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Theses/Dissertations

2016

Health and environmental sciences

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Nanoparticle Toxicity And Molecular Mechanisms In Fish: A Case Study With Silver Nanoparticles, Jiejun Gao Dec 2016

Nanoparticle Toxicity And Molecular Mechanisms In Fish: A Case Study With Silver Nanoparticles, Jiejun Gao

Open Access Dissertations

Nanoparticles (NPs) are widely used in a myriad of commercial and industrial products making their entry to the environment a likely event. NPs have unique physical-chemical properties that result from their small size and high surface area to volume ratio, making them highly reactive and potentially toxic. In Chapter 1, we summarize the effects and mechanisms of metal-based NPs on the vascular system. In vitro studies have shown that NPs are anti-angiogenic because they cause inflammation, oxidative stress, and apoptosis of endothelial cells resulting in increased permeability and decreased proliferation and migration. Whole animal studies examining the effects of NPs …


The Development Of Preclinical Strategies For Facilitation Of Lead Candidate Selection, Christopher Dale Kulczar Dec 2016

The Development Of Preclinical Strategies For Facilitation Of Lead Candidate Selection, Christopher Dale Kulczar

Open Access Dissertations

Chapter 1 details a background of techniques used for modeling the blood-brain barrier (BBB). The BBB represents a diffusive barrier to both paracellular and transcellular movement of many compounds in and out of the brain. The main rate- limiting barriers of the BBB include exclusive tight junctions that prevent the movement of hydrophilic molecules through intercellular gaps, and efflux proteins in the membrane which pump many hydrophobic molecules back into the blood. In addition, the BBB contains metabolizing enzymes, including Cytochrome P450s. This barrier acts to protect the vulnerable tissues of the brain from harmful xenobiotics, but also can serve …


Ambient Ionization - Mass Spectrometry: Advances Toward Intrasurgical Cancer Detection, Alan Keith Jarmusch Dec 2016

Ambient Ionization - Mass Spectrometry: Advances Toward Intrasurgical Cancer Detection, Alan Keith Jarmusch

Open Access Dissertations

My dissertation research has focused on the development of ambient ionization – mass spectrometry (MS) for clinical measurements, specifically intrasurgical cancer detection. The molecular differences between normal and cancerous tissue were detected via direct tissue analysis in vitro by touch spray ionization (TS) or by analyzing sectioned or smeared tissue using desorption electrospray ionization (DESI). The physical form of the tissue, e.g. in vitro sampling, sectioned, or smeared, was inconsequential in differentiating normal from cancerous tissue; however, the spectra acquired by TS and DESI differed due to differences in ionization processes. We envision that TS-MS and DESI-MS could impact diagnostic …


Quantifying Terrestrial Ecosystem Carbon Dynamics With Mechanistically-Based Biogeochemistry Models And In Situ And Remotely Sensed Data, Shaoqing Liu Dec 2016

Quantifying Terrestrial Ecosystem Carbon Dynamics With Mechanistically-Based Biogeochemistry Models And In Situ And Remotely Sensed Data, Shaoqing Liu

Open Access Dissertations

Terrestrial ecosystem plays a critical role in the global carbon cycle and climate system. Therefore, it is important to accurately quantify the carbon dynamics of terrestrial ecosystem under future climatic change condition. This dissertation evaluates the regional carbon dynamics by using upscaling approach, mechanistically-based biogeochemistry models and in situ and remotely sensed data.

The upscaling studies based on FLUXNET network has provided us the spatial and temporal pattern of the carbon fluxes but it fails to consider the atmospheric CO2 effect given its important physiological role in carbon assimilation. In the second chapter, we consider the effect of atmospheric CO2 …


The Relationship Between Protein And Phosphorus Digestion And Retention In Growing Pigs And Broiler Chickens, Pengcheng Xue Dec 2016

The Relationship Between Protein And Phosphorus Digestion And Retention In Growing Pigs And Broiler Chickens, Pengcheng Xue

Open Access Dissertations

Xue, Pengcheng. Ph.D., Purdue University, December 2016. The Relationship between Protein and Phosphorus Digestion and Retention in Growing Pigs and Broiler Chickens. Major Professor: Dr. Layi Adeola. The objective of this study was to investigate the relationship between protein and P digestion and retention in growing pigs and broiler chickens. The methodology of determining the digestibility of AA and P and the effect of dietary N and P on the digestion and retention of these two nutrients were investigated.

An experiment was conducted in growing pigs to investigate the additivity of AID or SID of CP and AA in mixed …


Examining The Impact Of The Affordable Care Act On Small Businesses And Industries In Northwest Indiana, Onias Muza Taruwinga Dec 2016

Examining The Impact Of The Affordable Care Act On Small Businesses And Industries In Northwest Indiana, Onias Muza Taruwinga

Open Access Dissertations

This research examined the lived experiences of small businesses in Northwest Indiana with the implementation of the Affordable Care Act. The interviews were conducted over a period of six months with an attempt to answer the question, “What was the impact of the Affordable Care Act on small businesses and industries in Northwest Indiana?” Additional research questions were, “Did the Affordable Care Act extend coverage to the uninsured, include other medical services that were not covered before, and reduce cost sharing and what lessons can be learned from the implementation of the Affordable Care Act for future policy implementation?” 15 …


The Effects Of Dietary Probiotic Inclusion On Skeletal Health Of Poultry And Its Possible Mechanisms, Feifei Yan Dec 2016

The Effects Of Dietary Probiotic Inclusion On Skeletal Health Of Poultry And Its Possible Mechanisms, Feifei Yan

Open Access Dissertations

Probiotics are live microorganisms which may confer health benefits on the host when administered in appropriate amounts. Numerous studies have shown that probiotics improve bone health in humans and rodents with less information available on the skeletal health of avians given probiotics. The objective of this study was to determine the effects of probiotic supplementation on bone health of egg-laying and meat-type chickens. Dietary supplementation of a multi-species based probiotic reduced the percentage of shell-less eggs beginning at 4 wk following treatment and increased tibial and femoral bone mineral density in egg-laying hens at 7 wk post-treatment. Similarly, bone mineralization …


Lower Food Web Dynamics In Lakes Michigan And Huron: Spatial And Temporal Responses To Recent Oligotrophication, Margaret Hutton Stadig Dec 2016

Lower Food Web Dynamics In Lakes Michigan And Huron: Spatial And Temporal Responses To Recent Oligotrophication, Margaret Hutton Stadig

Open Access Theses

Nutrient abatement programs, originally enacted to counter eutrophication have successfully suppressed nutrient loads and relative primary production in marine and freshwater systems. Recently, the additive impacts of invasive filter feeders have further reduced offshore primary production in several aquatic systems throughout the world. It has been hypothesized that the biological activity of these invasive species may sequester nutrients within the nearshore benthic environment, creating steep gradients in primary production between nearshore and offshore habitats. In the Laurentian Great Lakes, past studies of oligotrophication have primarily focused on food web responses in offshore habitats. Organisms at higher trophic levels have been …


Mathematical Analysis Of Feedback Targets Of Bmp Signaling In Drosophila Embryonic Development, Yan Luo Dec 2016

Mathematical Analysis Of Feedback Targets Of Bmp Signaling In Drosophila Embryonic Development, Yan Luo

Open Access Theses

Bone morphogenetic proteins (BMPs) drive a range of cellular processes especially in the early stages of embryonic development. This family of proteins acts as one of the most important extracellular signals in development pattern formation across the animal kingdom. Cells in embryos differentiate into different cell types in response to the concentration level of BMP. This complex process is regulated by multiple regulators that serve to tune the signal response.

Extensive experimental and computational research has been performed to analyze BMP regulation in Drosophila, a widely studied model organism, and has advanced our understanding of animal development. Because of …


Innovative Novel Immunotherapies For The Treatment Of Glioblastoma Multiforme, Salma Salem Dec 2016

Innovative Novel Immunotherapies For The Treatment Of Glioblastoma Multiforme, Salma Salem

Open Access Theses

Glioblastoma Multiforme GBM is a very aggressive type of malignant brain tumors that affects peoples’ lives. The diffusive, infiltrative, and metastatic behaviour of GBM is the major reason for the disease recurrence. The morphological and immunohistological characteristics of Central Nervous System (CNS) tumors including GBM are heterogeneous. GBM is either primary (de novo) or secondary to low-grade astrocytomas.

Current treatment options include surgery, radiotherapy, and temozolomide chemotherapy have not achieved any improvement in success rates over the past decades. The survival time reached by GBM patients was approximately 12 months only after being treated with radiotherapy alone without temozolomide. However, …


Exploring The Cause Of Injury Or Death In Grain Entrapment, Engulfment And Extrication, Salah F. Issa Dec 2016

Exploring The Cause Of Injury Or Death In Grain Entrapment, Engulfment And Extrication, Salah F. Issa

Open Access Dissertations

Grain entrapments and engulfments are one of most common hazards associated with grain storage facilities. Since the 1970’s over 1,880 incidents have been documented in agricultural confined spaces of which 65% of all recorded incidents were grain entrapments and engulfments. There have been several studies conducted on the contributing factors behind these incidents; however, there have been very few attempts to understand the environmental, physiological or psychological factors the victims experience while entrapped, engulfed, or extricated. This includes understanding how secondary injuries are caused by grain or during extrication by first responders. The research effort was divided into three segments. …


Gonadal Intersex In Teleosts: Mechanisms, Molecular Biomarkers And Diagnostic Assays, Ahmed M.E. Abdel-Moneim Mohamed Dec 2016

Gonadal Intersex In Teleosts: Mechanisms, Molecular Biomarkers And Diagnostic Assays, Ahmed M.E. Abdel-Moneim Mohamed

Open Access Dissertations

Natural and synthetic estrogenic and androgenic compounds are continuously released into aquatic ecosystems. Exposure of teleost fishes to these contaminants can negatively impact sex differentiation and reproductive output. Specifically, development of gonadal intersex in gonochoristic (fixed sex) fish species has been studied extensively in relation to exposure to this class of compounds. The main objectives of this dissertation were to: 1) conduct field and laboratory studies to investigate the molecular signaling pathways behind the development of gonadal intersex; and 2) establish molecular biomarkers and assays for testing the ability of environmental pollutants to develop this condition using a battery of …


Repurposing Non-Antimicrobial Drugs To Treat Multi-Drug Resistant Bacterial And Fungal Infections, Shankar Thangamani Dec 2016

Repurposing Non-Antimicrobial Drugs To Treat Multi-Drug Resistant Bacterial And Fungal Infections, Shankar Thangamani

Open Access Dissertations

Bacterial and fungal resistance to conventional antimicrobials is a burgeoning global health epidemic that necessitates urgent action. Even more alarming, the development of new antimicrobials to treat these multidrug-resistant pathogens has not kept pace with the rapid emergence of resistance to current antimicrobials. Antimicrobial drug development through the traditional de novo process is a risky venture given the significant financial and time investment required by researchers and limited success rate of translating these compounds to the clinical setting. This has led researchers to mine existing libraries of clinical molecules in order to repurpose old drugs for new applications (as antimicrobials). …


Understanding The Formation Of American Mental Health Policy Preferences, 1952-1981, Andrew D. Tuholski Dec 2016

Understanding The Formation Of American Mental Health Policy Preferences, 1952-1981, Andrew D. Tuholski

Open Access Dissertations

In the United States, the emergence of an outpatient-centered, drug-based model of mental health care was physically feasible from the 1950s onward, with the introduction of thorazine and other first-generation antipsychotics. However, it was not until 1981, with President Reagan’s veto of the Mental Health Systems Act, that American mental health policy tipped over definitively into the outpatient-centered, drug-based model. In this quantitative study of the formation of policy preference, the delay between the feasibility of the outpatient-centered, drug-based model and its adoption was explored through five research questions answered through corpus analysis and time series statistics: How do shifts …


Unraveling The Fingerprints Of Nox Using Stable Isotopes: Implications For Nox Source Partitioning And Oxidation Chemistry, Wendell William Walters Dec 2016

Unraveling The Fingerprints Of Nox Using Stable Isotopes: Implications For Nox Source Partitioning And Oxidation Chemistry, Wendell William Walters

Open Access Dissertations

The nitrogen (N) and oxygen (O) stable isotope composition (δ15N & δ18O) of nitrogen oxides (NOx )may be a useful tool for constraining NOx emission sources as well as for understanding the atmospheric oxidation pathways responsible for its removal if various NOx sources and sink processes exhibit characteristic isotopic compositions (“fingerprints”). However, this requires (1) an accurate and complete inventory of δ15N(NOx) values from major emission sources, (2) an assessment of the kinetic and equilibrium isotope effects that can impact δ15N and δ18O values of NOx, (3) and test these assumptions by conducting accurate in situ δ15N and δ18O measurements …


Structure-Function Analysis Of The Dopamine Transporter In The Presence Of Synthetic Cathinones And Amphetamines, Shari Melissa Radford Dec 2016

Structure-Function Analysis Of The Dopamine Transporter In The Presence Of Synthetic Cathinones And Amphetamines, Shari Melissa Radford

Open Access Theses

The dopamine transporter (DAT) is a monoamine transporter that regulates dopamine (DA) neurotransmission by clearing DA from the synapse. DAT is acted on by a number of psychostimulant drugs, which block reuptake and potentiate DA signaling. Several inhibitors of DAT, both amphetamines and cathinones, also cause reversal of transport. Previous research has shown the importance of a conserved salt bridge in another monoamine transporter, the serotonin transporter, in amphetamine-induced efflux. In our studies here, we engineered a mutant Drosophila melanogaster DAT (dDAT D475N) designed to interrupt this salt bridge and examine the effects on amphetamine- and cathinone-induced efflux in vitro. …


Willingness To Pay For Irrigation Water Under Scarcity Conditions, Tyler Robert Knapp Dec 2016

Willingness To Pay For Irrigation Water Under Scarcity Conditions, Tyler Robert Knapp

Graduate Theses and Dissertations

Reliance of Arkansas agricultural producers on groundwater for irrigation has led to depletion of the Mississippi River Valley alluvial aquifer. Without intervention, consequences include insufficient groundwater to meet irrigation demand as well as drawdown of the deeper Sparta Aquifer, upon which communities in eastern Arkansas rely for non-agricultural use. Among proposed solutions to combat groundwater decline is the construction of off-farm surface water infrastructure to meet the irrigation needs of producers. Despite the importance of irrigated agriculture to Arkansas, there is little know about the economic value of irrigation water to producers. Thus, we implement a double-bounded dichotomous choice contingent …


Apparel Design Process: Shifting The Basic Pattern Block Into A New Framework To Fit The Demands Of Post Double Mastectomy Women, Shan Gao Dec 2016

Apparel Design Process: Shifting The Basic Pattern Block Into A New Framework To Fit The Demands Of Post Double Mastectomy Women, Shan Gao

Graduate Theses and Dissertations

Breast cancer is a leading cancer among women today. Mastectomy is one of the most common paths for breast cancer prevention and treatment. However, this treatment path can cause noticeable body changes around the woman’s bust area. Recently more and more post mastectomy women are deciding to live without breast reconstruction surgery. This decision referred to as “going flat” or “living flat.” Due to the changed bodies and a lack of information on functional and aesthetic concerns related to clothing, clothing selection becomes difficult for post mastectomy women who choose to “live flat.”

The purpose of this study was to …


Daily Variability Of Body Weight And Hydration Markers In Free Living Men And Women, Lynndee Grace Summers Dec 2016

Daily Variability Of Body Weight And Hydration Markers In Free Living Men And Women, Lynndee Grace Summers

Graduate Theses and Dissertations

Body weight and hydration markers change greatly during strenuous exercise, especially in the heat. However, in a non-athletic population, changes in body weight and hydration markers may not be so obvious. It is important to classify the normal fluctuation of these measurements for future studies in order to delineate when an intervention results in a change outside of what can be expected during normal daily living. PURPOSE: The purpose of this study was to describe the normal fluctuations in body weight and urine hydration markers over the course of 29 days. METHODS: One-hundred two male and female participants, ranging from …


The Association Between Known Risk Factors For Type 2 Diabetes, And The Body Mass Index Of Diabetic Adults, Faten Ahmed Almubarak Dec 2016

The Association Between Known Risk Factors For Type 2 Diabetes, And The Body Mass Index Of Diabetic Adults, Faten Ahmed Almubarak

Graduate Theses and Dissertations

Diabetes mellitus (DM) has been a major research topic in scientific health studies. Diabetes is a chronic condition in which blood glucose levels are chronically elevated to more than 7.0 mmol/l in fasting plasma glucose test. The most common form of diabetes is Type 2 (TD2M). The International Diabetes Federation (2015) estimated the number of DM cases worldwide to be 415 million people in 2015. This number is predicted to increase by the year 2040, to 642 million people. The purpose of this study was to use the National Health Interview Survey (NHIS) data to identify the risk factors for …


Immunotherapeutic Strategies To Reverse Tumor Associated Immunosuppression In Breast Cancer, Sruthi Ravindranathan Dec 2016

Immunotherapeutic Strategies To Reverse Tumor Associated Immunosuppression In Breast Cancer, Sruthi Ravindranathan

Graduate Theses and Dissertations

Heterogenous cancers such as breast carcinoma, would highly benefit from personalized vaccine approaches such as autologous tumor cell vaccines (ATCVs). By using cancer cells that are isolated from self, this approach has the potential to generate a polyclonal immune response against tumor antigens, that are specific to the individual. However, so far, ATCVs against breast cancers have not had any clinical success due to the poor immunogenicity of the malignant cells.

In this study, for the first time, we determined tumor derived G-CSF to play a major role in affecting immune response against breast cancer ATCVs. By using CRISPR/Cas9 genome …


Examining The Sociocultural Experiences Of Cherokee Nation Citizens In Athletic Competition And Sport, Michael Dewayne Merrie Dec 2016

Examining The Sociocultural Experiences Of Cherokee Nation Citizens In Athletic Competition And Sport, Michael Dewayne Merrie

Graduate Theses and Dissertations

The purpose of this dissertation was to examine the sociocultural experiences of Cherokee adults in athletic competition and sport. Specifically, following a qualitative design, fifteen participants were interviewed about their personal experiences in athletic competition and sport while growing up in rural Oklahoma. Interviews were open-ended and followed a semi-structured script of questions with additional probes. Once completed, the recorded interviews were transcribed and data were analyzed. The data revealed six axial codes and three selective codes. Cherokee culture, psychoSocial identity, and athletic competition were the three major selective codes discovered in this study. Qualitative analyses revealed that participants have …


Phenotypic Analysis And Localization Of Leukocytes At The Site Of Intradermal Injection Of Phytohemagglutinin In Chickens, Kallie Alyce Sullivan Dec 2016

Phenotypic Analysis And Localization Of Leukocytes At The Site Of Intradermal Injection Of Phytohemagglutinin In Chickens, Kallie Alyce Sullivan

Graduate Theses and Dissertations

Phytohemagglutinin (PHA) is commonly used to gain insight into an individual’s cellular immuno-competence. PHA is typically injected intradermally (i.d.) into the skin (e.g. wing web) and the tissue swelling response is then monitored, whereby the extent of the swelling positively relates to the individual’s cellular immune system capabilities. Although i.d. injected PHA was shown to stimulate mononuclear cell- and basophil-infiltration to the site of injection, reports on temporal, qualitative and quantitative aspects of the local PHA response are limited. The objective of this study was to use the growing feather (GF) as a cutaneous test-site to assess and monitor the …


Liming Characteristics Of A High-Calcium, Dry Flue Gas Desulfurization By-Product And Its Effects On Runoff Water Quality, Jason Richard Burgess-Conforti Dec 2016

Liming Characteristics Of A High-Calcium, Dry Flue Gas Desulfurization By-Product And Its Effects On Runoff Water Quality, Jason Richard Burgess-Conforti

Graduate Theses and Dissertations

In 2013, only 37% of the 32 million Mg of flue gas desulfurization (FGD) by-products generated in the United States were reused beneficially. If FGD by-products could be used as a beneficial soil amendment, millions of megagrams may be diverted away from surface impoundments and landfills. The purpose of this research was to identify the liming characteristics of a high-Ca dry FGD (DFGD) by-product in comparison to a Class-C fly ash (FA) and reagent-grade CaCO3, and to evaluate the effects of land application to a managed grassland on runoff, plant, and soil quality. Liming characteristics were determined by measuring the …


Gastrointestinal Health As A Stimulus For Native American Attraction To Medicinal Asteraceae And Further Implications For Human Evolution, Christopher David Stiegler Dec 2016

Gastrointestinal Health As A Stimulus For Native American Attraction To Medicinal Asteraceae And Further Implications For Human Evolution, Christopher David Stiegler

Graduate Theses and Dissertations

The Asteraceae, or the daisy family, is the largest family of flowering plants in the world, and its ethnobotanical, medical, and economic value is readily apparent cross-culturally. The aim of this thesis is to examine why constituent genera of the Aster family have remained such an integral part of human medicinal plant knowledge, and thereby to reveal any potential physiological, biological, or evolutionary mechanisms underlining human patterns of use regarding the Asteraceae. The present study focuses specifically on Native American plant knowledge made available by the expansive database in the works Daniel Moerman (Moerman 2003). Frequencies of plant use and …


The Lived Experiences Of Emergency Department Personnel In Working With Individuals With Mental Health Needs, Sarah Wohlford-Neubauer Dec 2016

The Lived Experiences Of Emergency Department Personnel In Working With Individuals With Mental Health Needs, Sarah Wohlford-Neubauer

Graduate Theses and Dissertations

Individuals who work in emergency departments and emergency services in the United States have daunting, overwhelming, and difficult tasks to perform. In addition to medical emergencies that include physical trauma and illnesses, emergency personnel treat individuals with psychiatric emergencies. This qualitative research study explored the lived experiences of ten emergency department personnel that had experienced working with individuals with mental health needs. The ultimate purpose of the study was to break down individuals’ experiences into a shared description of a universal phenomenon. The study utilized a phenomenological, qualitative research design to capture the essence of this phenomenon. Participants’ responses to …


Effect Of Delayed Wrapping And Wrapping Source On Intake And Digestibility Of Alfalfa Silage In Gestating Sheep, Valens Niyigena Dec 2016

Effect Of Delayed Wrapping And Wrapping Source On Intake And Digestibility Of Alfalfa Silage In Gestating Sheep, Valens Niyigena

Graduate Theses and Dissertations

Baling silage with oxygen can result in dry matter deterioration and reduce silage intake by animals. This study was conducted to investigate the effects of two different wrapping sources and time intervals between baling and wrapping on intake and digestibility of alfalfa silage. The second objective was to assess the correlation of alfalfa silage fermentation parameters with intake and digestibility parameters in gestating sheep. Alfalfa silage was baled in large round bales then wrapped with plastic either with (KURA) or without (SUN) an oxygen-limiting barrier either the day of baling or 1, 2 or 3 d after baling. Beginning in …


Extracellular Matrix Remodeling And The Inflammatory Response During Skeletal Muscle Regeneration In Sarcopenic Obese Mice, Lemuel Arthur Brown Dec 2016

Extracellular Matrix Remodeling And The Inflammatory Response During Skeletal Muscle Regeneration In Sarcopenic Obese Mice, Lemuel Arthur Brown

Graduate Theses and Dissertations

AIM: Sarocpenic obesity is a national concern within the United States because this metabolic syndrome is tied with reduced mobility and quality of life. Both obesity and aging are associated with insulin-resistance, chronic low-grade inflammation and muscle weakness. Skeletal muscle regeneration is a process that involves the coordinated effort of myogenic regulatory factors (MRFs), inflammatory signaling, and extracellular matrix (ECM) remodeling for optimal regeneration. It has been demonstrated that obesity and aging have a reduction in muscle regeneration. It has not been examined if sarcopenic obesity will further reduce muscle mass and the regenerative process. The purpose of this study …


Calculating Evapotranspiration Of Arundo Donax Along The Rio Grande, Jose R. Escamilla Jr. Dec 2016

Calculating Evapotranspiration Of Arundo Donax Along The Rio Grande, Jose R. Escamilla Jr.

Theses and Dissertations

Invasive species have been recorded to cause large economic and ecological impacts on various ecosystems and their services. Locally, giant reed (Arundo donax L.), a woody grass native to the Mediterranean, adversely impacts riparian ecosystems in southwestern United States by aggressively displacing their native flora and fauna. Giant reed also has become a cause of concern for national water security, especially in water-limited areas of the arid southwestern United States. The main objective of this study is to provide the first, landscape-level estimates of water use by giant reed in the United States. Evapotranspiration was monitored using the eddy …


Mobile Appointment Reminders In Patient-Centered Care: Design And Evaluation, Ying Wang Dec 2016

Mobile Appointment Reminders In Patient-Centered Care: Design And Evaluation, Ying Wang

Theses and Dissertations

Reminder systems have great potential to enhance healthcare outcome if it can facilitate collaborative appointment management with accessible mobile communication technology in patient-centered care. Yet, Current appointment reminder systems are effective but not optimal (McLean, et al. 2016). Following the design science process delineated by Peffers et al. (2007) and other requirements, this study proposes a design of reciprocal reminder system that automates the process of appointment rescheduling for healthcare providers and patients in addition to confirmation and cancellation. Based on the premises of media synchronicity theory, media naturalness theory and stakeholder theory as kernel theories, this study develops a …