Digital Commons Network^™

Sex-Specific Effects And Gene-Sex Interactions In Serum Metabolome Levels: The Atherosclerosis Risk In Communities Study, Zhe Wang

Dissertations & Theses (Open Access)

Metabolomic signatures associated with complex disease have been identified. Metabolomic profiling and the integration of genomic data have proven to be powerful tools to investigate genetic effects underlying intermediate phenotype levels and may facilitate improved understanding of pathophysiologic processes of disease. However, most published studies did not consider sex as an effect modifier, analyze sex-specific effects, nor gene by sex interactions. One reason can be incomplete knowledge of the power of statistical methods used in a given dataset.

I first investigated sex-specific genetic effects by performing sex-stratified exome-wide association studies for 271 chromatography-mass spectrometry measured metabolites in the Atherosclerosis Risk …

Factors Contributing To Lower Cancer Screening Utilization In A Sub-Sample Of United Way 2-1-1 Callers, Jason M. Rhoton

Dissertations & Theses (Open Access)

This dissertation was a secondary analysis of data from a Cancer Prevention Research Institute of Texas (CPRIT)-funded [grant # PP100077 & PP120086] cancer-control intervention with The University of Texas Health Science Center at Houston (UTHealth) School of Public Health and United Way 2-1-1. The aims of the three dissertation papers were addressed by examining a sub-sample of 2-1-1 callers that were drawn from the parent study baseline data. Participants were required to need at least once cancer prevention service to be included in the parent study and dissertation analyses. This dissertation was a cross-sectional analysis of de-identified data examining the …

Assessment And Findings Of The Vulnerability Index (Vi-Spdat) Survey Of Individuals Experiencing Homelessness In Travis County, Tx, Benjamin T. King

Dissertations & Theses (Open Access)

Homelessness is a significant barrier to the quality of an individual’s health. Federal housing interventions attempt to eliminate homelessness by providing varying degrees of subsidization, but available units do not currently keep pace with the scale of the problem. Coordinated Assessment is a process requirement put in place by HUD to organize and prioritize the waiting list for housing, based on community priorities. Several tools measuring health and social vulnerability, including the Vulnerability Index-Service Prioritization Decision Assistance Tool (VI-SPDAT), have become popular options for prioritizing housing resources. Such assessments currently in use are not thoroughly researched and the effects of …

Bayesian Based Semiparametric Multidimensional Approaches To Analysis Parkinson's Disease, Jun Zhang

Dissertations & Theses (Open Access)

In the slow progression of Parkinson's Disease (PD), impairments arise and affect multiple domains (e.g., motor, cognitive, and behavioral). Mixed types, multivariate longitudinal data are commonly used in PD studies. Challenges exist in assessing PD status and investigating disease progression due to lack of biomarkers and ubiquitous impairment in the disease. We proposed a model framework by combining the semi-parametric approach and multi- dimensional framework, and used the proposed model to investigate the heterogeneous disease development and the non-linear treatment effects in the multiple domains predefined in PD.

Furthermore, we extended the semi-parametric multidimensional approach to the data with multi-types …

Censored Count Data Analysis – Statistical Techniques And Applications, Xiao Yu

Dissertations & Theses (Open Access)

Count data are commonly used to report frequency statistics of diverse health outcomes. However, some data are marked intentionally to avoid leaking information that could be used to identify individuals when population sizes are small. The situation hinders the further use from those data in public health research. Thus, an accurate and efficient method for dealing with censored count data is needed.

We developed Integrated Nested Laplace Approximation algorithm to censored Poisson regression model to deal with censored count data and improve the computational efficiency. In addition, we applied three methods to deal with censored count data: 1) multiple imputation …

Collateral Benefits Of Diabetes Self-Management Associated With Self-Administered Outpatient Parenteral Antimicrobial Therapy, Anisha P. Ganguly

Dissertations & Theses (Open Access)

Self-administered outpatient parenteral antimicrobial therapy (S-OPAT) is a self-care treatment modality in which patients requiring extended courses of intravenous antibiotics are trained to safely self-administer treatment via an indwelling catheter in their home. Many patients seen in the S-OPAT program have a diagnosis of diabetes and present with infections associated with poor glycemic control, including skin and soft-tissue infections and osteomyelitis. Given the degree of patient activation required to successfully complete the S-OPAT process, we hypothesized that participation in this self-care program may benefit patients in self-management of other chronic health conditions, such as diabetes. The study team included Anisha …

Relationship Between Nursing Safety Culture And Patient Perception Of Safety In Inpatient Units Of An Academic Specialty Hospital, Miguel Angel Lozano Garcia

Dissertations & Theses (Open Access)

The objective of this research was to analyze the relationship between nursing safety work culture in inpatient nursing units of a specialty academic hospital and their patients’ perception of safety using quantitative and qualitative methods. The aim of the quantitative study was to quantitatively evaluate whether nursing safety culture, as measured on the Hospital Survey on Patient Safety Culture (HSOPS) safety questions of the institutional employee opinion survey, was associated with patients’ perception of safety during their inpatient care, as measured by responses on the inpatient Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The aim of the …

Identifying Risk Factors Associated With Cardiovascular Disease Risk In Lesbians, Sofia S. Velazquez

Dissertations & Theses (Open Access)

Cardiovascular disease (CVD) is the leading cause of female deaths in the United States (1). While women, in general, are at risk for CVD, current research indicates that sexual minority women (i.e. lesbians and bisexual women [SMW]) may be at greater risk for CVD than heterosexual women. This heightened risk potentially stems from an increased prevalence of traditional CVD risk factors in SMW, creating health disparities between SMW and their heterosexual counterparts (2). Further research into this high-risk population is needed, in order to minimize these disparities.

The purpose of this study was to establish differences in the prevalence of …

Effects Of Extreme Precipitation On Gastrointesitnal Related Hospital Admissions In Texas, Sharmila Giri

Dissertations & Theses (Open Access)

Extreme precipitation has been implicated in more than 51% of the waterborne disease outbreaks in the United States between 1948-1994. With increased incidence of extreme precipitation projected to be more likely due to ongoing climate change, the burden of waterborne disease is expected to rise even in the United States where drinking water is considered to be one of the safest in the world. In this study we aim to quantify the risk of extreme precipitation on gastrointestinal (GI) related hospital admissions by using meteorological and emergency hospital data from twelve major metropolitan statistical areas (MSA) of Texas from year …

Hours Of Gaming Or Non-Academic Computer Use, Substance Use, Mental Health Status And School Performance Among Texas Adolescence: Findings From The 2017 Yrbs In Texas, Shanxiazi Gao

Dissertations & Theses (Open Access)

Online gaming activities among adolescents and adults has increased exponentially in the last decade, and mental health issues associated with excessive gaming have drawn attention from health care professionals worldwide (Griffith, 2016). Recognizing this trend, American Psychiatric Association (APA) categorized gaming disorder/addiction as a mental health condition in 2013 in an effort to prevent the expansion of relevant mental health issues (American Psychiatric Association, 2013). Additionally, the World Health Organization (WHO) declared gaming disorder/addiction as a mental health disease, (World Health Organization, 2018). As a result of this declaration, Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has established nine …

Adverse Childhood Experiences, Depression, And Resilience In African-American Adolescents, Jamie C. Freeny

Dissertations & Theses (Open Access)

Research shows that exposure to adverse childhood experiences (ACEs) is common among adolescents; however, no studies have examined the prevalence of ACEs in a racially homogenous sample of African-American adolescents. Thus, the present study examined the cumulative and individual prevalence of ACEs in African-American adolescents. Data were collected from African-American adolescents (n = 241) who attended youth events hosted by churches in Houston, TX. An expanded ACEs tool was used to collect data. ACE scores were summed and dichotomized to 0-3 ACEs versus 4-19 ACEs because a score of four or more indicates a higher risk for adverse mental and …

Development And Usability Testing Of Quit4health, A Smoking Cessation Smartphone App For Young Adults, Katarzyna Czerniak

Dissertations & Theses (Open Access)

Tobacco use is the leading cause of death in the United States. As of 2016, 23.5% of American 18-25 year olds reported having used cigarettes in the last month compared to 20.2% of adults and only 3.4% of adolescents. Due to the efficacy and widespread general use of mobile technology today, mobile-phone health, or mHealth apps, have become increasingly popular methods of delivering smoking cessation programs. However, there is a lack of evidence in regards to the quality and the effectiveness of using mHealth to deliver smoking cessation interventions to young adults. This study aims to fill this gap to …

Sociodemographic Determinants Of Mental Health Outcomes Among Unhealthy Weight Youth In The United States, Chenchita Malolan

Dissertations & Theses (Open Access)

Background

The prevalence of unhealthy weight (defined as a body mass index ≥ 85th %ile for age and sex) among children and adolescents in the United States remains unacceptably high. In parallel, the prevalence of mental health issues in youth is rising as well. Current research shows a strong association between overweight/obesity and poor mental health outcomes. Specifically, youth of unhealthy weight have higher rates of anxiety and depression. The objective of this study is to evaluate the specific the current (2016-17) population-level prevalence of unhealthy weight, mental health issues and the sociodemographic (e.g. sex, age, race, ethnicity, household income) …

Health Outcomes Of Adolescents And Young Adults After Traumatic Injury: The Role Of Stress Resilience And Social Support, Belanie Peavy

Dissertations & Theses (Open Access)

Background: Traumatic injury is a major health problem and has been linked to mental and physical disability following injury. Although it is the leading cause of disability in the United States (US) for adolescents and young adults, there is a paucity of evidence in the literature regarding association(s) of perceived stress on the outcomes of anxiety and depressive symptoms and the moderating role of resilience and social support in which to develop prevention and treatment interventions for this patient population.

Purpose: The purpose of this study was to examine the effect of perceived stress on anxiety and depressive symptoms …

A Role For Epac1 And Epac2 In Nociceptor Hyperexcitability And Chronic Pain After Spinal Cord Injury, Samantha Berkey

Dissertations & Theses (Open Access)

Chronic pain is a major complaint of those living with spinal cord injury (SCI), affecting 65-80% of the SCI population, but the treatment options remain limited or non-existent. The cAMP sensor EPAC has previously been shown to play a key role in chronic inflammatory and neuropathic pain, though the contribution from each of its two main isoforms, EPAC1 and EPAC2, is unclear. Here I test the hypothesis that both EPAC1 and EPAC2 play a key role in the maintenance of persistent nociceptor hyperexcitability and chronic pain after SCI.

Using both a T9 SCI mouse model and a T10 SCI rat …

Il-1Α Blockade Reduces Immune Suppression In The Early Tumor Micro-Environment, Brenda Melendez

Dissertations & Theses (Open Access)

IL-1α Blockade Reduces Immune Suppression in the Early Tumor Micro-Environment

Brenda Melendez, B.S.

Advisory Professor: Gregory Lizee, PhD.

Immunotherapy against melanoma has shown great promise in the clinic for treating advanced-stage patients. However, a major barrier against effective T cell mediated cytotoxicity is immunosuppression in the tumor micro-environment. It has been described that tumors secrete pro-inflammatory cytokines capable of modulating immune responses that favors the growth of tumor cells. Specifically, IL-1 plays a critical role in myeloid cell recruitment and activation, which can in turn inhibit T cell activity in vivo. Moreover, IL-1 is also known to up-regulate immune inhibitory …

Observed Cooking Behaviors Of Families With And Without Childhood Cancer Survivors And The Development Of A Healthy Cooking Assessment Tool, Margaret Pleta Raber

Dissertations & Theses (Open Access)

Diet is a modifiable risk factor for several cancers and other chronic diseases. Cooking skills are a target for dietary intervention, with much of the general population reporting infrequent and inadequate home preparation of meals. Childhood cancer survivors (CCS) are a population at high risk of several chronic conditions including secondary cancers that may be influenced by home cooking behaviors. We conducted observations of food preparation practices in 29 parents of healthy school-aged children and 11 parents of CCS. Observations included an audio and video recording of one evening meal per family. Parents were asked to wear a small body …

Characterizing Young Adult Exposure And Engagement With Social Media Tobacco And Nicotine Product Marketing And Messaging, Stephanie L. Clendennen

Dissertations & Theses (Open Access)

Tobacco use remains a critical public health issue in the United States. Young adults are disproportionately affected by high rates of tobacco use and heavily targeted by tobacco marketing. Social media has become an important source of exposure to tobacco and nicotine product marketing and messaging for young adults. This dissertation examined the prevalence and socio-environmental characteristics associated with young adults’ exposure to and engagement with tobacco-related social media (paper 1); the prospective associations between young adults’ exposure and engagement and tobacco and nicotine product use (paper 2); and young adults’ experiences with tobacco and nicotine product messaging on social …

Ontology-Based Clinical Information Extraction Using Snomed Ct, Jun Li

Dissertations & Theses (Open Access)

Extracting and encoding clinical information captured in unstructured clinical documents with standard medical terminologies is vital to enable secondary use of clinical data from practice. SNOMED CT is the most comprehensive medical ontology with broad types of concepts and detailed relationships and it has been widely used for many clinical applications. However, few studies have investigated the use of SNOMED CT in clinical information extraction.

In this dissertation research, we developed a fine-grained information model based on the SNOMED CT and built novel information extraction systems to recognize clinical entities and identify their relations, as well as to encode them …

Microrna Functions In Uv-Induced Cutaneous Squamous Cell Carcinoma, Tran Nguyen

Dissertations & Theses (Open Access)

Cutaneous squamous cell carcinoma (cuSCC) is the second most common skin cancer, for which long term UV exposure and chronic wounding are the dominant risk factors. Despite these clinically established connections, little is understood about the early molecular response of human skin to UV exposure and its connection to acute wounding and cuSCC. Thus, our goal is to find common and specific signatures driven by UV-exposure and wounding as a means of developing new approaches for treating and preventing cuSCC.

Here, we perform integrated analyses of RNA-seq and miR-seq on 3 datasets: (1) UV-unexposed and acute UV-exposed human skin, (2) …

The Protective Effects Of Memantine On The Morphology And Activity Of Irradiated Dendritic Spines, Thanh Lam

Dissertations & Theses (Open Access)

Abstract: The Protective Effects of Memantine on the Morphology And

Activity of Irradiated Dendritic Spines

Thanh T. Lam, M.S.

Advisory Professor: David R. Grosshans, M.D, Ph.D.

Although radiotherapy is an effective treatment for brain tumors, the adverse effects of such treatments may result in a decline in cognitive functioning. To prevent or reverse such radiation-induced cognitive dysfunctions, it is critical to understand the cellular and subcellular effects of radiation. In this study, both Thy-1 YFP mice and cultured cortical neurons were used to investigate changes in dendritic spines after cortical neurons were irradiated. The results indicated that irradiation has long-term …

Sex-Related Differences In Outcomes Of Thoracic Organ Transplantation And Mechanical Circulatory Support, Daoud Daoud, Faisal H Cheema, Jeffrey A Morgan, Gabriel Loor

The Texas Heart Institute Journal

No abstract provided.

Auto-Delineation Of Oropharyngeal Clinical Target Volumes Using Deep Learning Techniques, Carlos Eduardo Cardenas

Dissertations & Theses (Open Access)

Head and neck intensity modulate radiation therapy allows for the delivery of high-precision radiotherapy by conforming radiation dose to the defined treatment targets achieving more accurate target dose distribution and better sparing of normal tissues. However, producing very precise treatment plans may be ineffective if the target volumes are not defined accurately. Furthermore, there are several reports of significant inter-observer variability when delineating these target volumes for head and neck cancers making this variability one of the largest sources of uncertainty in head and neck radiation therapy.

The purpose of this study was to develop algorithms to automate target delineation …

Genomic And Transcriptomic Landscape Of Colorectal Premalignancy, Kyle Chang

Dissertations & Theses (Open Access)

Colorectal cancer (CRC) is the third most commonly diagnosed cancer among men and women in the United States, with 3 to 5 percent of the cases diagnosed in the background of a hereditary form of the disease. Biologically, CRC is divided into two groups: microsatellite instable (MSI) and chromosomally unstable (CIN). Genomic and transcriptomic characterization of CRC has emerged from large-scale studies in recent years due to the advancement of next-generation sequencing technologies. These studies have identified key genes and pathways altered in CRC and provided insights to the discovery of therapeutic targets. Despite the wealth of knowledge acquired in …

Obstructive Sleep Apnea In Heart Failure: Review Of Prevalence, Treatment With Continuous Positive Airway Pressure, And Prognosis, Himad K Khattak, Faisal Hayat, Salpy V Pamboukian, Harvey S Hahn, Brian P Schwartz, Phyllis K Stein

The Texas Heart Institute Journal

Obstructive sleep apnea is a sleep-related breathing disorder that has a major impact on cardiovascular function. It has been associated with hypertension, coronary artery disease, cardiac arrhythmias, sudden cardiac death, and heart failure. This review focuses on the relationship between obstructive sleep apnea and heart failure with either reduced or preserved ejection fraction. We discuss the pathophysiology of obstructive sleep apnea, as well as its prevalence, treatment outcomes with continuous positive airway pressure, and prognosis in these 2 distinct types of heart failure. We also identify areas in which further work is needed to improve our understanding of this association …

Computational Insights Into The Generation Of Chromosomal Copy Number Changes, Yihua Liu

Dissertations & Theses (Open Access)

Deviations from a diploid configuration of the human genome, spanning single genes or entire chromosomes, can have wide-ranging impacts on the variation of human phenotypes, including Mendelian and complex forms of diseases. These chromosomal alterations — such as duplications, deletions or copy-neutral loss-of-heterozygosity — are thus important forms of genetic variation for phenotyping populations of individuals as well as populations of cells. Indeed, copy number variants (CNVs) serve as hallmarks of critical changes in the development of particular diseases such as cancer and thus may be used as biomarkers. These CNVs may be either inherited (transmitted by germ cells, originating …

Factors Influencing Physical Activity Among Immigrants From South India: A Qualitative Descriptive Study, Jaya Abraham

Dissertations & Theses (Open Access)

Background: In the United States (U.S), the percentage of diabetes and coronary artery diseases is higher among Asian Indian immigrants compared to other ethnic groups. Although research has been useful in describing patterns of physical activity among South Asian groups, very little is known about the factors influencing physical activity among Asian South Indian (ASI) immigrants. There is very limited research performed on the individual, social, cultural and environmental factors influencing physical activity among ASI immigrants.

Purpose: The study purpose was to explore the factors influencing physical activity with the following primary and secondary aims: The primary aim …

Relationships Of Moral Distress Among Interprofessional Icu Teams, Heather Vincent

Dissertations & Theses (Open Access)

Background: Moral distress is the psychological response to knowing the right action required by a healthcare professional but being unable to act upon the right course of action due to internal, external, and institutional constraints.

Purpose: The study investigated: 1. the level of moral distress among interprofessional healthcare providers working in four ICUs of a single academic hospital as measured by the 21-item Moral Distress Scale-Revised (MDS-R), 2. the differences in moral distress among interprofessional healthcare providers based on demographic characteristics and rankings of clinical scenario on the MDS-R.

Method: Descriptive, cross-sectional design using survey methodology.

Outcomes: Significant differences in …

Bridging The Gap Between Food Insecurity And Subsequent Child Body Mass: Mediating Effects Of Dietary Quality And Feeding Styles In Low-Income Hispanic Preschoolers, Nipa Kamdar

Dissertations & Theses (Open Access)

Background: Low-income Hispanic preschoolers face disproportionately high prevalence of food insecurity (FI) and obesity. Consumption of low-cost, energy-dense foods to compensate for FI leads to excess body-mass. FI parents may adopt feeding styles that contribute to decline in children’s dietary quality. Feeding style describes the amount of demandingness (i.e., control of children’s eating) and responsiveness (i.e., warmth used to express demandingness). FI may indirectly contribute to obesity through dietary quality and feeding style.

Purpose: This study investigated: 1. if dietary quality mediated the relationship between food security status (FSS) at Time 1 (T1) and child body-mass at Time 2 (T2), …

Associations Between Physical Activity, Health-Related Quality Of Life, Regimen Adherence, And Glycemic Control In Jordanian Adolescents With Type 1 Diabetes, Yousef Aljawarneh

Dissertations & Theses (Open Access)

Background: Adolescents with Type 1 Diabetes (T1D) display a greater than two-fold higher risk of developing microvascular and macrovascular complications compared with the non-diabetic population and the risk increases markedly as glycated hemoglobin (HbA1c) increases. The majority of the findings on the associated factors with improved glycemic control are geared toward Western population with a clear lack of studies on Middle Eastern populations.

Purpose: This study aimed to examine the effect of Physical Activity (PA), Health-Related Quality of Life (HRQoL), and regimen adherence on glycemic control in Jordanian adolescents with T1D.

Methods: The study utilized a cross-sectional design. Jordanian adolescents …