Objectives: The purpose of this study was to evaluate whether differences exist in: (1) orthodontists’ aesthetic analysis of treatment need from profile and frontal view photos of the same patient; (2) orthodontists’ proposed treatment type and their aesthetic analysis of treatment need from the frontal view, and (3) orthodontists’ treatment plans when given a frontal photo versus no frontal photo. A survey questionnaire was designed to test the utility of the frontal view in orthodontic treatment planning. Materials And Methods: The survey was dispersed through the Schulman Orthodontic Group utilizing SurveyMonkey. Part 1 of the survey implemented a Likert scale rating of the aesthetics of 5 patients’ frontal and profile photos. In part 2, SurveyMonkey randomly allocated participants into two groups. Survey-takers could proceed through any of the 20 customized pathways of the survey depending on their proposed treatment plans. Groups 1 and 2 were presented the same example patients; Group 1 was presented all diagnostic information and asked to formulate a treatment plan and Group 2 was given all diagnostic information minus the frontal view and asked to formulate a treatment plan, and subsequently presented with the frontal view photos to determine whether the newly revealed diagnostics changed their proposed treatment. Results: Data collection included seventy-three completed surveys from the Schulman Group composed of 140 orthodontists. A paired sample T-Test revealed significant differences in orthodontists’ analyses of need for treatment based on facial aesthetics from the frontal and profile view in all patients (p≤0.05). A Kruskal-Wallis non-parametric ANOVA test revealed no differences in proposed treatment type and orthodontists’ assessment of need for treatment based on facial view photos (p>0.05). A chi-squared analysis revealed no differences exist between treatment type proposed when a frontal view photo was provided versus not provided in 3 of 5 patients (p>0.05). Conclusion: Despite being heavily weighted from an aesthetic analysis of treatment need, the frontal view photo failed to affect significant differences in proposed treatment intervention and type. A stronger emphasis should be placed on information gained from the frontal view photos such as smile arc, buccal corridors, and incisor display, which are not being adequately considered in orthodontic treatment planning. / Oral Biology

Historically, the rear seat has been considered safer compared to the front seat for all restrained occupants; however, studies have found that the front seat in newer vehicles might be safer for older adults than the rear seat. While adults make up only 19% of rear seat occupants in frontal crashes, they make up 48% of fatalities (Tatem and Gabler, 2019). The rate of rear-seat occupancy by adults is expected to increase due to the use of ride share services and the potential of autonomous vehicles. Minimal research has been done to assess rear-seat occupant protection for a mid-sized adult male. Submarining, in which the lap belt slips off of the pelvis and directly loads the abdomen, is of particular concern as a restraint-based injury mechanism of the abdomen. The objective of this study is to investigate submarining protection and abdominal injury risk for rear-seated mid-sized male occupants in frontal crashes and to assess the biofidelity of two anthropomorphic test devices (ATDs) with respect to submarining response when compared to post-mortem human surrogates (PMHS). Twenty-four frontal crash sled tests were conducted with the THOR-50M and Hybrid III 50th-percentile male ATDs in three crash conditions and seven modern vehicles. The vehicles included a minivan, an SUV, 3 compact SUVs, and 2 sedans from the US vehicle fleet (model years 2017-2018). Four vehicles had conventional restraints (ie. 3-point belt with retractor at the shoulder) in the rear seat and three vehicles had advanced restraints (ie. 3-point belts with a pretensioner and load limiter at the retractor). Two of the crash conditions were vehicle-specific pulses: NCAP85 (ΔV = 56 kph) and Scaled (ΔV = 32 kph). The final pulse was a Generic (ΔV = 32 kph) pulse, created by averaging all seven Scaled pulses. Matched PMHS tests were conducted on four of the vehicles in the NCAP85 condition. Two tests were conducted for each vehicle with 8 PMHS for a total of 8 sled tests. The occurrence of submarining was identified and assessed for severity by: symmetry of lap belt slip, degree of abdominal loading, and forward excursion of the pelvis. Pelvis and lap-belt kinematics were assessed for the matched NCAP85 tests to identify trends with respect to submarining. Damage to the abdomen, pelvis, and lumbar spine of the PMHS was identified during post-test autopsy. The Hybrid III did not submarine in any test, but the THOR submarined in 16/24 tests. Three PMHS underwent submarining in 2/4 vehicles, and the THOR submarined in 3/4 vehicles in the matched NCAP85 tests. Three PMHS did not undergo submarining but sustained pelvis fractures at lap belt loads of 7.4 kN and higher, and damage to the abdominal viscera occurred regardless of submarining occurrence. Pelvis and lap-belt kinematics revealed the complex nature of the interactions of the occupant and the restraints within each vehicle environment, but did not clearly differentiate between submarining and non-submarining tests. The Hybrid III was not able to predict submarining risk for the PMHS in the rear seat environment. While the THOR underwent submarining, it was not perfect in predicting submarining risk. Pelvis geometry, lap belt engagement, and other factors contributed to the differences in submarining between the two ATDs and the PMHS. Restraint type was not indicative of whether or not the THOR or PMHS would submarine. Many other factors in the rear seat environments of these vehicles likely contribute in combination to the effectiveness of submarining prevention and occupant protection in the rear seat. This study provides information regarding submarining and abdominal injury for three surrogate types, two crash severities, and seven modern, real-world vehicle environments. Ultimately, this study found substantive gaps in occupant protection in the rear seats of modern vehicles for mid-sized adult male occupants. Tatem, W. M., and Gabler, H. C. (2019). Differential fatality risk between rear and front seat passenger vehicle occupants in frontal crashes. In Proceedings of the 2019 International IRCOBI Conference on the Biomechanics of Injury (pp. 554–560). / Doctor of Philosophy / Historically, the rear seat has been considered safer than the front seat for restrained occupants in frontal crashes. However, with advances in safety systems for the front seat, studies have found that the front seat might be safer for older adult occupants. The objective of this study is to investigate submarining protection and abdominal injury risk for rear-seated mid-sized male occupants in frontal crashes. Submarining occurs when the lap belt slips off of the pelvis and directly loads the abdomen, potentially producing severe abdominal injuries. Twenty-four sled tests were conducted with the THOR-50M and Hybrid III 50th-percentile male anthropomorphic test devices (ATDs) in three crash conditions and seven modern vehicles. The vehicles selected included a minivan, SUVs, compact SUVs, and sedans from the US vehicle fleet. Three of the vehicles had advanced restraints in the rear seat and four had conventional restraints. The three crash conditions were a generic low speed test and a low and high-speed vehicle-specific crash pulse. Eight tests were conducted with eight different post-mortem human surrogates on a subset of four vehicles (2 with advanced restraints, 2 with conventional restraints) using the high-speed crash condition. The Hybrid III never submarined, but the THOR submarined in 16 out of 24 tests (5 out of 7 vehicles). Three out of eight PMHS submarined, in two of the four vehicles. Three heavier PMHS sustained pelvis fractures, and all but one PMHS had sustained damage to the abdominal viscera. Restraint type was not an indicator of submarining risk in the rear seat, suggesting that other seat and vehicle design variables contribute to submarining risk. Comparison of the responses of the ATDs with the PMHS suggests that the THOR is a more reasonable surrogate than the Hybrid III for submarining assessment in the rear seat. Inclusion of data from other body regions is necessary to make a definitive determination of the appropriate ATD for the assessment of occupant protection for a mid-sized male in the rear seat during frontal crashes. Overall, this study suggests that protection against submarining and injury to the pelvis and abdomen for mid-sized male passengers in the rear seat of modern vehicles in the US fleet could be improved.

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Pain is a complex, ubiquitous phenomenon that can be debilitating and costly. Although it is well known that some individuals can easily tolerate pain while others are more intolerant to pain, little is known of the neurophysiological bases of these differences. Because differences in sensory information processing may underlie variability in tolerance to pain and because measures of sensory gating are used to explore differences in sensory information processing, sensory gating among college students (N = 14) who are tolerant or intolerant to pain was investigated. This investigation explored the hypothesis that those who were more tolerant to pain would evidence greater sensory gating. Pain tolerance was first determined using a cold pressor task. Sensory gating was then determined by the amount of attenuation of the amplitude of a second painful, electrical, somatosensory stimulus (S2) in relation to the amplitude of an identical first stimulus (S1) in a paired-stimulus evoked potential (EP ) paradigm. The results obtained showed the intolerant group exhibiting greater physiological reactivity than the tolerant group, indicating that the tolerant group attained greater sensory gating than the intolerant group. / Ph. D.

The purpose of this dissertation is to examine the occurrence of facial fractures in automotive collisions and to determine the tolerance of the facial bones to blunt impact. The effects of restraint use, impact severity and impact direction on facial fractures were evaluated using the NASS-CDS database. The association between brain injury and facial fractures was also examined. The tolerance of the frontal bone, nasal bone, maxilla and mandible was determined using the flat surface of a cylindrical impactor. The influence of anthropometric measures and geometrical descriptors on the tolerance of the facial bones is also presented. The force-displacement response of each impacted region was also determined and response corridors were created. These corridors were used to evaluate the biofidelity of the FOCUS headform under the same impact conditions. Mathematical models were also created to predict the force and displacement resulting from facial impact. The data contained in this dissertation can be used to determine the risk of facial fracture as a function of impact force and evaluate the biofidelity of models simulating facial impact. / Ph. D.

The focus of this project falls largely within the realm of investigating the development of brain-cognition relations from a developmental cognitive neuroscience perspective. There were two main goals of this study. First, this study focused on the regional differences in baseline-to-working memory task brain electrical activity and specifically investigated the hypothesis that there would be an increasing specificity of task EEG power between 3½ and 4½ years of age. The second goal of this study was to investigate the sources of variability in working memory function and to specifically examine the contributions of task-related EEG, the regulatory dimensions of temperament, and linguistic ability to the prediction of working memory performance. This second study objective included an investigation of the relation between working memory and each of these variables (1) separately, (2) in conjunction with age, and (3) collectively to examine any multivariate contributions to the explanation of variance in working memory function in early childhood. The results of this study provided some support to the increasing specificity of baseline-to-task EEG power hypothesis. Specifically, an increase in brain electrical activity was found for four scalp regions at age 4 and only two regions at age 4½. These findings coupled with previous work indicating an increase in task brain electrical activity for only one region at age 4½ suggest that cortical specialization is occurring during the early childhood years. With regard to the investigation of sources of variability working memory function, age, brain electrical activity, temperament, and linguistic functioning were all found to be meaningful variables in the explanation of variance in working memory. However, linguistic functioning " and specifically language receptivity " was found to be the strongest and most meaningful associate of working memory function. Additional findings of interest included the differential associations demonstrated between working memory and temperament for each age group and also an increase in the strength of the relation between working memory and language across the three ages. / Ph. D.

Developmental stuttering is a physiological disorder of speech motor control. Unlike acquired conditions, developmental stuttering is responsive to fluency-inducing conditions involving the manipulation or elimination of auditory feedback. It was hypothesized that stutterers experience interference effects from competing sensory feedback during the working memory interval in which contextual information is held on-line in order to prepare subsequent motor responses. Behavior and EEG activity of stutterers and non stutterers were compared during working memory tasks. Participants were 22 male, right-handed stutterers, mean age 28.2 years, age matched with 22 male, right-handed nonstutterers. Behavioral measures included a written verbal fluency task, an auditory delayed match-to-sample key press task, and a written digit span task. As hypothesized, there were no group differences in verbal fluency. Also as hypothesized, stutterers had higher error scores (more false positives) on the auditory delayed match-to-sample key press task. This suggests increased sensitivity to auditory stimuli and difficulty inhibiting response to stimulation. Groups did not differ in digit span, but there was a trend toward significance (p=.07). If stutterers do experience overlapping or excessive sensory stimulation during the working memory phase of speech motor plan assembly, the EEG of stutterers should evidence differences consistent with excessive or inefficient processing of "extra" sensory stimuli. Monopolar recordings were collected from 19 sites in accordance with the international 10-20 system of electrode placement. EEG was recorded during 60 seconds of resting-eyes-closed and resting-eyes-open~ 60 seconds during a silent backwards-subtraction math task; 120 seconds during an auditory delayed match-to-sample key press task. As hypothesized, stutterers exhibited more theta activity than nonstutterers in frontal regions in all conditions, both in the low theta subband (3-5 Hz) and the high theta subband (5.5-7.5 Hz). Also as hypothesized, stutterers produced more alpha activity in the low alpha subband (8-10 Hz) in frontal regions in all conditions. There were no group differences in the high alpha subband (10.5-13 Hz). There were no hemispheric differences in frontal regions. Increased cortical activity and increased sensitivity to stimuli support the proposed hypothesis that stutterers experience excess sensory stimulation while attempting motor plan assembly, suggestive of stuttering as a disorder of attention. / Ph. D.

Temporal context memory is memory for the timing of events. People can make temporal judgments based on strategies such as assessing the relative familiarity of events or inferring temporal order from the semantic associations among events. The purpose of present study is to investigate the brain regions that support temporal context retrieval in the absence of such non-temporal strategies (i.e. pure temporal context memory). We used three word familiar phrases (triplets) as stimuli. In study phase, three words were presented quickly one after another in either familiar or scrambled order. Participants were instructed to read aloud each word and try to remember the order of the words. Then they were tested on their memory for the order of the words in each triplet. We propose that memory for the scrambled triplets reflects primarily temporal retrieval for two reasons. First, participants were prevented from using semantic strategies during encoding. Second, the relative familiarity of the words in each triplet was similar and not diagnostic of the order of the words during encoding. Neuroimaging results indicate that temporal context retrieval, memory for the order of words in scrambled triplets, was associated with the hippocampus, parahippocampal cortex, ventromedial prefrontal cortex, retrosplenial cortex, and posterior cingulate, which are consistent with the retrieval of non-temporal context in episodic memory. The results also suggest that temporal context retrieval could rely on familiarity, which was demonstrated by the higher accuracy and greater activation of PRc in familiar phrases and scrambled triplets presented in studied order in the test phase. / Master of Science