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Articles 1 - 30 of 110
Full-Text Articles in Medicine and Health Sciences
The Evolving Landscape Of Mechanical Circulatory Support In The United States: Observations From National Registries, Ryan Segler Cantor
The Evolving Landscape Of Mechanical Circulatory Support In The United States: Observations From National Registries, Ryan Segler Cantor
All ETDs from UAB
Mechanical circulatory support (MCS) is a rapidly evolving field. This dissertation describes trends in patient selection, device utilization, and outcomes for adult and pediatric patients receiving MCS in the United States by examining data from two national registries. Trends in adult MCS device recipients and their support outcomes were evaluated using data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS), a national registry collecting detailed information for patients implanted with Food and Drug Administration (FDA)-approved durable MCS devices. Between June 2006 and December 2016, INTERMACS enrolled more than 19,000 patients. During this time, the widespread use of devices …
Adiposity And Health In Zoo African And Asian Elephants, Daniella Chusyd
Adiposity And Health In Zoo African And Asian Elephants, Daniella Chusyd
All ETDs from UAB
African (Loxodonta africana) and Asian (Elephas maximus) elephant populations are rapidly declining due to poaching, and habitat fragmentation and loss. Due to the precarious situation elephants are facing worldwide, captive elephant populations are being viewed as an insurance policy against extinction. Unfortunately, captive elephant populations are not self-sustaining, in part because of reproductive and health issues. One hypothesis for the observed reproductive and health issues is zoo elephants are obese. The current method of assessing obesity in elephants is based on a qualitative visual tool, the body condition score, which does not quantify fat mass. The purpose of this dissertation …
The Effects Of Body Size, Growth, And History Of Diabetes On Glioma Risk, Rebecca Barnhill Little
The Effects Of Body Size, Growth, And History Of Diabetes On Glioma Risk, Rebecca Barnhill Little
All ETDs from UAB
Many dietary exposures have weak or null associations with glioma risk. As nutrition can affect growth rate in adolescence, body size throughout the lifespan, and the propensity for Type 2 diabetes, the goal of this project was to examine the relationships between these surrogates of nutritional states and the risk of glioma. The aims of this project were to examine the associations between glioma risk and 1) self-reported body measures; 2) age when full height was attained; 3) and a history of diabetes. To investigate the first aim, 1,111 glioma cases and 1,096 community controls completed a structured interview to …
Heart Failure In A Contemporary Biracial Cohort, Matthew Mefford
Heart Failure In A Contemporary Biracial Cohort, Matthew Mefford
All ETDs from UAB
Heart failure (HF) is the inability of the heart to meet the perfusion needs of the body. HF is a leading contributor to the burden of cardiovascular disease (CVD) and remains a public health concern. Hypertension is a major modifiable risk factor for the prevention and management of HF. Hypertension develops earlier, is less controlled, and has a stronger association with some CVD and renal outcomes among blacks versus whites. These disparities may extend to HF. In addition, adults with HF often have complex treatment regimens due to multimorbidity, making medication adherence an issue. The goal of this dissertation was …
Exploring The Relationship Between Social Support, Pharmacy Access And Medication Adherence, Favel Leah Mondesir
Exploring The Relationship Between Social Support, Pharmacy Access And Medication Adherence, Favel Leah Mondesir
All ETDs from UAB
Barriers of medication adherence exist among people with coronary heart disease (CHD) and CHD risk factors, including, poor social support, poor pharmacy access and other patient, social/economic, therapy, condition, and health-care system/health-care team-related factors. However, there are few data on influence of these factors on medication adherence among people with CHD risk factors other than diabetes. Therefore, this dissertation aimed to investigate associations of medication adherence with social support (n=17,113) and pharmacy access (n=8,250) quantitatively using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study (black and white adults with CHD or CHD risk factors ≥45 …
Diet, Physical Activity, And Healthy Aging In People Living With Hiv, Josh Newson Muhammad
Diet, Physical Activity, And Healthy Aging In People Living With Hiv, Josh Newson Muhammad
All ETDs from UAB
As life expectancy for people living with HIV (PLWH) has increased, healthy aging in this community has become an emerging public health concern. Although the benefits of adopting healthy diets and regular physical activity are well-documented, implementing strategies for lifestyle modifications among older PLWH remains a challenge. The complex milieu of social, physiological and economic burdens encountered by PLWH exposes this population to increased risk for adverse health outcomes, especially from preventable metabolic diseases. The interaction of diet, physical activity and social determinants of health in persons who are HIV positive is an understudied area. The aim of this dissertation …
The Role Of Astrocytes In The Development Of Central Chemosensitivity, Kelsey Patterson
The Role Of Astrocytes In The Development Of Central Chemosensitivity, Kelsey Patterson
All ETDs from UAB
In the two decades since MECP2 was identified as the causative gene in the majority of Rett Syndrome (RTT) cases, transgenic mouse models have played a critical role in our understanding of this X-linked neurodevelopmental disease. However, their exclusive use presents a limitation in translating findings from animal models to the clinic. Here, we characterized growth, anatomical, behavioral, and motor deficits in a novel zinc-finger nuclease murine RTT model from birth through adulthood. Male rats lacking the transcriptional regulatory protein, MeCP2 (Mecp2ZFN/y), are noticeably symptomatic as early as postnatal day (P) 21 and die prematurely, while females lacking one copy …
The Effect Of Mitochondrial-Derived Ros On Calcium Handling And Cardiac Function In Heart, Kah Yong Goh
The Effect Of Mitochondrial-Derived Ros On Calcium Handling And Cardiac Function In Heart, Kah Yong Goh
All ETDs from UAB
Mitochondria are abundantly present in metabolic active organs such as the heart. The presence of mitochondria are crucial to provide energy in the form of ATP, regulate calcium handling, facilitate cell fate, and are involved in metabolic modulation. In the process of generating ATP through oxidative phosphorylation, mitochondria produce reactive oxygen species (ROS) as a side product. In the heart, mitochondria is a major source of ROS. Under normal conditions, ROS are kept at a physiologically relevant and healthy level. Unfortunately, excessive ROS levels during pathological states, such as pressure overload heart failure, appears as a threat to the whole …
African American Caregivers’ Decision To Use Hospice Services For A Loved One: A Grounded Theory Study, Paula M. Gordon
African American Caregivers’ Decision To Use Hospice Services For A Loved One: A Grounded Theory Study, Paula M. Gordon
All ETDs from UAB
This qualitative grounded theory study explored the process of decision making for African American family caregivers in the southeastern United States, as they make hospice decisions for their loved ones, Although hospice use in the United States has grown over the last decade, a disparity continues to exist between African American and Caucasian populations. African Americans represent a small percentage of hospice users in the United States, despite research that has found that patients who use hospice experience improved symptom control, fewer unmet needs, and better end of life care. Research has identified many reasons for this disparity; however, little …
Elucidating The Role Of Hedgehog Signaling In Modulating Macrophage Function In Breast Cancer, Ann Hanna
Elucidating The Role Of Hedgehog Signaling In Modulating Macrophage Function In Breast Cancer, Ann Hanna
All ETDs from UAB
In the tumor microenvironment, breast cancer cells participate in crosstalk with the surrounding stroma. This tumoral-stromal interaction forms a balance that dictates tumor suppressing or tumor promoting response mechanisms. Macrophages in the tumor microenvironment are plastic and can mediate several functions depending on their activation states. Tumor associated macrophages co-exist as two major phenotypes: anti-tumorigenic and immune-eliciting classically activated M1 as well as tumor-promoting and immune-suppressive alternatively activated M2 macrophages. Alternatively activated macrophages are specifically associated with more aggressive stages and poor clinical outcomes in breast cancer patients as they suppress the tumoricidal properties of the immune system, thus facilitating …
Applications Of Next-Generation Sequencing And Functional Genomics In Translational Medicine, Andrew Hardigan
Applications Of Next-Generation Sequencing And Functional Genomics In Translational Medicine, Andrew Hardigan
All ETDs from UAB
The development of next-generation sequencing (NGS) technologies has led to unparalleled advances in our understanding of the genetic basis of disease, evolution, and genetic and genomic regulation. Building on the advances made in the Human Genome Project and more recent efforts such as the Encylopedia of DNA Elements (ENCODE) and the Roadmap Epigenomics Project, whole-genome and whole-exome sequencing (WGS/WES) and a wide variety of NGS-enabled functional assays are bridging the gap between scientific discovery and clinical medicine. This trend towards genomically informed “bench-to-bedside” translational medicine is driven in large part by the sharply decreasing costs for NGS in both clinical …
A Qualitative Descriptive Study Exploring The Adaptation Of Families Of Children With Multiple Sclerosis From The Perspective Of Family Caregivers, Yolanda Carol Harris
A Qualitative Descriptive Study Exploring The Adaptation Of Families Of Children With Multiple Sclerosis From The Perspective Of Family Caregivers, Yolanda Carol Harris
All ETDs from UAB
Two to 5% of the US population of individuals afflicted with multiple sclerosis (N = 400,000) are diagnosed prior to the age of 18 with pediatric onset multiple sclerosis (POMS). Most children and teens with POMS have a relapsing remitting course of the disease with unpredictable relapse onset causing cognitive and physical disability. This can result in school absences, hospital and outpatient visits, poor academic performance and interruption in normal social activities. In turn, these individuals may develop an inability to provide self-care, which could lead to poor quality of life. POMS can affect the individual diagnosed but may also …
Novel Mediators Of The Blood Pressure Response To Acute Psychosocial Stress In Health And Disease, Brandon Fox
Novel Mediators Of The Blood Pressure Response To Acute Psychosocial Stress In Health And Disease, Brandon Fox
All ETDs from UAB
Psychosocial stress occurs in response to threatening or uncertainty-provoking stimuli and triggers a complex physiological reaction that facilitates survival and adaptation. In the cardiovascular system, acute psychosocial stress elicits a rapid increase in blood pressure, and importantly, cumulative exposure to psychosocial stress is a risk factor for cardiovascular disease. The present studies examined the impact of psychosocial stress on the cardiovascular system in both health and disease. Circulating endothelin-1 (ET-1) levels are induced by psychosocial stress. We hypothesized that endothelium-derived ET-1 contributes to the pressor response to stress via activation of the endothelin A (ETA) receptor. Vascular endothelium-specific ET-1 knockout …
Effects Of Novel Inhibitors Against Wnt/Β-Catenin Signaling In Ovarian And Triple-Negative Breast Cancers, Abhishek Gangrade
Effects Of Novel Inhibitors Against Wnt/Β-Catenin Signaling In Ovarian And Triple-Negative Breast Cancers, Abhishek Gangrade
All ETDs from UAB
Ovarian and triple-negative breast cancers (TNBC) are aggressive due to their dependence on Wnt/β-catenin signaling. Niclosamide, a strong inhibitor of Wnt/β-catenin signaling, is an efficacious cytotoxic agent for various cancers in vitro, including ovarian and breast cancers. However, it has cross-reactivity with mTOR, STAT3, and Notch pathways. A limitation of using the agent in animal studies involves its poor water solubility and bioavailability. This study investigates novel compounds based on the structure of niclosamide to improve specificity for the Wnt/β-catenin signaling pathway. The investigation evaluates three questions: 1) whether WNT974 inhibits Wnt/β-catenin signaling in ovarian cancer; 2) whether novel analogs …
Membrane Capacitance Derived From Bioimpedance Spectroscopy Is Associated With Insulin Resistance In Relatively Healthy U.S. Women, But Not Men, Valene Garr Barry
Membrane Capacitance Derived From Bioimpedance Spectroscopy Is Associated With Insulin Resistance In Relatively Healthy U.S. Women, But Not Men, Valene Garr Barry
All ETDs from UAB
Current screening methods have failed to detect more than 50% of the 120 million U.S. adults with insulin resistance and/or metabolic syndrome, conditions that substantially increase one’s risk for cardiometabolic disease (CMD).1 Evidence exists that metabolic health is associated with cell membrane composition, which is reflected in the electrical properties of the body cell mass. The objective of this study was to determine whether bioimpedance spectroscopy can identify insulin resistance and/or metabolic syndrome by evaluating membrane capacitance (CM). We hypothesized that CM would be higher in individuals with insulin resistance and/or metabolic syndrome when compared to healthy individuals. This cross-sectional …
Interorganizational Relationships And Hospital Adoption Of Surgical Robots, Stephen Cullen
Interorganizational Relationships And Hospital Adoption Of Surgical Robots, Stephen Cullen
All ETDs from UAB
INTERORGANIZATIONAL RELATIONSHIPS AND HOSPITAL ADOPTION OF SURGICAL ROBOTS STEPHEN G. CULLEN EXECUTIVE DOCTORIAL PROGRAM IN HEALTHCARE LEADERSHIP ABSTRACT The study investigates the relationship between interorganizational relationships (IORs) and hospital adoption of robotic surgery in the United States over a ten-year period. As a competitive strategy for hospitals, IORs should matter in a hospital’s decision to adopt a surgical robot given associated costs and risks. While literature exists on IORs and technical innovation, there is a gap in the literature on IORs and hospital adoption of surgical robots. This study explores four types of IORs (i.e., networks, systems, contract management, and …
Cheminformatic Discovery And Characterization Of Copperdependent Bacterial Inhibitors, Alex Dalecki
Cheminformatic Discovery And Characterization Of Copperdependent Bacterial Inhibitors, Alex Dalecki
All ETDs from UAB
Deaths due to antibiotic-resistant bacteria are predicted to exceed 10 million per year by 2050, endangering our ability to conduct fundamental medical procedures such as immunosuppressive therapy or even basic surgery. Unfortunately, we are largely falling behind in the evolutionary arms race against common pathogens. Not only are we in sore need of new antibiotics, we also evidently need altogether new approaches to drug discovery itself, as our familiar avenues are increasingly failing to meet demands. In this dissertation, we describe a promising new source of antibacterials: copper-dependent inhibitors (CDIs), compounds that exert significant antibiotic activity only in the presence …
An Investigation Of Sla Class Ii As A Xenoantigen, Joseph Ladowski
An Investigation Of Sla Class Ii As A Xenoantigen, Joseph Ladowski
All ETDs from UAB
Xenotransplantation, using genetically-modified pigs as organ donors, is a potential solution to the growing transplant organ shortage. Avoiding antibody-mediated rejection (AMR) is the remaining hurdle to widespread application. The development of a triple glycan knockout pig reduced antibody binding to clinically acceptable levels, allowing for the screening of the history of antibodies to the major histocompatibility complex (MHC). In allotransplantation, the MHC is a group of proteins divided into two classes and anti-MHC antibodies possess the ability to cause both acute and chronic AMR. The pig MHC, the swine leukocyte antigen (SLA), is a hypothesized target of antibodies. This dissertation …
The Effect Of Primary Palatal Repair On Growth In Cleft Lip And Palate Patients, Nadia Abou Kheir
The Effect Of Primary Palatal Repair On Growth In Cleft Lip And Palate Patients, Nadia Abou Kheir
All ETDs from UAB
Cleft lip and palate (CLP) is a facial defect that is represented as a split in the mouth, palate or both. In the United States approximately 4440 babies are born with CLP annually. More than US$600 million are spent on their treatment and mostly on surgical interventions. Considering the high expenses of primary palatal repair, its effect on growth has been controversial. Surgical scaring is postulated as the cause of maxillary hypoplasia. However, this operation has been considered necessary for function and development of speechHowever, this operation has been considered as necessary for better functional and speech outcomes. Materials and …
Characterization Of Membrane Associated Mucins In Ocular Surface Disease, Anna Ablamowicz
Characterization Of Membrane Associated Mucins In Ocular Surface Disease, Anna Ablamowicz
All ETDs from UAB
Mucins on the ocular surface are found in the tear film and are attached to corneal and conjunctival epithelial cells on the eye. The bulbar conjunctiva of the ocular surface can be divided into four anatomical regions: temporal, superior, nasal, and inferior. The palpebral conjunctiva is the epithelial layer of the inner surfaces of the upper and lower eyelids. In the tears, mucins provide lubrication of the ocular surface through formation of a hydrophilic gel. The primary mucin in the tear film is MUC5AC which is secreted by goblet cells that are located in varying densities within the bulbar conjunctiva. …
Culture And Patient Safety Outcomes: Examining The Impact Of The Departmental Work Environment On Outcomes, Dawn Ahner
Culture And Patient Safety Outcomes: Examining The Impact Of The Departmental Work Environment On Outcomes, Dawn Ahner
All ETDs from UAB
This study examined the relationship between the departmental work environment and patient safety outcomes to determine if there were particular subcomponents of a department’s work environment that had a more significant impact on patient safety outcomes. The work environment was defined as the culture of an individual nursing department which consisted of the employee’s perception of engagement and patient safety culture. The research was informed by the commitment-based theory. Based on this theory, it was predicted that a team-based approach in the work environment would lead to a learning and positive environment, which would be positively associated with quality of …
Vestibular And Oculomotor Function In Children With Cerebral Palsy, Anwar B. Almutairi
Vestibular And Oculomotor Function In Children With Cerebral Palsy, Anwar B. Almutairi
All ETDs from UAB
Cerebral palsy (CP) is the most common motor disability of childhood, caused by non-progressive permanent injury to the fetal or infant’s brain. Visual and balance impairments are prominent hallmarks of these disorders. Although musculoskeletal and neuromuscular causes are well established in the literature, the role of vestibular and oculomotor disabilities was not explored in this population. Because of that, this dissertation aims to describe the vestibular and oculomotor function in children with CP, aged 7-12years, GMFCS levels I-III, and to determine the feasibility, sensitivity, specificity and retest reliability of vestibular and oculomotor clinical tests in children with CP, compared to …
Effects Of Medicare Reimbursement Policies On The Quality Of Hospital Care, Monica Aswani
Effects Of Medicare Reimbursement Policies On The Quality Of Hospital Care, Monica Aswani
All ETDs from UAB
This dissertation is composed of two papers related to the role of social risk factors in the Hospital Readmissions Reduction Program (HRRP). As value-based initiatives like the HRRP become more commonplace, there is growing need to understand the relationship between performance in these programs and social risk factors, such as race and poverty, which are not incorporated in the program’s risk adjustment methodology. To address this gap in the literature, this dissertation specifically focuses on three areas: 1) how hospital and community factors are related to average HRRP penalties, taking the context of geography into account, 2) how hospital and …
A Study To Examine The Relationship Between Hospital Mergers And Patient Experience, Timothy William Attebery
A Study To Examine The Relationship Between Hospital Mergers And Patient Experience, Timothy William Attebery
All ETDs from UAB
Since 2009, the United States has experienced another wave of hospital mergers. Consequently, health systems are getting larger and increasing their market concentration. How patients benefit from hospital consolidation remains an open issue for policy-makers, economists, health care executives, community leaders, politicians, government agencies, and others. One measure of healthcare consolidation’s impact, and its potential benefit/detriment, is how mergers affect patient experience, which, since 2007, has been measured by the standardized HCAHPS instrument. Hundreds of studies conducted over the past 50 years have found mergers trigger an internal, socially-disruptive effect in the first 12 to 24 months following the event …
The Impact Of The Cd11b 77his And 1146ser Variants On Mac-1 Activity And Functions, Justin Timothy Avery
The Impact Of The Cd11b 77his And 1146ser Variants On Mac-1 Activity And Functions, Justin Timothy Avery
All ETDs from UAB
Mac-1 (CD11b/CD18, ITGAM/ITGB2, CR3) is a member of the β2 integrin family. While primarily expressed on myeloid lineage cells such as monocyte/macrophages, neutrophils, and dendritic cells, Mac-1 is also found on natural killer cells and some B cells and T cell populations. Mac-1 has over 50 ligands, many of which are critical for adhesion, signaling, and the promotion of immune functions like phagocytosis. Genome-wide association studies (GWAS) have linked several SNPs in ITGAM, the gene which codes for CD11b, with the autoimmune disease systemic lupus erythematosus (SLE). rs1143679 results in an arginine to histidine change at amino acid position 77 …
Parental Self-Efficacy, Feeding Practices, And Weight Gain During Infancy: A Secondary Analysis, Jessica Bahorski
Parental Self-Efficacy, Feeding Practices, And Weight Gain During Infancy: A Secondary Analysis, Jessica Bahorski
All ETDs from UAB
Mechanisms contributing to childhood obesity begin during early life, including infant feeding practices and an excessive rate of infant growth. Parental decisions regarding their infant contribute to these mechanisms. Parental self-efficacy (PSE) is the belief parents have in their ability to accomplish the tasks of parenting and is associated with infant outcomes. A high sense of PSE, breastfeeding self-efficacy, or self-efficacy for feeding has been found to be associated with healthy infant feeding practices. However, this research is limited in scope and has not been conducted in populations at greatest risk for childhood obesity such as low-income or African-American infants. …
The Mechanism Of Tgf-Β Function In Development Of The Axial Skeleton, Ga I Ban
The Mechanism Of Tgf-Β Function In Development Of The Axial Skeleton, Ga I Ban
All ETDs from UAB
THE MECHANISM OF TGF-β FUNCTION IN DEVELOPMENT OF THE AXIAL SKELETON GA I BAN CELL, MOLECULAR DEVELOPMENTAL BIOLOGY ABSTRACT Back pain is caused by degeneration of intervertebral discs (IVD). IVD consists of two compartments: the annulus fibrosus (AF) and the nucleus pulposus (NP). One strategy for treatment of IVD degeneration is stem cell therapy, which would require an in-depth knowledge of how the IVD develops. Currently, the molecular mechanism of IVD development are not well defined. AF and vertebral bodies (VB) are derived from the same embryonic progenitor, sclerotome. Specification of sclerotome is determined by complex interactions among various growth …
The Effect Of Novel Antibiotic Compounds On Endodontic Biofilms, Steven Rhodes
The Effect Of Novel Antibiotic Compounds On Endodontic Biofilms, Steven Rhodes
All ETDs from UAB
Purpose: To investigate the effects of three novel experimental antibiotics on monospecies (Enterococcus faecalis) and polymicrobial (mixed) endodontic biofilms. Materials and Methods: Biofilms containing pure Enterococcus faecalis, as well as biofilms derived from mixed bacterial samples aspirated from inside the pulp spaces of necrotic human teeth, were grown onto slices of human dental in vitro. Biofilm formation capability was verified with SEM. The treatment groups consisted of 3 novel experimental antibiotics. 8.25% sodium hypochlorite and sterile saline were used as the controls. The biofilms were investigated with live/dead fluorochrome staining and confocal laser scanning microscopy. Results: The full strength sodium …
The Effect Of Allergic Airway Sensitization On The Immune Response To Pulmonary Bacterial Infection., Arthur Harold Totten
The Effect Of Allergic Airway Sensitization On The Immune Response To Pulmonary Bacterial Infection., Arthur Harold Totten
All ETDs from UAB
Asthma is a chronic respiratory disease associated with small airway obstruction and hy-perreactivity. Greater than 300 million people are estimated to live with asthma world-wide, and in the United States (US), estimated cost-of-care is over $50 billion per year. Allergic sensitization and infections have proven to be important in both asthmatic development, as well as recurrent exacerbations. Diversity and number of bacterial species are increased in asthmatics compared to non-asthmatics, and is also predictive of increased incidence of res-piratory infections. Mycoplasma pneumoniae (Mpn) is an atypical bacterial pathogen of the class Mollicutes, which lacks a cell wall and is an …
Clinical And Histomorphometric Outcomes Following The Use Of Small Versus Large Particle Sized Bone Allografts In Ridge Preservation Procedures: A Randomized Clinical Trial, Gentiane Valiquette
Clinical And Histomorphometric Outcomes Following The Use Of Small Versus Large Particle Sized Bone Allografts In Ridge Preservation Procedures: A Randomized Clinical Trial, Gentiane Valiquette
All ETDs from UAB
Alveolar ridge preservation at the time of tooth extraction is a commonly performed procedure as it significantly minimizes ridge resorption and allows for more optimal implant placement. The amount of new vital bone has been shown to vary with the use of different types of bone replacement grafts, however, the effect of bone graft particle size on the outcomes following ridge preservation has not been elucidated in the scientific literature. The present randomized clinical trial compared clinically, radiographically and histomorphometrically the use of small- (0.25-1.0mm) versus large- (1.0- 2.0mm) sized particle mineralized cortico-cancellous bone freeze-dried bone allografts (FDBAs) in ridge …