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Amber Cruise\u27s interview transcript
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Utilizing artificial intelligence for enhanced quality assurance in emergency medical services: feasibility and applications
No full texthonors thesisCollege of HealthHealthGraham Breant-ZawadzkiLarge Language Models (LLMs) are a type of machine learning, a subset of artificial intelligence (AI), capable of learning language and generating human-like text in response to input they receive. These models are trained on vast amounts of data, allowing them to recognize patterns, context, and semantics in language. Over the last decade, LLMs have increased in quantity and quality, showing strong performance in language generation, information retrieval, and, more recently, complex reasoning (Bathaee, 2018). Many fields have begun integrating LLMs, streamlining or completely automating many processes that require language comprehension. In healthcare and especially emergency medicine, where accuracy and efficiency are necessary for complex situations, LLMs can support healthcare professionals in several ways. As the capabilities of LLMs rapidly expand, their utility and impact are only beginning to be realized. A wide variety of AI technologies are already being integrated or tested in clinical applications. This honors thesis explores the emerging applications of LLMs in Emergency Medical Services (EMS), in three main areas: triage, documentation, and quality assurance. I will devote the most attention to this latter application. Building on a recent publication that I coauthored exploring the potential of LLMs to perform quality assurance, I will propose updated methods that address limitations based on recent innovations. Additionally, I will address the practical challenges of implementing an AIassisted quality assurance system in a real EMS agency. I believe that proactive consideration of the ethical and effective use of AI-generated clinical assistance in EMS is essential to safely maximize their potential impact
Targeting excess ceramides as an Alzheimer\u27s disease intervention
No full texthonors thesisCollege of EngineeringBiomedical EngineeringWilliam L. HollandNeurodegenerative disorders such as Alzheimer\u27s Disease (AD) are increasingly associated with irregular lipid accumulation. Dysfunction in the catabolism of sphingolipids leads to many neurodegenerative disorders and has recently gained interest in AD. Excess ceramide deposition has been observed in amyloid-beta (Aβ) plaques, plasma, and cerebrospinal fluid of AD patients. Ceramide-lowering strategies have been underexplored as a treatment for AD and may prove beneficial in mitigating the disease. We used both pharmaceutical and genetic approaches to target ceramide accumulation in the 5xFAD mouse model of AD. Myriocin, an inhibitor of ceramide de novo synthesis, was administered to mice fed either a normal chow diet or a pro-ceramide diet. As a genetic approach, we developed an inducible loss-of-ceramides model by overexpressing Asah1 in neurons, the gene encoding the ceramide degrading enzyme acid ceramidase. We assessed the loss of ceramides as a preventative disease treatment. We assessed Aβ plaques and the activation and quantity of glia by immunohistochemistry. Mitochondrial function was assessed using high resolution respirometry. Cognitive behavior was assessed using Barnes mazes and fear conditioning chambers. Pharmaceutical inhibition of ceramide synthesis and targeted neuronal ceramide reduction enhanced cognitive outcomes and mitigated AD pathology in 5xFAD mice. Myriocin-treated 5xFAD mice exhibited reduced plasma and hippocampal ceramides, smaller Aβ plaques, fewer glial cells, improved memory, and mitochondrial function. Early neuronal Asah1 overexpression rescued memory loss but did not alter plaque size. However, it eliminated gliosis, restoring glial morphology to wild-type patterns. Our findings highlight ceramides as a promising AD therapeutic strategy
Strategic dilemmas of ecological businesses: a case study of value creation across ten firms to combat climate change
No full texthonors thesisGeneral CatalogQuantitative Analysis of Markets & OrganizationsRebekah ShraderClimate change is the modern world\u27s most pressing problem, threatening ecosystems, livelihoods, and the state of the world as we know it. The crisis is created and fueled by economic market failures, where the allocation of market resources is inefficient and leads to suboptimal outcomes. This has created the emergence of ecological firms seeking to exploit market failures to achieve profitability while reducing environmentally degrading behavior. Our analysis of 10 ecological businesses reveals specific strategic dilemmas shaping the value-creation ability of these firms. Through interviews with firm executives, we provide needed literature on particular practices adopted by companies to address market failures, meet business objectives, and create innovation in an emerging landscape
Social support across the cancer care continuum in Malawi: narratives from cancer survivors
No full texthonors thesisCollege of Social & Behavioral ScienceSociologyMelissa WattInformational, emotional, and instrumental support provided by an individual\u27s social network can help individuals cope with life stressors like a cancer diagnosis. As the cancer burden in lower-and middle-income countries (LMICs) continues to increase, cancer patients face challenges that may be alleviated in part through the provision of social support. The goal of this study was to examine the role of social support in the journeys of cancer survivors, from diagnosis to initiation of care to completion of treatment, and to better understand how social support can act as a facilitator to the initiation and completion of treatment. We conducted individual in-depth interviews with 29 patients who completed treatment for breast cancer or lymphoma at Kamuzu Central Hospital in Lilongwe, Malawi. Interviews examined the lived experiences of survivors along the cancer continuum (diagnosis, initiation of care, retention in care). Applied thematic analysis was used to identify patterns of informational, emotional and instrumental support across each of the three stages of the cancer care continuum. Participants included 17 women and 12 men, with 20 lymphoma survivors and 9 breast cancer survivors. The median age of the sample was 45 years old, with a median of 3 years since diagnosis. The interviews demonstrated social support was an important facilitator at all stages of the cancer care continuum, but the types of social support that emerged as important differed at each stage. At the stage of diagnosis, informational support was important, with recognition of symptoms and knowledge of healthcare facilities by patients\u27 family and friends helping to facilitate faster diagnosis. At the initiation of treatment stage, emotional and informational support were important, with patients receiving encouragement and advice from family and friends to begin medical treatment. At the retention and completion of treatment stage, instrumental and emotional support were most important. This involved caretakers helping patients adhere to treatment through managing medications and appointments, helping to manage side effects such as nausea, assisting the patient with activities of daily living, and providing reassurance and motivation for the patient to continue treatment. These findings can be used to inform effective and appropriate interventions along the cancer care continuum to promote patient wellbeing and adherence to treatment in Malawi. This could include community-level education about cancer symptoms, screening, and treatment to address informational support needs at diagnosis; support groups composed of cancer patients and survivors to address emotional and informational support needs at the initiation of treatment stage; and supporting caretakers fulfilling emotional and instrumental support needs at the retention and completion stage while filling in the gaps for those who do not have this support with formal assistance such as provision of transportation and food
The role of autism-associated Gene Kirrel3 in synapse maintenance and hippocampal activity
No full texthonors thesisSchool of Biological SciencesBiologyMegan WilliamsKirrel3 is a synaptic cell adhesion protein necessary to form a specific type of synapse in the hippocampus. During development, Kirrel3, expressed on excitatory dentate gyrus (DG) neurons and inhibitory GABAergic neurons, binds transcellularly with itself, forming a synapse between the two. Previously, the Williams lab found that germline Kirrel3 knockout mice are missing these synapses, resulting in increased hippocampal activity. Interestingly, mice expressing Kirrel3 during development continue to express it after a synapse is formed. However, it is unknown if Kirrel3 is needed to hold the synapse together after development. To test this, I used a transgenic mouse with Kirrel3 flanked by lox p segments and an AAV virus carrying Cre recombinase to remove Kirrel3 after synapse formation. After two weeks, I foot-shocked the mice and analyzed them for cFos; a proxy activity marker. My results showed increased cFos signaling in conditional Kirrel3-injected adult mice compared to wild-type injected adult mice. This suggests that Kirrel3 is necessary to maintain synapse formation. Continuing this investigation of Kirrel3 in adult mice will bring us closer to understanding the mechanical role of Kirrel3 in synaptic formation and neuronal connectivity. Moreover, understanding the function of Kirrel3 may be clinically beneficial as variations in Kirrel3 are associated with neurodevelopmental disorders like autism and learning disabilities
Knowledge of condition among pediatric patients with a difference of sex development and their caregivers
No full texthonors thesisCollege of Social & Behavioral SciencePsychologyKristina Suorsa-JohnsonDifferences of Sex Development (DSD) are congenital conditions that affect an individual\u27s sex characteristics due to genetic (i.e., sex chromosomes) or phenotypic differences (i.e., gonadal or genital development). DSD are rare, occurring in approximately 1 in 4,500 to 5,000 live births. Additionally, there are limited data available on patient and parent/caregiver (hereafter referred to as "caregiver") knowledge of the condition. Understanding patient and caregiver knowledge regarding the condition is critical as it allows them to understand why the difference occurred and supports their engagement in medical decision making. Through this study, I hoped to understand rates of knowledge of both patients and caregivers presenting to pediatric DSD clinics across the United States. Both patients (>10 years old) and caregivers completed a Knowledge of Condition (KoC) form at least 6 months following their initial appointment in clinic. The KoC examines the name of the condition and their understanding of what caused the condition. Caregivers also completed the Psychosocial Assessment Tool (PAT), which includes information about social determinants of health (e.g., race, ethnicity, caregiver\u27s highest level of education). Medical chart review was also completed for each patient to confirm DSD diagnosis. Data from 328 caregivers and 170 patients were collected. Participants included 170 patients, ranging from 9 to 39 years old, who had been diagnosed with a DSD and 328 caregivers (age range = 16-69 years old). Results showed that roughly 75% of patients and caregivers that provided a name for the diagnosis were accurate when compared to the diagnosis in the medical chart. However, from these responses, 16% (n = 79) of participants were not able to accurately recall the name of their condition. Related to social determinants of health, fathers\u27 highest level of education was positively correlated with whether patients could name their diagnosis-patients that had fathers with higher education levels were more likely to report knowing a diagnosis. Similarly, fathers\u27 education was also correlated with caregivers\u27 ability to provide a cause for the diagnosis. In conclusion, understanding patient and caregiver condition-specific knowledge is essential and will allow healthcare providers to better understand the educational needs of patients. With a better understanding that different social determinants of health were associated with knowledge, specifically caregiver education, it will help ensure healthcare providers are targeting those who may require additional educational supports and offers healthcare providers the opportunity to provide higher quality care for their patients via addressing knowledge gaps. Improving patient and caregiver education will allow them to participate with a greater understanding of their plan of care and allows for more confidence in their treatment
Fire history and climate responses at Fish Lake, Utah: an examination of fire, climate, and vegetation at the Pando Aspen clone for the last 15,000 years
No full texthonors thesisCollege of Social & Behavioral ScienceEnvironment, Society & SustainabilityAndrea BrunelleThis research focuses on a fire history reconstruction for Fish Lake, Utah, for the last 15,000 years. The majority of the data presented here are for the fire record. However, the team has also generated high-resolution pollen data to assess past climate, fuel loads, and other environmental variables. The fire history covers the last 60,000 years, which is the longest fire record in Utah, this research only focuses on the last 15,000 years. The sediment from this core was analyzed in half-centimeter increments, allowing for a detailed charcoal analysis of the region. Adjacent to Fish Lake is the Pando Aspen Clone, identified as the oldest (approximately 65,000 years) and potentially largest (single) organism in the world. The fire history shows variability over time, likely associated with the changes in climate, vegetation, and fuel loads over the last 60,000 years. Indigenous peoples have influenced ecosystems by modifying vegetation and making this land more prone to fire (Carter et al. 2021). However, as we look forward, climate change may be the main driver for an increased number of fires. We hope these data will be useful in the current and future land management of this important ecosystem
Restoration of wild North American Bison: a pathway to justice and the recovery of ecosystem services
No full texthonors thesisCollege of Social & Behavioral ScienceEnvironment, Society & SustainabilityIngrid WeinbauerIn what ways does the potential recovery of the North American bison (Bison bison bison) in the United States represent an opportunity for restorative justice, improved ecological integrity, and the reimposition of many grassland ecosystem services? Further, could the story of the American bison from 1865 onward, including future possibilities, be viewed as a potential turning point in the American perspective on the environment? This thesis aims to explore how the restoration of wild North American bison populations, particularly in the northern range and Great Plains regions of their former habitat, could offer cultural, economic, and environmental benefits. To do so, the paper explores the history of wild bison management in the United States, including the near extinction of the species in the wild and modern policy, the ecological processes and ecosystem services that wild bison contribute to, opposition to bison restoration, the management techniques for wild bison in thirty-seven different areas of the United States (the sample includes most but not every wild bison population), the and value of wild bison to specific Indigenous cultures. By doing so, this thesis also highlights the ways American environmental policy has shifted over time and how bison restoration could be a form of restorative justice by recovering a species that was so crucial to both grassland ecosystems and multiple Indigenous Tribes
Chemical bonding & bonds in chemistry: peer-led team learning as a strategy to address underrepresented and minority student attrition
No full texthonors thesisCollege of ScienceChemistryKim Hackford-Peer,It has become an increasingly popular opinion that in order for the United States to maintain a robust workforce and a competitive edge on the global stage, a college and university education in science, engineering, technology, and math (STEM) is key. Chemistry, often remarked upon and arranged as the gateway science course at the postsecondary level, is considered the foundational material of the scientific careers of so many students. Every year, countless students enter postsecondary education aiming to complete a STEM degree. And yet, statistics show that a significant portion of these students will not complete the introductory chemistry sequence that is required by many colleges and universities, or even move away from STEM education and career paths entirely, such as the decision to change majors. This issue is most prevalent in relation to the growing student body of underrepresented and minority (URM) students attending postsecondary institutions across the United States. Despite a call to diversify the scientific workforce to better represent the increasing ethnic and cultural diversity in America, these students are still in the minority of those who complete undergraduate STEM degrees. They are more likely as a population to experience attrition within STEM, a phenomenon which is most visible in the introductory general chemistry sequence that many colleges and universities offer. Peer-led team learning is a fairly recent strategy that has shown promise in reducing these attrition levels by supporting the development of metacognitive strategies that aid in complex learning and fostering a supportive network between students engaged in learning