or for other medical reasons. The literature also pointed to the importance of providing naloxone to high risk individuals and those who would be most likely to be at the scene of an overdose. This is critical because most overdoses occur at home. Additionally, negative attitudes and stigmatization towards individuals with substance use disorders (SUD) can result in provision of suboptimal patient care for this population. The literature demonstrated that education can improve knowledge gaps and negative attitudes towards patients with SUD. The purpose of this evidence-based practice improvement project (EBPI) was to address the knowledge gaps and attitudes of Emergency Department Registered Nurses (EDRNs) about the scope of the opioid overdose epidemic, SUDs as a disease, pathways from prescription opioids to heroin, treatment, recovery, harm reduction education, and nasal naloxone spray. The goal of the EBPI was to use evidence to increase the EDRNs' knowledge and improve attitudes to facilitate delivery of evidence-based care. The clinical question guiding the EBPI was “In EDRNs caring for patients at high risk for opioid overdose, how does providing a standardized education intervention about harm reduction education and naloxone nasal spray (HRENNS), compared to not providing standardized education, affect the EDRNs' knowledge and attitudes about providing HRENNS to patients at high risk for opioid overdose, measured immediately and 30 days following completion of the education intervention.” The project framework included Plan, D (open full item for complete abstract)

Committee: Eva Fried DNP, WHNP (Committee Chair); John Chovan PhD, DNP, RN, CNP, CNS (Committee Member); Jennifer Biddinger Mpsy (Committee Member) Subjects: Health Care; Mental Health; Nursing

PhD, University of Cincinnati, 2015, Nursing: Nursing - Doctoral Program

This dissertation study aimed to evaluate the feasibility of an innovative group-based opioid overdose educational intervention in individuals at high-risk for overdose. Opioid overdose is the leading cause of injury death in the United States and overdose fatalities have more than tripled in the past 25 years. Fatal opioid overdoses have been declared an epidemic by the Centers for Disease Control and Prevention and can be reversed by the timely administration of naloxone, brand name Narcan®. There are approximately 188 opioid overdose prevention programs (OOPPs) distributing naloxone to individuals at high-risk for witnessing an overdose and there is vital need to expand the dissemination of interventions that reduce the risk of overdose and expand access to naloxone. In 2013, the Substance Abuse and Mental Health Services Administration (SAMHSA) released the Opioid Overdose Prevention Toolkit to assist OOPPs in the development and implementation of opioid overdose prevention efforts. However, in its current format the toolkit is not amenable for use in the group setting. Therefore, the overall purpose of this feasibility study was to develop a group-based OOPP educational intervention and determine the implementation fidelity and intervention effect size. Specifically this study aimed to: 1). Modify the SAMHSA Opioid Overdose Prevention Toolkit for use in the group setting; 2). Determine whether clinicians, who have received training, can deliver the intervention with implementation fidelity in the group setting; 3). Determine participant responsiveness to the intervention; 4). Determine the intervention effect size. A total of 49 subjects, receiving inpatient treatment for opioid dependence, participated in the educational intervention. Participants completed a pre-test and a post-test to determine their knowledge about preventing overdoses, risk factors for overdose, and responding to overdoses, including the administration of naloxone. The end product of this (open full item for complete abstract)

Committee: Donna Martsolf Ph.D. R.N. (Committee Chair); Yvette Pryse Ph.D. (Committee Member); Erin Winstanley Ph.D. (Committee Member) Subjects: Nursing

MA, University of Cincinnati, 2024, Arts and Sciences: Geography

The escalating substance use disorder (SUD) crisis in the United States (US), marked by a significant rise in mortality since 1999, underscores the urgent need for a comprehensive analysis of its spatiotemporal dynamics. This study aims to elucidate the heterogeneous geospatial distribution of SUD mortality, identifying specific locations where vulnerable communities face heightened risk. By examining SUD mortality data from the US Center for Disease Control, for the period 2005-2020, scan statistics were used to delineate temporal and geospatial clusters of elevated SUD-related deaths, further dissecting these patterns across racial subpopulations and regions. Our findings reveal 27 distinct clusters nationwide, predominantly emerging post-2013 and persisting until 2020, indicating a shifting epicenter of the epidemic. Notably, the White subpopulation was associated with 26 clusters, closely mirroring the broader national trends, yet with a pronounced concentration in the eastern US. Conversely, the Black subpopulation demonstrated a different pattern, with 17 clusters arising between 2013 and 2020, primarily post-2015, suggesting a temporal and spatial divergence in the impact of the epidemic across racial subpopulations. This analysis not only highlights the critical need for targeted public health interventions and policies but also calls for continued surveillance to monitor and mitigate the evolving SUD crisis. By understanding the complex spatiotemporal and racial variations in SUD mortality, we can better allocate resources, develop effective prevention strategies, and support the communities most in need.

Committee: Diego Cuadros Ph.D. (Committee Chair); Xi Chen Ph.D. (Committee Member); Kevin Raleigh Ph.D. (Committee Member) Subjects: Geography

PhD, University of Cincinnati, 2024, Design, Architecture, Art and Planning: Regional Development Planning

The opioid overdose crisis is a public health emergency with devastating consequences in the United States. This crisis is an unprecedented increase in mortality due to unintentional overdoses involving opiates, such as prescription analgesics, heroin, and illegally manufactured fentanyl. Community-led initiatives (CLIs) are organizations of citizens with a common interest in taking ownership of their health and ultimately saving lives from opioid overdoses. Design supports CLIs' mission at strategic and operative levels, even when there is no participation of professional designers, and these processes happen organically. Design is also an enabler of innovation, but we do not understand the current design processes inside this organization and how they impact the mission of overdose prevention. The purpose of this research is to understand the impact of design in CLIs working in the prevention of opioid overdoses. This research used a mixed-methods approach and engaged in: 1) a systematic review of the tools available for communities to fight the overdose crisis. 2) A spatiotemporal analysis of opioid overdose mortality in Hamilton County, Ohio, in relation to naloxone distribution sites. 3) A content analysis of the types of design artifacts associated with overdose prevention. 4) Interviews with 2 CLI officers working in Cincinnati, Academic researchers working in participatory action research with communities, and professional designers working in this space. And 5) non-participant observation of design interventions in the urban environment around CLIs. This research found that the most common tools for CLIs are health, harm reduction, and other adjacent services; collaboration with other CLIs or intersectorally; community engagement; and social change strategies. Different design typologies support these community strategies, including service and participatory design from a strategic perspective and graphic, industrial, and UX design fro (open full item for complete abstract)

Committee: Christopher Auffrey Ph.D. (Committee Chair); Daniel Arendt Pharm.D. (Committee Member); Claudia Rebola Ph.D. (Committee Member) Subjects: Design

MDES, University of Cincinnati, 2023, Design, Architecture, Art and Planning: Design

The Opioid Overdose (OD) epidemic has been recognized as a public health issue in the United States. Harm reduction organizations, syringe service programs and safe use sites have been developed, while products such as mobile applications and devices are being proposed for various community needs. Despite the research and effort going into digital and technological innovation for OD prevention, there is a gap in access to care, support, and resources to ensure safety at any given location and time. NarConnect is a community-based and human-centered interface and systems design developed for saving lives from an opioid OD. NarConnect provides its primary users with a physiological monitor to measure vitals, and a mobile application that helps its users to convert any place into a safe use site. The objective of this thesis is to utilize participatory research methods to evaluate the usability of the NarConnect application for further development. The outcome of this thesis is a robust mobile application prototype that is rooted in user-centered design. Additionally, this thesis aims to report research findings that can be utilized by prospective applications and interventions supporting harm reduction needs.

Committee: Daniel Arendt Pharm.D. (Committee Member); Claudia Rebola Ph.D. (Committee Chair) Subjects: Design

Doctor of Philosophy, The Ohio State University, 2023, Public Health

Drug-related overdoses are the leading cause of injury-related death in the United States. Previous drug overdose research has focused primarily on death-related outcomes and opioid-related overdoses. Currently, little is known about drug-related hospitalizations and non-opioid-related overdoses. A drug overdose occurs when a toxic amount of a drug or drugs overwhelms a person's body, limiting normal body functions. A better understanding of drug-related hospitalizations and ecological associations will aid in interventions and policy creation to lessen the severity of the Florida drug epidemic, and possibly the US drug epidemic. In this research project, I analyzed an extensive database of more than 63 million inpatient hospital billing records from all Florida hospitals collected by the Agency for Health Care Administration in Florida (AHCAF) from 1988 to 2012. The overall objective of this study was to elucidate trends and patterns of hospitalizations for drug-related overdoses during the study period. There were four specific aims of this study: examine epidemiological trends of drug-related overdose hospitalizations in Florida between 1988 and 2012, explore risk factors for predicting an intensive care unit admission during a drug-related overdose hospitalization in Florida from 2010 to 2012, examine the association between county-level demographics and county-level drug-related overdose hospitalization rates in Florida in 2010, and compare comorbid psychiatric condition profiles between Florida residents discharged to home and psychiatric care after a drug-related overdose hospitalization in 2010. Over the 25 years of the study, drug-related overdose hospitalization rates increased significantly for opioids and analgesics (908%), sedatives and hypnotics (38%), psychotropic agents (27%), and central nervous system stimulants (4550%). During the same period, the hospitalization rates due to central nervous system depressants and anesthetics decreased by 41% (open full item for complete abstract)

Committee: Randall Harris (Advisor); Jared Huling (Committee Member); Kathyrn Lancaster (Committee Member); Tasleem Padamsee (Committee Member) Subjects: Public Health; Public Policy

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

The rise in rates of opioid overdose is a public health crisis in the United States. Retrospective studies show that the opioid overdose crisis is not homogeneously distributed across space and time, and there is increasing recognition that its etiology is rooted in part by social determinants such as poverty, environmental disadvantage, isolation, and social upheaval. It's important to understand the spatiotemporal variation in opioid overdose emergencies and its possible social and environmental determinants to guide public policy responses to the crisis as the obtained knowledge can benefit health care administration and epidemiological purposes, coupled with the need for generating reliable risk assessment for small geographical areas. This dissertation aims to develop new spatial-temporal methods and utilize new geospatial data for understanding the space-time pattern of opioid overdose events (OOEs) and associated socio-environmental factors for OOEs. This dissertation consists of three major parts: 1) Understand how OOEs evolved over space and time using a regionalized sequence alignment method; 2) Understand the social and physical environmental determinants in OOEs at high spatial-temporal resolution using found geospatial data; and 3) Use city municipal 311 service requests as indicators of neighborhood distress and predicting the trends of OOE hotspots when OOEs data is not available. The outcome of this dissertation helps us understand the critical spatiotemporal characteristics of the opioid overdose crisis and provides valuable information to identify the potential socio-economic and environmental drivers of the crisis as well as geographic areas where vulnerable populations are located, and where interventions should be implemented.

Committee: Harvey Miller (Advisor); Ayaz Hyder (Committee Member); Elisabeth Root (Committee Member); Desheng Liu (Committee Member) Subjects: Geographic Information Science; Geography; Public Health

PhD, University of Cincinnati, 2022, Arts and Sciences: Chemistry

Reactive oxygen species are a group of highly reactive oxygen-containing entities that are important at a cellular level for multiple biological processes. Low concentrations of ROS can be beneficial as powerful signaling molecules in those biological processes, although excessive concentrations can promote high levels of DNA damage and a variety of diseases such as skin cancer. A newly identified intracellular ROS production source in skin cells is NADPH oxidases. Out of the NOX enzyme family, the NOX1 holoenzyme is most abundantly expressed in the human keratinocyte cells. UV radiation can trigger the activation of NOX1 isoforms which stimulate the assembling of member CYBA and the cytoplasmic protein NOXO1. Inhibition of these enzymes represents a catalytic approach toward reducing ROS for the prevention of ROS inducible diseases. Key disease states include melanoma induced by UV exposure. The first half of the dissertation focuses on investigating new small molecule inhibitors of a key NOX1 holoenzyme to address these challenges. We designed a series of molecules by optimizing the structure of diapocynin and evaluated by in-silico docking methods to determine the binding affinity with NOXO1 cytoplasmic protein (1WLP crystal structure). And have synthesized the series of target molecules for the structure-activity relationship studies. In the first section of the project, we discovered that inhibitor NOX_inh_5 was not cytotoxic, but instead improved the viability of human primary cells from UV exposure, decreased the cellular stress in human skin through the p53 pathway, and reduced the UV-induced DNA damage as monitored by quantification of cyclobutane dimer formation after UV exposure. Then, we characterized the inhibition potential of NOX_inh_5 by using an Isothermal calorimetric (ITC) binding assay and heteronuclear single quantum coherence (HSQC) technique and revealed that the candidate molecule can prevent the complex formation of NOXO1 and CYBA me (open full item for complete abstract)

Committee: Edward Merino Ph.D. (Committee Member); Peng Zhang Ph.D. (Committee Member); In-Kwon Kim Ph.D. (Committee Member) Subjects: Pharmaceuticals

Doctor of Philosophy, University of Toledo, 2020, Health Education

The fatality rate of prescription and non-prescription opiate overdoses in the United States (U.S.) continues to rise, constituting an ongoing public health threat. One effective measure to prevent opiate overdose fatalities is the administration of an antidote Naloxone hydrochloride (Narcan®) by medical and non-medical first responders. Research indicates that training members opiate users' social networks (i.e., family members, loved ones, and others with whom they use opiates) to administer Narcan®, is an effective strategy for preventing overdose fatalities. The scientific community has reached a consensus that expanding Narcan®, access positively impacts the rate of fatal opiate overdoses in the U.S. Thus, the purpose of the first study listed within this dissertation, was to examine former opiate users' perceptions regarding the barriers that members of their social networks may have faced in accessing and using Narcan®. In the second study, the perceived efficacy of fear appeal and positive framed health communication messages in influencing the decision of members of the social network of opiate users to administer Narcan® was assessed. Findings from the first study provide insight into the opiate use scenarios shared by former users that did or should have involved Narcan® administration as a lifesaving measure. The participants in this study shared their self-assessed risk of experiencing an opiate overdose while they were using and how this impacted the awareness and use of Narcan® among members of their social network. These individuals also described the overall perceived benefits and barriers to Narcan® access and use among the members of their social network. The former opiate users further differentiated between perceived barriers to Narcan® use among opiate users and non-users. Participants also shared valuable insights regarding the settings in which they secured or purchased opiates. Some described scenarios where they successfully administered (open full item for complete abstract)

Committee: Tavis Glassman (Committee Chair); Joseph Dake (Committee Member); Ling Na (Committee Member); Kasey Tucker-Gail (Committee Member) Subjects: Behavioral Sciences; Social Research

Master of Science (MS), Wright State University, 2020, Chemistry

Illicitly manufactured fentanyls (IMFs) have become a global and local epidemic and have recently caused an increase in the number of accidental exposures and overdoses in first responders and the community. The aim of the research is to explore a method to discriminate between IMFs and cutting agents in mock street samples using Raman Spectroscopy. Predominant Raman bands corresponding to the structural moieties of each individual illicit, licit drugs, and cutting agents were tracked, then used to discriminate between varying components in a mock street sample. In conclusion, discrimination between the components in the mixture was obtained using Raman Spectroscopy. The inquiry will provide the basis for a viable method in the prevention of accidental exposures and overdoses in first responders and the general public.

Committee: Ioana Pavel Ph.D. (Advisor); David Dolson Ph.D. (Committee Member); Steven Higgins Ph.D. (Committee Member) Subjects: Chemistry; Toxicology

PHD, Kent State University, 2017, College of Public Health

This study evaluates the acceptability of pharmacy based opioid misuse and abuse interventions by surveying practicing pharmacists and patients in treatment for substance use disorders. The survey instrument examines five specific pharmacy-based interventions using a Likert scale to measure acceptability: (1) Pharmacists counseling patients on the risks associated with opioid misuse and abuse, (2) pharmacists referring patients to drug treatment programs within the community, (3) pharmacists utilizing Prescription Drug Monitoring Programs (PDMPs) to validate prescriptions, (4) pharmacists providing emergency opioid overdose treatments such as naloxone with opioid prescriptions, and (5) pharmacists providing naloxone without a prescription. The goal of this study is to answer three research questions: which interventions are most acceptable to pharmacists, which interventions are most acceptable to patients, and which interventions produce statistically significant agreement on acceptability when both pharmacist and patient attitudes are compared. These data are used to identify a subset of interventions with high acceptability within and across the two groups. These findings are, in turn, used as an indication of professional and patient receptivity to specific interventions. The interventions with the greatest acceptability within each group and the strongest agreement across groups are identified, and changes to State regulations, organizational policy, and professional training that foster these interventions, as supported by the literature, are proposed.

Committee: Sonia Alemagno PhD (Committee Chair); VanGeest Jonathan PhD (Committee Member); Phillips Lynette PhD (Committee Member); Deric Kenne PhD (Committee Member); Mark James PhD (Other) Subjects: Pharmacy Sciences; Public Health Education; Public Policy

MS, University of Cincinnati, 2016, Medicine: Epidemiology (Environmental Health)

The problem of prescription opioid pain reliever misuse and abuse has become a critical public health issue in the United States. Current public health efforts include monitoring patients on courses of opioid pain therapy, treatment interventions for those who are already abusing or misusing opioids, prescription drug monitoring programs aimed at reducing misuse and diversion, and Naloxone distribution programs to save the lives of those who overdose. To date, there has been little definitive research on prescribed opioids as an initial exposure preceding opioid abuse. This study examined the proportion of emergency department patients with a history of opioid abuse who reported their initial exposure as medical (prescribed to them by their doctor for a medical purpose) and, if so reported, how many of those initial prescriptions came from an emergency department (ED). In this cross-sectional study design, ED patients who self-reported nonmedical opioid use were surveyed about their initial opioid exposure, non-opioid substance use prior to initial opioid exposure, and subsequent opioid use including time from initial exposure to nonmedical use. From 59 enrolled subjects, 35 reported their initial opioid exposure as medical (35/59; 59%; 95% confidence interval [CI] 47% to 71%), and of these, 10 reported their initial exposure was from an emergency department (10/35; 29%; 95% CI 16% to 45%). Thirty-one of the 35 medically exposed subjects reported that time from initial exposure to onset of nonmedical use, with a median time from initial medical exposure to onset of nonmedical use was 12 months (interquartile range [IQR] 2 to 36). Most medically exposed subjects (28/35; 80%; 95% CI 65% to 91%) reported non-opioid substance use (illicit substance use) or treatment for non-opioid substance use (alcohol or illicit substance use) prior to, or at the time of, their initial medical exposure. Medically exposed subjects were similar in characteristics, in their non-opioid su (open full item for complete abstract)

Committee: Kim Dietrich Ph.D. (Committee Chair); Michael Lyons M.D. M.P.H. (Committee Member); Marepalli Rao Ph.D. (Committee Member) Subjects: Epidemiology

MS, University of Cincinnati, 2012, Medicine: Clinical and Translational Research

Background: Medication errors are a common cause of injuries sustained in hospitals and up to 6% are related to opioids. A challenging task for clinicians is to find the perfect balance between providing effective analgesia and preventing adverse events Objective: Evaluate the incidence and risk factors associated with opioid overdose in a non-surgical inpatient population. Methods: A case-control study based on information from the electronic health record following discharge from a large community hospital in Cincinnati, OH between June and December 2008. Participants were adults hospitalized on medical wards and receiving opioid therapy. Cases met clinical criteria for opioid overdose and were treated with Naloxone, while. controls were randomly selected from the same time interval. We excluded patients admitted for opioid overdose, those on patient controlled analgesia, or those in a perioperative setting including same-day outpatient procedures. Main Measures: Opioid overdose events, patient demographics, laboratory values, comorbidities, type and number of opioids used, dose in morphine equivalents and other psychotropic medications used. Results: Of a total of 19,111 patient discharges, 40 (0.21%) met the case inclusion criteria for opioid overdose. Patients with overdoses had a lower weight and were receiving higher opioid doses both prior and during the hospitalization. Hydromorphone was the opioid most frequently associated with overdose events while Hydrocodone was the least. Multivariate logistic regression analyses showed older age (OR 1.06 [95% CI 1.01 to 1.11], p= 0.012), serum creatinine (OR 1.36 [95% CI 1.07 to 1.73], p=0.011) and 24-hour total morphine equivalents received (OR 1.01 [1.00 to 1.02], p=0.002) to be most highly associated with overdose. Hydrocodone use (OR 0.12 [95% CI 0.02 to 0.69], p=0.018) was associated with a decreased risk of overdose. Conclusions: Opioid overdose events were more frequent among older patients with increased cr (open full item for complete abstract)

Committee: Erin Nicole Haynes DrPH (Committee Chair); Mark Eckman MD (Committee Member); Mark Wess MD (Committee Member) Subjects: Surgery

Master of Sciences, Case Western Reserve University, 2012, Physics

Radiation exposure in medical imaging has become a major concern all around the world. Specifically, CT scanners carry the highest risk of a high dose of radiation, delivering hundreds of times more radiation than that of a single X-ray image. Studies have shown a direct relation between CT scans, the chance of getting cancer, and mortality rates. The contradicting problem is that lowering the radiation dose causes inferior image quality, which may result in rescan or a misdiagnosis. Plexar Imaging, a startup situated in Cleveland, has found an innovative way to reduce unnecessary exposure to radiation in CT scans, by quantifying the lowest dose that will produce acceptable image quality, as determined by the radiologists in a hospital system. The product of a CT scan is a set of images. The requirement is that the radiologist can make the right diagnosis from those images. With a universal metric based on image quality and a method to calibrate any CT scanner to that metric, PI has developed a way to make sure the desired IQ will be achieved while using only the least amount of radiation that is necessary. The use of IQ as the measurement unit will help standardize the radiation dosage in CT scans, and will provide, for the first time, a common scale technologists and radiologist can use to communicate with each other.

Committee: Edward Caner MS (Committee Chair); Bruce Terry MBA (Committee Member); Robert Brown PhD (Committee Member); David Rohler PhD (Committee Member); Steven Izen PhD (Committee Member) Subjects: Entrepreneurship; Medical Imaging; Radiation