Lung cancer is the second most common cancer and maintains a small survival rate (~20%). Non-Small Cell Lung Cancer (NSCLC) makes up 80-85% of all lung cancer diagnoses. Lung cancer patients routinely undergo surgical procedures, chemotherapy, and/or radiation and these therapies can drive ongoing systemic issues, greatly hindering patient welfare and recovery timelines. Importantly, chemotherapy and radiation can induce deleterious systemic side effects, particularly within skeletal muscle, that are not reversible even in remission. We conducted experiments to determine whether Metformin can reduce lung cancer tumor burden in immunocompetent mice while maintaining skeletal muscle health. Mice were given Lewis Lung Cancer, a form of NSCLC, in the left lung. Control animals received a vehicle treatment of saline and treated animals received Metformin. The cancer cells contained a bioluminescent reporter allowing tumor growth tracking throughout the study. Skeletal muscle homogenates from the cancer-bearing mice were analyzed for changes related to inflammation, muscle mass, and metabolism. Experiments with lung cancer cells in vitro were also conducted to determine how Metformin influences the oncogenic program of NSCLC. These findings led us to conclude that Metformin treatment, while exhibiting anti-neoplastic characteristics for many other cancers, may not be the best monotherapy for NSCLC tumor growth.
Posttraumatic growth theory (PTG) posits that positive psychological changes can result from the struggle to resolve traumatic experiences (Tedeschi & Calhoun, 2004). According to PTG, growth develops through a specific process beginning with violated core beliefs, occurring when traumatic experiences shatter one’s conceptualization of the world as safe and trustworthy. Violated core beliefs lead to intrusive and then deliberate rumination. Failure to progress from intrusive to deliberate rumination leads to depreciation, or feeling stuck in the traumatic experience. However, empirical investigations of the pathways to growth and depreciation have led to mixed results regarding the extent to which violated core beliefs contribute to depreciation. This gap suggests that an additional route to depreciation exists that is not yet understood. Cognitive Processing Therapy (CPT; Resick & Schnicke, 1993) may be able to fill this gap. CPT posits that two cognitive outcomes can occur after traumatic experiences: positive core beliefs can be violated or negative core beliefs can be confirmed. Confirmed, or assimilated, core beliefs may be the missing link that provides another pathway to depreciation. This dissertation proposes and investigates a model integrating PTG and CPT theories at the level of core beliefs. Results support that core beliefs are assimilated and accommodated by the trauma of infidelity. However, results indicate that more research is needed to fully understand the implied cyclical nature of rumination and specific elements that facilitate growth and depreciation.
In the modern airspace, small unmanned aircraft systems (sUAS) such as multi-rotor aircraft, commonly referred to as "drones", are becoming increasingly popular with both amateur enthusiasts as well as professional pilots. In recognition of the necessity to integrate sUAS traffic into the national airspace system, Congress passed the FAA Modernization and Reform Act of 2012, which created the mandate for the FAA to regulate sUAS operation in United States national airspace. This legislation also created a number of obligations and duties for UAS pilots, including avoidance of restricted airspace, maximum flight levels, safe separation from aircraft (including other UAS), as well as avoiding flight over civilian human population and contact with personal property such as buildings or cars. Because of the nature of flying a drone either for pleasure or commercial purpose, it is very easy for operators to lose their situational awareness (SA) of the operating environment. A study published by the NASA Langley Research Center in 2017 found that the majority of commercial aviation accidents not attributable to aircraft systems failure involved the crew’s loss of SA of the aircraft or the environment, and that crew distraction from operation was associated with all of these accidents. If this is the case with commercial aircraft pilots inside of an enclosed aircraft cockpit in relative isolation, it is easy to imagine that the potential for distraction in the UAS environment is at least as great. This demonstrates the potential for a decreased SA state to create an unsafe environment for other pilots and bystanders and lead to fines and penalties for the UAS pilot if damage, injury, or disruption to the airspace occurs.
One mode of pathological flight phenomena in fixed-wing aircraft is that of pilot-induced oscillations (PIOs). These PIOs can occur either as a result of pilot-airframe coupling as in the case of biodynamic feedthrough or as a result of the lag between pilot observation and action and the propagation of the pilot’s actions and the control response of the aircraft under the influence of structural or environmental stimulus on the aircraft system. Under either scenario, the actions necessary to identify and resolve PIOs can quickly distract the pilot and cause a degradation of pilot SA level. This pilot distraction can lead to mission task element (MTE) failure, loss of aircraft control, or damage or destruction of the aircraft and surrounding persons and property. In the case of UAS, some PIOs can be induced as a result of a lack of direct tactile feedback and neurosensory coupling between the remote pilot and the aircraft. While some of these effects can be mitigated with the addition of haptics in the control actuators or through the use of first-person view monitor goggles, increased distance between the remote pilot and the UAS reduces the ability for the remote pilot to judge the effects of fine control inputs on UAS attitude. This can lead to the development of PIOs as the remote pilot attempts to control the UAS from a distance. Long-range, beyond line-of-sight missions rely upon autonomous flight control system to guide the UAS using global navigation satellite systems (GNSS) or more complex navigational methods such as inertial guidance, celestial navigation, or terrain-matching in communications-denied environments; however, these autonomous methods do not work well for primarily human remote pilot operations with augmented control applications such as bridge or communications tower inspection, where the UAS must be guided from a distance by a human pilot while focusing on specific tasks identified during the mission. To better enable an individual UAS operator to carry out complex mission task elements, we sought to develop a head-mounted display (HMD) equipped with see-through augmented reality (AR) capabilities. The objective of this HMD is to provide information to the pilot using low-complexity visual cues with sufficient information capacity to help improve mission performance and maintain pilot SA while minimally increasing or even decreasing pilot cognitive processing workload. We refer to this system as AviatAR. The contributions of this research include: new and additional insights into the development of PIO phenomena during rotary-wing UAS operation, the detection of PIO development in real-time during flight operation of rotary-wing UAS, and comparisons of the effects of communication of visual flight information to a pilot through the primary and peripheral visual fields using a see-through AR headset.
The purpose of this narrative qualitative study was to explore how artist-teachers perceive themselves, their strategies for maintaining a balance of the artist-teacher dual identity and their perceived benefits for students. This study included eight participants with a minimum of five years of teaching art in a K-12 public school and considered themselves an artist-teacher. The analyzed data resulted in the following findings:
K-12 artist-teachers perceive themselves as having a dual identity of both an art educator and practicing artist, that early artmaking experiences and past art teachers were influential in their identity formation and that in addition to teaching, personal artmaking is needed for their job satisfaction and life fulfillment. Findings also include:
K-12 artist-teachers maintain the balance of their dual identity by having a designated place for art making, prioritizing and scheduling time for their art practice and connecting with other creative individuals or groups for accountability and collaboration. Additionally, this study’s findings demonstrates that K-12 artist-teachers perceive their dual identity benefitting students by infusing excitement and energy from their own artistic practice into their teaching, building strong connections through shared experiences and explorations, and readily integrating and introducing students to diverse and relevant contemporary artists. Implications include increased professional development for art educators in opportunities for collaboration, knowledge of new media and techniques and methods for integration of diverse and contemporary artists Additional implications include increased training for preservice art educators on attaining and sustaining the balance of the artist-teacher identity .
In this dissertation document, we describe the potential for Information Extraction, Information Retrieval, and Machine Learning methods to improve the process of analyzing medical texts and, in particular, Clinical Practice Guidelines (CPGs). We present the results of three in-depth studies consisting of dozens of experiments on finding condition-action and other conditional sentences in guideline documents. We are improving the state-of-the-art results (from 5% to 17%) and showing for the first time the applicability of domain adaptation and transfer learning to this problem.
We also present new methods for identifying inconsistencies in disagreements between medical guidelines, and for analyzing them using a combination of machine learning, information retrieval, and text mining methods. We show the need for a formal distinction between contradictions and disagreements in natural language texts to formally reason between contradictory medical guidelines.
We introduce new representations for collections of guideline documents and an algorithm for comparing collections of documents. We use these to investigate conceptual distances between guidelines for the same conditions. Throughout this process, we prove the hypothesis that the difference in recommendations largely (by 69% to 86%) correlates with the differences in concepts used by the medical bodies authoring the guidelines.
Finally, we show the applicability of text analysis methods to practical problems of analyzing textual information in electronic health records. We achieved 83% accuracy in matching medical records with a list of pre-defined conditions in an EHR system, resulting in clinical system support changes in one of the leading US hospitals.
Many communities use the Vulnerability Index-Service Prioritization Decision Tool (VI-SPDAT) to determine which individuals and/or households experiencing homelessness are most vulnerable and therefore prioritized for the limited housing resources available. Because of the tool’s widespread use and implications for housing, the present study examined the reliability and validity of the second version of the VI-SPDAT for Single Adults with a sample of individuals experiencing chronic homelessness in Charlotte, NC. Results suggest that the VI-SPDAT is strongest in measuring areas associated with psychological symptomatology and/or mental health, but that the scale had significant limitations in its internal consistency, ability to adequately measure the construct of vulnerability, and convergent, concurrent, and predictive validity. Furthermore, findings raise concerns related to the VI-SPDAT’s ability to adequately reflect the complex and dynamic behavioral, social, and medical needs of those experiencing chronic homelessness. Taken together, the findings from this study point to issues with the VI-SPDAT’s reliability and validity and provide actionable information to help inform areas that should be strengthened and/or modified to better capture the needs and vulnerability of individuals experiencing homelessness. It is hoped the findings from this study can inform local efforts for assessing the needs and functioning of individuals experiencing homelessness and, more importantly, provide information that can be used to ensure equitable allocation of services in the homeless service system.
Veteran business owners are essential contributors to American society and the U. S. economy. Statistics showed a looming drawdown of military personnel and comparatively higher unemployment rates than the civilian population, which led to a growing interest in assisting veterans with entrepreneurship. Studies show that military service has a strong association with entrepreneurship. Few studies have identified key factors of veteran business ownership and action-oriented questions on how or why veteran entrepreneurs find their way to business ownership. There are calls in the literature to answer the question of whether entrepreneurial competencies can influence entrepreneurial intentions. Veterans are often faced with the challenge of building a second career following separation from the military. There is limited research about what factors may motivate and support their transition to self-employment or how they fare compared to nonveteran employees. Furthermore, there are no studies that examine the role of resilience in the entrepreneurial process related to American Veteran Entrepreneurs. The purpose of the study is to determine if resilience and entrepreneurial competencies influence veteran entrepreneurial intention to start a business. This study examines the relationship between entrepreneurial competencies and entrepreneurial intentions among Veterans.
Prescription drug expenditures and utilization are the fastest and most widely varying expenditures within Medicaid programs across US states. The passage of the Affordable Care Act (ACA) in 2010 and the subsequent Medicaid state expansions resulted in very large coverage gains among several demographics at the state level. A number of studies prior to ACA highlighting determinants of health utilization and expenditures have been identified and studied discreetly, however, the relationships among these determinants, and the latent constructs of policy, access, enabling health system and predisposing characteristics have not been tested concurrently in relation to drug expenditures
Data from the Centers for Medicare and Medicaid Services ( CMS), US Department of Labor , Department of Education, and state Medicaid programs were merged to create a balanced panel data (n=350 observations and 53 variables over a seven ( 7) period from 2009 to 2015); and was analyzed using random effects (RE) panel regression analysis to estimate a model for drug expenditure across US state Medicaid programs.
Based on Andersen’s Behavioral Model of Health Services, and using a Structure Equation Modeling the study also examined the relationships between and tested the hypothesized effects of policy, access and predisposing factors on State Medicaid expenditures. Findings on effects of cost containment policies, ACA expansion, access to health care facilities and demographic distribution within Medicaid and an econometric model that estimates state drug expenditures are included followed by discussions, limitations and future directions for research
