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Understanding Motivation to Engage in Healthy Lifestyle Behaviors for Dementia Risk Reduction in Midlife Using a Person-Centered Approach
No full textOBJECTIVE: The number of individuals diagnosed with dementia is expected to reach over 135 million by 2050 (World Health Organization, 2022). Without a cure, research has focused on identifying ways to prevent or reduce dementia risk. The brain changes associated with Alzheimer’s disease (AD) begin several years before the onset of clinical symptoms and disability (Jack et al., 2013), offering a window of opportunity to engage in interventions to delay or prevent clinical symptoms and extend functional independence. Midlife appears to be a critical time during which certain modifiable risk factors and healthy lifestyle behaviors are most impactful for reducing dementia risk or delaying its onset. However, engaging and maintaining healthy behaviors requires considerable motivation in midlife, as benefits are not readily observed, and risks may not be relevant for up to decades later. The beliefs and knowledge associated with engagement and adherence to healthy lifestyle behaviors remain poorly understood and have not been investigated using person-centered approaches. The present study identified subgroups of participants in midlife with similar profiles of beliefs and knowledge about dementia prevention using latent profile analysis and examined associations between latent profiles and demographic features, extrinsic factors, and engagement in healthy lifestyle behaviors.
METHODS: Three-hundred forty-seven middle-aged adults completed an online survey assessing demographic characteristics and a battery of self-report measures evaluating beliefs and knowledge related to dementia and dementia prevention, including motivation to engage in healthy lifestyle changes for dementia risk reduction. Participants also reported whether they had certain AD risk factors (e.g., hypertension, high cholesterol, obesity), and how often they engaged in dementia risk-reducing behaviors (physical activity, cognitive activity, sleep quality, social activity). Latent profile analysis identified subgroups of participants based on measures of beliefs and knowledge related to dementia risk reduction (Aim 1). Differences between latent profiles were examined on demographic characteristics and extrinsic factors (e.g., family history of AD and other risk factors), and profiles were validated on measures of frequency of engagement in healthy behaviors (Aim 2).
RESULTS: Latent profile analysis revealed four distinct profiles: Profile 1Low Motivation/No Concern, Profile 2High Motivation/Low Knowledge, Profile 3Moderate Motivation/No Concern, and Profile 4Average-Low Avg Motivation/Pessimistic (Aim 1). Profile 1 included older individuals with the lowest dementia risk. They reported the best sleep quality and were the least lonely. Profile 2 included younger participants with high annual incomes relative to the other profiles and the general US population who were more likely to be current/past caregivers for someone with AD and more likely to have been told that they were at increased risk of dementia. Profile 2 reported being the most cognitively active but were the loneliest. Profile 3 included older participants who were current/past caregivers for someone with AD and who reported moderate engagement in all healthy lifestyle behaviors. Finally, Profile 4 was a group of individuals with lower incomes and greatest physical and mental health problems. Profile 4 reported the least engagement in all healthy lifestyle behaviors (Aim 2).
CONCLUSIONS: Results provide preliminary evidence for distinct subgroups of middle-aged adults with similar patterns of intrinsic factors and different types and levels of engagement in healthy lifestyle behaviors for dementia risk reduction. Specific subgroups, namely Profile 2High Motivation/Low Knowledge and Profile 4Average-Low Avg Motivation/Pessimistic, are ideal targets for interventions and would likely benefit differentially from tailored interventions to reduce dementia risk. Insights gained from this study may be used to inform the design of dementia prevention programs and policies targeted at people in midlife. Future studies should attempt to replicate these latent profiles in other samples to confirm the generalizability of these findings and conduct longitudinal assessments of cognition and stability of engagement in healthy lifestyle behaviors to assess dementia risk and incidence across the lifespan.Psycholog
THE USE OF PREVENTATIVE CANNABIDIOL, CANNABIGEROL, AND MITRAGYNINE TO AMELIORATE MECHANICAL SENSITIVITY OF PACLITAXEL-INDUCED PERIPHERAL NEUROPATHY IN FEMALE MICE
No full textChemotherapy-induced peripheral neuropathy (CIPN) is a disabling side effect of cytotoxic chemotherapy drugs. It has been reported that >60% of patients receiving chemotherapy suffer from this debilitating condition, which manifests itself in a polyneuropathy of paresthesia, hyperalgesia, allodynia, and numbness, primarily felt in the hands and feet. With no current FDA-approved medications to treat the entirety of CIPN’s symptoms, it is essential to find solutions for this condition.
Veering away from classic prescription pharmaceuticals, pharmacological studies have favored medicinal plant–based analgesic therapies, anticipating that these approaches could offer effective pain relief. These preclinical studies have demonstrated the antiallodynic effects of Cannabidiol and Cannabigerol from Cannabis Sativa along with Mitragynine from Mitragyna Speciosa. Not only did they show reduction in mechanical allodynia, but Mitragynine studies showed promise in female-only models.
In the present set of experiments, we conduct dose-response studies using both single agents and combinations of these plant alkaloids. These studies were designed to fully evaluate the extent to which these compounds can alleviate mechanical allodynia in a chemotherapy-induced, female-only mouse model.
To further emphasize the nature of a female-only preclinical model, we employed a commonly used breast, ovarian, and cervical chemotherapy, taxane, Paclitaxel.Biomedical Science
BARRIERS TO ABORTION CARE ACCESS IN NORTH PHILADELPHIA: A CALL FOR BOTTOM UP CHANGE
No full textThis project aims to identify the need for abortion care services at Temple University Health System (TUHS), attitudes surrounding these services among providers and staff, and limitations in providing this care. A 13-question, anonymous survey was sent to the Family Medicine and Obstetrics and Gynecology departments at TUHS to measure the frequency in which patients request abortion care services at TUHS, perceived patient barriers to abortion care, and perceived attitudes surrounding abortion care. The results show a need for abortion care services in North Philadelphia, a trend toward support for abortion provision among faculty and staff, with a belief amongst providers and staff that offering abortion care services would relieve a disparity in access within this community. However, the results show multiple internal barriers remain to offering these services, including perceived resistance and potential conflict with TUHS leadership. This project solidifies the support for abortion care services at TUHS and the ethical duty TUHS has to improving the health and wellbeing of the North Philadelphia community, including providing abortion care.Urban Bioethic
Microperforated Panel (MPP) Absorbers for Impulsive and Narrow-Band Noise Control: Design, Simulation, and Experimental Validation
No full textEnvironmental noise pollution, particularly in urban and suburban areas, poses a growing threat to public health and quality of life. Among the most challenging forms of such pollution are impulsive and narrow-band noises, which are often tonal, repetitive, and difficult to suppress using conventional mitigation strategies. The rapid rise of pickleball as a recreational sport has sparked widespread noise complaints, primarily due to the sport's distinct and repetitive mid-frequency “pop” sound. Conventional mitigation strategies, including porous absorbers, rigid barriers, and quiet paddles, have proven insufficient for addressing this specific acoustic challenge, especially in outdoor environments with oblique sound incidence. This dissertation explores the development of microperforated panel (MPP) absorbers as a scalable, fiberless, and visually transparent solution to mitigate impulsive narrowband noise that is similar to the pickleball sound.
Building upon Maa’s classical theory, the research first presents the analytical modeling of single-layer MPPs, followed by numerical simulations and impedance tube validation. Key design parameters such as hole diameter, perforation ratio, and cavity depth are systematically evaluated to optimize absorption near 1 kHz—the dominant frequency of pickleball noise. A novel parallel MPP configuration is then introduced, combining multiple perforation ratios in a modular format to enhance angular robustness and broadband absorption.
Large-scale testing in a 3 ft × 3 ft × 3 ft acrylic cube chamber under quasi-reverberant conditions validates the practical performance of the MPP system. Both interior and exterior analyses—spanning time- and frequency-domain evaluations—confirm substantial attenuation of transmitted acoustic energy, with perceptible sound pressure level reductions exceeding 8 dB in critical frequency bands. These results demonstrate the feasibility of deploying transparent MPP absorbers as an effective and community-friendly solution for outdoor recreational noise mitigation.Mechanical Engineerin
GEOPHYSICAL INVESTIGATION OF GLACIER GEOMETRY AND SUBGLACIAL GEOLOGY, AND THEIR INFLUENCE ON GLACIER DYNAMICS: CASE STUDIES OF TAKU GLACIER, ALASKA AND THWAITES GLACIER, WEST ANTARCTICA
No full textMass loss from glaciers and ice sheets is a significant contributor to the rise of global mean sea level (GMSL) and will continue to be in the future. Rising GMSL will cause displacement of coastal populations, loss of ecosystems and rising food in- security. To plan for and mitigate these impacts, it is important to improve estimates of the rate of GMSL rise in the future. Large uncertainties remain in the future evolution of glaciers in the Greenland and Antarctic Ice Sheets due to poorly con- strained processes such as Marine Ice Sheet Instability (MISI). Additionally, glaciers outwith ice sheets lack observations of many model input parameters, which lead to uncertainties in predictions of their rate of mass loss. Key parameters affecting marine-terminating glaciers both within and outwith ice sheets are the bed elevation and the material at the bed. The bed elevation is well known for glaciers within ice sheets due to extensive data from radio-echo sounding (radar) surveys. But in glaciers with temperate ice, high attenuation due to high meltwater content within and at the base of ice prevents radar from surveying the bed. Therefore, many glaciers out- with ice sheets lack accurate observations of their bed elevation. For glaciers within ice sheets, although their bed elevation is well known, obtaining measurements of the material beneath the bed relies on intensive ground-based techniques and hence observations are limited in spatial extent. In this work, we focus on two glaciers, Taku Glacier in Alaska and Thwaites Glacier in West Antarctica, and improve on observations of their subglacial environments that are currently poorly constrained. We employ a multi-modal geophysical technique, utilizing a combination of seismic and gravity- and magnetic-anomaly data.
Taku Glacier is a tidewater glacier located in the Juneau Icefield, Alaska. Until recently, the Taku had been advancing or stable in contrast to most of other glaciers in the Juneau Icefield. In 2018, the Taku began retreating and limited observations of the bed geometry leaves uncertainty on how its retreat will proceed. We collect new ground-based gravity measurements and perform a 3D inversion with a novel methodology to estimate the bed elevation along a 12-km segment of the glacier ∼30 km upstream of the current terminus. We derive the first along-flow bed elevation profile on the Taku and find the deepest bed at 445 ± 166 m below sea level with a maximum ice thickness of 1556 ± 143 m. We additionally find two bedrock bumps in the along-flow profile, which would be important in stabilizing a potentially rapid retreat due to marine influence.
Thwaites Glacier, located in the Amundsen Sea Embayment in West Antarctica, has been identified as the key component in the future evolution of the West Antarctic Ice Sheet. Its retrograde slope makes it susceptible to rapid retreat from MISI but uncertainty remains on when and how fast that retreat may occur. Modeling has shown the bed types under Thwaites will influence its rate of retreat but currently the bed-type distribution is only known within two small areas. We model the crustal structures under Thwaites to identify the origin of the currently identified bed-type distribution and inform how the bed type might vary over the whole glacier. We perform this modeling at two sites on Thwaites using a combination of long-offset seismic and gravity- and magnetic-anomaly data.
The first is at the lower region of Thwaites, close to the coast. Here we model the crust along two lines extending ∼120 km inland from the coast. We find a 40-km- long sedimentary basin with a maximum thickness of 1651 ± 218 m and two mafic intrusions 5 - 10-km deep with maximum thickness of ∼9 km. The sedimentary basin coincides with an area of continuous soft bed, indicating the sedimentary rock is the likely source of weak, easily deformable sediment at the bed. The sedimentary basin and mafic intrusions are indicative of a rift origin, indicating the dynamics of Thwaites are being influenced by subglacial geologic structures resulting from the development of the West Antarctic Rift System.
The second study site on Thwaites is further inland. Here we model the crustal structures along a ∼180 km line that extends inland from the first study site across the central region of Thwaites. Previous studies across the central region of Thwaites have found thinned crust across a narrow region. We find sedimentary rocks with the maximum thickness of ∼2000 m coinciding with this area of thinned crust and estimate that the crust has low flexural rigidity across this region. These results suggest that the central region of Thwaites has undergone a relatively recent rifting. We additionally model more mafic intrusions but find they decrease in size under the central region, compared to the first study closer to the coast. This suggests the intrusions may have been formed by a different mechanism than the rifting in the near- coastal region. We find sedimentary rock under ∼75% of the central-region profile, indicating there is a plentiful supply of deformable sediment at the bed of Thwaites. The possible extensive sediment cover and thinned crust are likely influencing the ice dynamics on Thwaites by facilitating fast ice flow.Geoscienc
Three Essays on Economics of Risky Behavior
No full textAre youths who consume pornography more likely to engage in risky sexual behaviors? Using longitudinal data from the National Study of Youth and Religion (NSYR) and an individual fixed effects strategy, chapter one investigates the relationship between pornography use among 13- to 23-year-olds and a range of subsequent risky sexual behaviors. It also estimates a lagged dependent variable (LDV) model where risky sexual behavior of the previous wave is included as a control. The findings suggest that moderate and frequent pornography use increases the likelihood of engaging in acts such as unprotected sex and having multiple sexual partners. Finally, a heterogeneity analysis by gender reveals that males and females behave differently in response to exposure to pornography, but that is true for only a few indicators of risky sex. This chapter's findings provide critical information on determinants of risky sexual behavior and meaningful evidence for the policy debate on government censoring and monitoring online behavior.
Does the widespread consumption of internet pornography trigger violence? By analyzing local market (USA) website traffic data from major pornographic websites spanning from September 2019 to October 2022 and crime measures from NIBRS, chapter two sheds light on this question. For identification, I leverage exogenous variation in the supply of pornographic materials caused by the publication of an opinion essay in the New York Times and employ a Difference-in-Differences (DiD) strategy with a treatment intensity approach. The analysis utilizes geographical variation in the fraction of pornographic users visiting the impacted website. The DiD estimates indicate that one-percentage-point increase in exposure to the supply shock is associated with a reduction of approximately 2.4\% in all measures of violence, such as simple and aggravated assault, relative to their respective average observed in the data. This finding provides valuable insights into the ongoing policy debate regarding government censorship and monitoring of online behavior, suggesting that reducing access to certain online content can influence violent behavior at the community level.
Instantly accessible digital goods, such as online pornography, are deliberately designed to capture attention, prolong engagement, and encourage habitual use, often without any explicit financial cost. This phenomenon prompts an important question: Can digital goods, perceived as free, generate addictive consumption patterns similar to those observed with substances such as drugs or alcohol? Using website traffic data from U.S. local markets and after-tax hourly wage as a proxy of price, chapter three investigates this question through the lens of the theory of rational addiction in the context of internet pornography consumption. The result documents strong empirical support for the rational addiction hypothesis, which suggests that consumers of internet pornography are forward-looking and make consumption decisions that maximize their lifetime utility, even when those decisions lead to persistent and potentially harmful patterns. This finding provides valuable insights into the ongoing policy debate regarding government censorship and monitoring of online behavior.Economic
DNA POLYMERASE THETA COOPERATES WITH ADH5 AND ALDH2 DEHYDROGENASES TO PROTECT HEMATOPOIETIC CELLS FROM FORMALDEHYDE-MEDIATED DNA DAMAGE
No full textHematopoietic stem and progenitor cells (HSPCs) are exposed to physiological levels of formaldehyde but can occasionally be challenged by high levels of formaldehyde generated by various endogenous and exogenous sources. In addition, leukemia cells stressed by oncogenic mutations continuously produce excessive amounts of formaldehyde. Here, we show that DNA polymerase theta (Polθ) cooperates with alcohol dehydrogenase 5 (ADH5) and aldehyde dehydrogenase 2 (ALDH2) to protect healthy and malignant HSPCs challenged by formaldehyde. ADH5 and ALDH2 metabolize formaldehyde while Polθ-mediated DNA repair by microhomology-dependent end-joining (TMEJ) protects cells from the lethal effect of DNA double strand breaks (DSBs) resulting from formaldehyde-mediated DNA-protein crosslinks (DPCs). Genetic or pharmacological targeting of ADH5 or ALDH2 enhanced the effect of Polθ inhibitors in leukemia cells. Thus, ADH5 and ALDH2 cooperate with Polθ to protect normal and malignant HSPCs challenged by high levels of formaldehyde and inhibition of Polθ and ADH5 or ALDH2 may exert an anti-leukemic effect.Biomedical Science
Non-surgical Root Canal Therapy Clinical Success Rate compared between Undergraduate and Graduate Students and Reasons for Failure
No full textNon-surgical root canal therapy (NSRCT) aims to eliminate infected or necrotic pulpal tissue from the root canal system while preserving the tooth’s function within the oral environment. The definition of success in endodontic therapy varies, ranging from strict to more lenient criteria. Treatment outcomes are commonly categorized as good, questionable, poor or hopeless. The success of non-surgical root canal therapy has been widely studied, with reported success rates ranging from 70% to 95%, depending on factors such as operator experience, case complexity, tooth vitality and the presence of a restoration. Despite extensive research, few studies compare non-surgical root canal outcomes between graduate and undergraduate dental students within the same institution. This study examines success rates in both groups and key factors affecting treatment failure, such as tooth number, pulp vitality, and final restoration.
Purpose:
The purpose of this study is to compare the clinical success rates of non-surgical root canal therapy (NSRCT) performed by undergraduate dental students and graduate endodontic residents. Additionally, this research aims to assess how factors such as tooth number, pulp vitality, and the presence of a final restoration influence treatment success or failure.
Materials and Methods:
A total of 881 cases of non-surgical root canal therapy (NSRCT) performed at Temple University Kornberg School of Dentistry from 2018 to 2023 were analyzed retrospectively. Patient data were extracted from the axiUm electronic health records system using the recall code D3999RC, with recalls completed by undergraduate dental students at a minimum follow up of three months. Cases were categorized by operator level: undergraduate dental students or graduate endodontic residents. Treatment outcomes were classified into four categories based on the Strindberg Index (1956): Good (successful treatment), Questionable (uncertain prognosis), Poor (unsuccessful treatment), and Hopeless (definitive failure). For analysis, “Good” outcomes were considered successful, while the remaining categories were classified as failures. Independent variables included operator level, tooth number (anterior vs. posterior), pulp vitality (vital, non-vital, or previously initiated), and restoration status (presence of a final restoration). The primary dependent variable was treatment success or failure.
Conclusion:
Non-surgical root canal therapy performed by undergraduate dental students showed higher success rates, likely due to structured case selection, while graduate residents treated more complex cases, leading to greater variability in outcomes. Restored teeth demonstrated significantly improved success rates. Future research should explore standardized follow-up protocols and increased recall data from graduate residents to enhance success rates and ensure comprehensive data analysis.Oral Biolog
EVOLUTION OF MUTUAL INSURANCE COMPANIES: BALANCING TRADITION WITH MODERN CHALLENGES
No full textMutual insurance companies, which are owned by their policyholders rather than shareholders, have demonstrated remarkable resilience and longevity, making them some of the industry’s strongest and most enduring entities. However, with rapid technological advancements, challenging market conditions, unprecedented catastrophic losses, and an ever-evolving and complex regulatory landscape, mutuals face the pressing question of adapting and ensuring their continued relevance. This research was conducted during a remarkable time for the industry to explore strategies that address these multifaceted challenges while preserving mutuals’ unique value proposition rooted in policyholder ownership and community focus. This dissertation involved examining the mutual holding company (MHC) structure and its potential to enable insurers to adapt to changing market dynamics while maintaining the core values of mutuality. An MHC is a hybrid organizational structure that allows a mutual insurer to preserve policyholder ownership while gaining access to greater financial and competitive flexibility. The insurer’s adoption of a mutual holding structure approach provides a pathway for mutual companies to innovate, raise capital, and expand operations while maintaining the foundational ethos of serving policyholder interests.
A quantitative approach, focusing on data analysis of financial performance, surplus management, and underwriting outcomes, was utilized in this research to evaluate the strategic and operational impacts of adopting a mutual holding structure. By examining key financial metrics, such as surplus-to-assets ratios, underwriting gains, premium growth, and operating ratios, the aim of the study was to uncover patterns and trends that indicate this structure’s economic viability and competitive advantage. The analysis situates these findings within significant periods marked by economic volatility, technological advancements, and regulatory shifts, providing a data-driven assessment of how mutuals, can leverage innovative structures while maintaining financial stability and policyholder value. This study is highly relevant for all the constituents in the mutual insurance community. It offers practical and strategic insights into sustainable pathways for mutual insurance organizations. The findings could equip these stakeholders with a deeper understanding of the motivations behind structural transitions and the potential outcomes of adopting a mutual holding company model, supporting informed decision-making in an evolving industry landscape.Business Administration/Risk Management and Insuranc
An Exploration of Compatibility
No full textLet G=\SO^\circ(3,1), H=\SO^\circ(4,1), be a lattice, and be a Zariski-dense representation. This thesis considers conditions required for to extend to a continuous homomorphism , formulated as a classic superrigidity theorem. These conditions require to contain an infinite family of nonconjugate maximal Fuchsian subgroups associated with closed \SO^\circ(2,1)-orbits on such that fails to be Zariski-dense in . This extends work of Bader--Fisher--Miller--Stover, who used similar techniques find a geometric characterization of arithmeticity. Their work relies on and satisfying a technical compatibility condition that does not hold for the pair considered here.
In particular, the situation considered here falls outside the scope covered by their work. This is a interesting case, because and are the isometry groups of hyperbolic 3- and 4-space respectively.
This thesis applies a construction of Bader--Furman to the map that will extend to, called , and upgrades from a map to a homomorphism, while utilizing a subgroup , related to the failure of compatibility. The first goal of this thesis is to understand the failure of compatibility in terms of the triples with a real algebraic subgroup. A triple is \textit{compatible} or \textit{incompatible} depending on whether the methods of Bader--Fisher--Miller--Stover apply to prove superrigidity via the techniques of Bader--Furman.
We then split into two cases: when is a compatibility triple and when is an incompatibility triple. In the former case, we use the methods of Bader--Fisher--Miller--Stover mentioned above to prove superrigidity. In the latter case, we prove there is only one such that makes an incompatibility triple. In the incompatible case, we use works of Kim--Oh to understand the boundary map \partial\hh^3\to\partial\hh^4 classically associated with the representation , and this ultimately allows us to conclude that no such could ever exist.Mathematic