Assessment of Dental Students' Attitudes and Awareness of Climate Change in a Midwestern Dental School

Title from PDF of title page, viewed March 1, 2023Thesis advisor: Melanie Simmer-BeckVitaIncludes bibliographical references (pages 46-52)Thesis (M.S.)--Department of Oral and Craniofacial Sciences. University of Missouri--Kansas City, 2022The purpose of this project was to investigate the knowledge and attitudes of dental students toward climate change, and whether certain demographic characteristics were associated with high or low knowledge as well as attitude toward climate change. An IRB-approved 20-item survey was constructed and administered to 432 UMKC dental students spanning all four years to test if demographics including school year, gender, geographic region of upbringing, socioeconomic status during childhood, previous climate change-related education, and use of environmentally-friendly behaviors at home are associated with climate knowledge and attitude. The survey was introduced to students via an IRB-approved verbal script during a class, and the students anonymously completed the surveys. The survey questions were divided into 4 domains; demographic characteristics, knowledge of climate change, attitude toward climate change, and perceived barriers seen by the student which may prevent the use of environmentally-sustainable office practices. Student demographics were then used to evaluate whether there was an effect on students’ climate change-related knowledge and attitude toward climate change. The survey results show a significant association between dental students’ gender and previous climate change-related education and both their knowledge of and attitude toward climate change. However, utilization of environmentally-friendly behaviors at home and year in dental school were significantly associated with attitude toward climate change only. There was no correlation found between overall knowledge of climate change and attitude.Introduction -- Materials and methods -- Results -- Discussion -- Conclusion

A. Studies In The Allylic Substitution Chemistry Of Copper Hydride B. Stereoselective Silylcupration Of Conjugated Alkynes In Micellar Media C. Palladium-Catalyzed Synthesis Of 1,3-Butadienes and [3]-[6]Dendralenes D. Synthesis Of Small Molecule Underwater Adhesives Inspired By Mussels

Copper hydride (CuH) has been shown to enable a number of selective 1,2- and 1,4-reductions when complexed with the appropriate ligand, yet the allylic substitution chemistry of CuH has been much less studied. This dissertation describes the further study of CuH to perform sequential reductions on Morita-Baylis-Hillman (MBH) adducts. Specifically: I) Selectivity in the SN2’ reduction of MBH adducts was shown to be highly dependant on the nature of the ligand used. II) The reaction of MBH alcohols was shown to involve an initial dehydrogenative silylation with PMHS, where both the oligomeric nature and electronics of the initially formed trialkoxysilyl ether intermediate are important in determining both the observed stereoselectivity, and efficiency of the substitution. III) MBH ketones could be employed in tandem SN2’/1,2-reduction sequences to arrive at stereodefined allylic alcohols with central chirality. Vinylsilanes are versatile intermediates in organic synthesis owing to numerous methods for their transformation into other functional groups that proceed with high stereoretention. While there are numerous methods to synthesize stereodefined vinylsilanes from alkynes, many existing methods require the use of highly reactive moisture intolerant reagents and harsh reaction conditions, features that limit the functionality that can be accommodated. Even fewer of these existing methods are conducted under environmentally responsible conditions. The use of Suginome’s reagent as a moisture tolerant source of nucleophilic silicon, small catalytic quantities of a simple copper(I) salt, and an aqueous solution of TPGS-750-M as an environmentally benign nonionic surfactant, is described herein as a highly effective combination of reagents that allows for the stereoselective silylcupration of conjugated alkynes giving access to a variety of (E)-β-silyl-substituted carbonyl derivatives under environmentally responsible conditions. This dissertation also describes the application of substituted allenoates as electrophilic butadienyl coupling partners under palladium catalysis in aqueous micellar media. The substituted allenoates could then be transformed by the methods developed herein into a variety of 2-substituted butadienes, where the methods were then extended to provide entry into a variety of substituted [3]-[6]dendralenes. Specifically: I) Application of an additive based screen allowed for evaluation of functional group tolerance in the Pd-catalyzed coupling of substituted allenoates with boronic acids. II) Curiosity driven investigations to identify boron based sp3 coupling reagents compatible with the conditions of micellar catalysis led to the identification of OBBD alkylborinate reagents as stable and isolable coupling reagents, which was the applied to the synthesis of 2-alkyl 1,3-butadienes. III) An analogous vinylallenyl coupling partner that functions formally as an electrophilic [3]dendralene synthon was proposed, and a number of synthetic routes were examined to access this molecule. Optimization of the synthetic route allowed for access to multigram quantities of this material, where it was applied to the synthesis of variously substituted [3]-[6]dendralenes. Efforts to understand the marine mussels mechanism of strong wet adhesion has been a subject of intense scientific investigation. Analysis of the peptide sequence of mfp-5, a mussel foot protein most correlated with interactions at the interface, revealed a high proportion of charged, hydrophobic, and catechol containing residues. Described in this dissertation is the synthesis of small molecule underwater adhesives by incorporation of these key features of mfp-5. These newly designed molecules formed adhesive bilayers underwater, and were shown to replicate and even exceed mfp-5’s strong wet adhesive energy, while also being orders of magnitude smaller than both the native mussel proteins or existing biomimetic adhesive platforms. By systematically varying key portions of these small molecular adhesives, the adhesive bilayers could be transformed into molecularly uniform monolayers which were applied to the nanofabrication of organic electronic devices

RAMPART: RowHammer Mitigation and Repair for Server Memory Systems

RowHammer attacks are a growing security and reliability concern for DRAMs and computer systems as they can induce many bit errors that overwhelm error detection and correction capabilities. System-level solutions are needed as process technology and circuit improvements alone are unlikely to provide complete protection against RowHammer attacks in the future. This paper introduces RAMPART, a novel approach to mitigating RowHammer attacks and improving server memory system reliability by remapping addresses in each DRAM in a way that confines RowHammer bit flips to a single device for any victim row address. When RAMPART is paired with Single Device Data Correction (SDDC) and patrol scrub, error detection and correction methods in use today, the system can detect and correct bit flips from a successful attack, allowing the memory system to heal itself. RAMPART is compatible with DDR5 RowHammer mitigation features, as well as a wide variety of algorithmic and probabilistic tracking methods. We also introduce BRC-VL, a variation of DDR5 Bounded Refresh Configuration (BRC) that improves system performance by reducing mitigation overhead and show that it works well with probabilistic sampling methods to combat traditional and victim-focused mitigation attacks like Half-Double. The combination of RAMPART, SDDC, and scrubbing enables stronger RowHammer resistance by correcting bit flips from one successful attack. Uncorrectable errors are much less likely, requiring two successful attacks before the memory system is scrubbed.Comment: 16 pages, 13 figures. A version of this paper will appear in the Proceedings of MEMSYS2

Some schemes for on-line correction of the closed orbit, dispersion and beta functions in PEP

PEP has been operated successfully under computer control. It is necessary for colliding beam operation that the errors in closed orbits, dispersion and beta functions be corrected. The schemes in the PEP control program for on-line correction of these errors are described in this paper. The orbit control tasks in the PEP control system perform the functions of data gathering, data presentation (color display, printing), calculation and setting of corrector magnets. The tasks are generally small and modular, taking information from the database, processing it, then returning the results to the database. The PEP operator communicates with the tasks through touch panels monitored by the Director program. The display task, which displays orbit and corrector information on a TV color display, provides the main information required by the operator

Kinetic modeling of tumor growth and dissemination in the craniospinal axis: implications for craniospinal irradiation

BACKGROUND: Medulloblastoma and other types of tumors that gain access to the cerebrospinal fluid can spread throughout the craniospinal axis. The purpose of this study was to devise a simple multi-compartment kinetic model using established tumor cell growth and treatment sensitivity parameters to model the complications of this spread as well as the impact of treatment with craniospinal radiotherapy. METHODS: A two-compartment mathematical model was constructed. Rate constants were derived from previously published work and the model used to predict outcomes for various clinical scenarios. RESULTS: The model is simple and with the use of known and estimated clinical parameters is consistent with known clinical outcomes. Treatment outcomes are critically dependent upon the duration of the treatment break and the radiosensitivity of the tumor. Cross-plot analyses serve as an estimate of likelihood of cure as a function of these and other factors. CONCLUSION: The model accurately describes known clinical outcomes for patients with medulloblastoma. It can help guide treatment decisions for radiation oncologists treating patients with this disease. Incorporation of other treatment modalities, such as chemotherapy, that enhance radiation sensitivity and/or reduce tumor burden, are predicted to significantly increase the probability of cure

Primary spinal cord tumors of childhood: effects of clinical presentation, radiographic features, and pathology on survival

To determine the relationship between clinical presentation, radiographic features, pathology, and treatment on overall survival of newly diagnosed pediatric primary spinal cord tumors (PSCT). Retrospective analysis of all previously healthy children with newly diagnosed PSCT at a single institution from 1995 to present was performed. Twenty-five pediatric patients (15 boys, average 7.9 years) were diagnosed with PSCT. Presenting symptoms ranged from 0.25 to 60 months (average 7.8 months). Symptom duration was significantly shorter for high grade tumors (average 1.65 months) than low grade tumors (average 11.2 months) (P = 0.05). MRI revealed tumor (8 cervical, 17 thoracic, 7 lumbar, 7 sacral) volumes of 98–94,080 mm3 (average 19,474 mm3). Homogeneous gadolinium enhancement on MRI correlated with lower grade pathology (P = 0.003). There was no correlation between tumor grade and volume (P = 0.63) or edema (P = 0.36) by MRI analysis. Median survival was 53 months and was dependent on tumor grade (P = 0.05) and gross total resection (P = 0.01) but not on gender (P = 0.49), age of presentation (P = 0.82), duration of presenting symptoms (P = 0.33), or adjuvant therapies (P = 0.17). Stratified Kaplan–Meier analysis confirmed the association between degree of resection and survival after controlling for tumor grade (P = 0.01). MRI homogeneous gadolinium enhancement patterns may be helpful in distinguishing low grade from high grade spinal cord malignancies. While tumor grade and gross total resection rather than duration of symptoms correlated with survival in our series, greater than one-third of patients had reported symptoms greater than 6 months duration prior to diagnosis

Combined treatment modality for intracranial germinomas: results of a multicentre SFOP experience

Conventional therapy for intracranial germinomas is craniospinal irradiation. In 1990, the Société Française d'Oncologie Pédiatrique initiated a study combining chemotherapy (alternating courses of etoposide–carboplatin and etoposide–ifosfamide for a recommended total of four courses) with 40 Gy local irradiation for patients with localized germinomas. Metastatic patients were allocated to receive low-dose craniospinal radiotherapy. Fifty-seven patients were enrolled between 1990 and 1996. Forty-seven had biopsy-proven germinoma. Biopsy was not performed in ten patients (four had diagnostic tumour markers and in six the neurosurgeon felt biopsy was contraindicated). Fifty-one patients had localized disease, and six leptomeningeal dissemination. Seven patients had bifocal tumour. All but one patient received at least four courses of chemotherapy. Toxicity was mainly haematological. Patients with diabetus insipidus (n = 25) commonly developed electrolyte disturbances during chemotherapy. No patient developed tumour progression during chemotherapy. Fifty patients received local radiotherapy with a median dose of 40 Gy to the initial tumour volume. Six metastatic patients, and one patient with localized disease who stopped chemotherapy due to severe toxicity, received craniospinal radiotherapy. The median follow-up for the group was 42 months. Four patients relapsed 9, 10, 38 and 57 months after diagnosis. Three achieved second complete remission following salvage treatment with chemotherapy alone or chemo-radiotherapy. The estimated 3-year survival probability is 98% (CI: 86.6–99.7%) and the estimated 3-year event-free survival is 96.4% (CI: 86.2–99.1%). This study shows that excellent survival rates can be achieved by combining chemotherapy and local radiotherapy in patients with non-metastatic intracranial germinomas. © 1999 Cancer Research Campaig

Retrospective analysis of 104 histologically proven adult brainstem gliomas: clinical symptoms, therapeutic approaches and prognostic factors

BACKGROUND: Adult brainstem gliomas are rare primary brain tumors (<2% of gliomas). The goal of this study was to analyze clinical, prognostic and therapeutic factors in a large series of histologically proven brainstem gliomas. METHODS: Between 1997 and 2007, 104 patients with a histologically proven brainstem glioma were retrospectively analyzed. Data about clinical course of disease, neuropathological findings and therapeutic approaches were analyzed. RESULTS: The median age at diagnosis was 41 years (range 18-89 years), median KPS before any operative procedure was 80 (range 20-100) and median survival for the whole cohort was 18.8 months. Histopathological examinations revealed 16 grade I, 31 grade II, 42 grade III and 14 grade IV gliomas. Grading was not possible in 1 patient. Therapeutic concepts differed according to the histopathology of the disease. Median overall survival for grade II tumors was 26.4 months, for grade III tumors 12.9 months and for grade IV tumors 9.8 months. On multivariate analysis the relative risk to die increased with a KPS ≤ 70 by factor 6.7, with grade III/IV gliomas by the factor 1.8 and for age ≥ 40 by the factor 1.7. External beam radiation reduced the risk to die by factor 0.4. CONCLUSION: Adult brainstem gliomas present with a wide variety of neurological symptoms and postoperative radiation remains the cornerstone of therapy with no proven benefit of adding chemotherapy. Low KPS, age ≥ 40 and higher tumor grade have a negative impact on overall survival

Dissecting the COW

The COW, or Console On Wheels, is the primary operator interface to the SLC accelerator control system. A hardware and software description of the COW, a microcomputer based system with a color graphics display output and touch-panel and knob inputs, is given. The ease of development and expandability, due to both the modular nature of the hardware and the multitasking, interrupt driven software running in the COW, are described. Integration of the COW into the SLCNET communications network and SLC Control system is detailed