Medicine and Health Sciences Commons^™

Preparing To Break Barriers: A Mixed Methods Exploration Of The Knowledge, Attitudes, And Perceptions Of Hiv, Prep, And Hiv Risk Behaviors Among Women Of Color In Miami, Florida, Amanda C. Ichite

FIU Electronic Theses and Dissertations

The U.S. HIV epidemic is characterized by regional, racial, and ethnic disparities. HIV rates are disproportionately higher in the South and Black and Hispanic populations are most impacted. Moreover, the intersectional identity of being a Black or Hispanic woman living in the South has been associated with profound disparities in HIV impact. Prior to the advent of the biomedical HIV prevention tool pre-exposure prophylaxis (PrEP) in 2012, women were limited in their options for female-controlled HIV prevention strategies. Despite the proven efficacy of PrEP, utilization in women is significantly lower than other at-risk groups. In the present study, secondary analysis …

Serpin-Derived Novel Peptide For The Treatment Against Hiv-Induced Inflammation In The Central Nervous System, Yemmy Soler

FIU Electronic Theses and Dissertations

In the brain, HIV predominantly infects microglia/macrophages and astrocytes to a lesser extent. These cells form virus reservoirs with low levels of infection that are very hard to eradicate. Even though the use of cART increases survival rate in HIV patients, the virus persists as a chronic condition. cART is not able to effectively cross the BBB, control HIV replication, or attenuate inflammation in brain reservoirs. Therefore, the virus still causes neuronal dysfunction, pain-related pathology, and ultimately HAND. In this study, we decided to test the hypothesis that a serpin-derived small peptide, SP16, can serve as an anti-viral, anti-inflammatory, pro-survival, …

Means To An End: A Qualitative Interview Study On Medical Students And Debt, Alberto Juan Diaz Jr

FIU Electronic Theses and Dissertations

Today, 43.4 million Americans owe 1.7 trillion dollars in student loan debt (Hanson, 2022). The American Association of Medical Colleges (2021) reported that 73% of medical students graduate with educational debt, of which the average medical student borrowed $203,062 in student loans. The problem addressed through this study is that as the narrative about student loan debt grows, the hegemonic understanding of debt revolves around the undergraduate student's experience and their eminent struggles regarding repayment of student loans and employment. However, limited research exists on how medical students understand and experience debt.

Several researchers have discussed the lack of understanding …

Role Of Novel Immunoregulatory Long Noncoding Rnas In Airway Epithelial Pathophysiology And Chronic Pulmonary Disease, Marko Manevski

FIU Electronic Theses and Dissertations

COPD is currently the third leading cause of death globally, accounting for approximately 6% of all deaths in 2019, and cigarette smoke (CS) is the primary risk factor for disease development.

Transcriptomic analysis of a 3D in vitro model using differentiated human airway epithelial cells (AECs) identified a novel lncRNA on the antisense strand of ICAM-1 or LASI that showed increased expression upon CS exposure. The lncRNA was significantly upregulated in CS-induced Rhesus macaque airways and in human COPD airways that exhibited higher mucus expression and goblet cell hyperplasia, which was recapitulated in vitro. Blocking lncRNA expression in cell culture …

Effect Of Using The Snackability Smartphone Application To Improve The Quality Of Snack Intake, General Diet Quality, And Weight Among College Students, Lukkamol Prapkree

FIU Electronic Theses and Dissertations

College is a challenging period to make healthy food and snack choices and this could lead to poor diet quality and weight gain in the future. The Snackability application (app) was developed using the Social Cognitive Theory for behavior change to help students choose healthy snacks based on the USDA guidelines. The objective of this study was to determine whether the app improved snack, diet quality, and body weight in overweight and obese college students within a two-arm, 12-week randomized controlled trial (RCT). A total of 139 participants completed all baseline measures and were randomized into the control or app …

Local Health Department Capacity To Improve Public Health - The Impact Of Public Health Accreditation And Public Health Funding, Nancy S. Elliott

FIU Electronic Theses and Dissertations

Public health accreditation and public health funding have the potential to transform the way local health departments (LHDs) deliver public health, but it is unclear if they are having their intended impact. Since performance expectations are high and public health funding is scarce, LHD leadership will continually be interested in finding the most effective ways of improving public health. The purpose of this research is to examine whether LHDs are reaching their goal of public health improvement through public health accreditation and public health funding. Data from the National Association of County and City Health Officials Profile Surveys, Public Health …

Evaluation Of Swallowing Related Measures In Different Head And Neck Postures In Healthy Young And Older Adults, Mabell Vargas

FIU Electronic Theses and Dissertations

This study evaluated swallowing related measures (oral transit time and number of swallows, tongue force and lip force) and different head and neck postures in a group of healthy young adults and older adults. Participants consisted of 19 healthy young and 17 healthy old. They were asked to ingest 2 different liquid consistency to measure the time they take to swallow and the number of swallows. The maximum tongue and lip force was measured with the IOPI device for 3 seconds and repeated 3 times.

The results of the study showed that the number of swallows is not significant regardless …

The Politics Of The Self: Psychedelic Assemblages, Psilocybin, And Subjectivity In The Anthropocene, Joshua Falcon

FIU Electronic Theses and Dissertations

This dissertation examines how psychedelic substances become drawn into particular sociohistorical and political arrangements, and how psychedelic experiences with psilocybin ‘magic mushrooms’ are used as tools of subjectivation. Guided by literatures in philosophy, critical theory, and the social sciences that focus on subjectivity, assemblage theory, and critical posthumanism, I argue that psychedelics are drawn into variegated assemblages, each of which conceptualizes the nature of psychedelics in highly specific ways that reflect implicit conceptions of the world and the self. In developing the concept of psychedelic assemblages, this research provides a window onto the politics of the self in the Anthropocene. …

Discovery Of First-In-Class Small Molecule Agonists Of The Rxfp2 Receptor As Therapeutic Candidates For Osteoporosis, Maria Esteban Lopez

FIU Electronic Theses and Dissertations

Osteoporosis is a chronic bone disease characterized by decreased bone mass and increased risk of developing fractures, predominantly observed in the elderly. The pathophysiological cause of the disease is a decrease in the activity of the bone-forming cells (osteoblasts) that alters bone remodeling in favor of bone resorption, leading to a decrease in bone mass. Recent studies identified the relaxin family peptide receptor 2 (RXFP2), the G protein-coupled receptor (GPCR) for insulin-like 3 peptide (INSL3), as an attractive target expressed in osteoblast cells to increase bone formation. The goal of this dissertation is to discover and characterize small molecule agonists …

Use Of Mobile Technology: Effects On Diabetic Health Outcomes And Health Care Costs In The Kingdom Of Saudi Arabia, Ahmad M. Rayani

FIU Electronic Theses and Dissertations

Diabetes in Saudi Arabia has reached an epidemic rate and is a significant cause of major medical complications, premature death, and health costs. Recent statistics indicates that up to 30% of Saudi population are diabetic and this number is expected to increase. As diabetes is increasing in extremely high rates in Saudi Arabia, a texting intervention has the potential in improving the health outcomes for this population. This data is needed in Saudi Arabia to improve the outcomes with diabetic patients and to guide the development of practice models with the aim to improve diabetics non-adherence to medically prescribed treatments …

Understanding Exosomal Extracellular Vesicles And Morphine In The Neuropathology Of Human Immunodeficiency Virus And Differential Zika Virus Strain-Associated Pathology, Allen Caobi

FIU Electronic Theses and Dissertations

Exosomal Extracellular Vesicles (xEVs), integral to intercellular communication and regulation of immune responses, have functional effects based on their contents, which they transport to neighboring cells. However, in the context of infection, EV cargo can be modulated, by either infected or uninfected cells. We hypothesize that CNS-associated neuropathology, is partially, due to the cargo transported by the exosomes. We theorize that the cargo released from infected cell-derived xEVs may either facilitate or inhibit viral neuropathogenicity. Here we investigated xEVs in the case of two neurotropic viruses, Zika virus (ZIKV) and Human Immunodeficiency Virus (HIV). The hallmark characteristic of ZIKV-infection is …

Determinants Of Waterpipe Smoking Trajectories And The Effects Of Pictorial Health Warning Label Among Young Waterpipe Smokers In The Us, Prem Gautam

FIU Electronic Theses and Dissertations

In recent years waterpipe tobacco (WPT) smoking has increased among young people in the United States (US). Adequate characterization of the WPT smoking trajectories (initiation, progression, and cessation), their predictors, and examination of the effects of a pictorial health warning label (PHWL) on WPT smokers is essential to guide interventions and policies to curb WPT smoking among young people in the US. Using the Population Assessment of Tobacco and Health Study (PATH) and clinical lab data, this dissertation assessed: 1) prevalence and predictors of WPT smoking initiation and progression among adolescents and young adults; 2) magnitude and predictors of WPT …

Development Of A Microwave-Based Dna Extraction Method To Increase The Success Of Direct And Rapid Pcr Technique, Fabiana Taglia

FIU Electronic Theses and Dissertations

The goal of this project was to develop a fast, microwave-based extraction technique that could be employed for direct and rapid DNA analysis. The hypothesis was that the use of a microwave could increase the yield of DNA by opening the cell membrane, rendering the DNA available without the use of any other chemical treatment, and improving results from very low quantity samples.

At present rapid human DNA analysis is mainly restricted to genotyping saliva and sometimes blood samples. We hypothesized that microwave processing could expand the types of samples assessable to these procedures and increase sensitivity.

There were two …

Changes Of Harm Perception And Effect Of Health Warnings On Electronic Cigarette Use In Us Youth, Wei Li

FIU Electronic Theses and Dissertations

This dissertation 1) assessed the influence of electronic nicotine delivery systems (ENDS) harm perception on ENDS initiation over time among US youth and young adults; 2) tracked the changes in harm perception of ENDS use and examined their predictors among US youth; 3) conducted a pilot study to address the effectiveness of graphic health warning labels (GHWLs) on important outcomes among US young adult ENDS users. Data from 2013-2018 of the Population Assessment of Tobacco and Health (PATH) study were used for aims 1 & 2. Primary data with 26 participants that were collected from university campus during the year …

Examining The Effects Of Individual And Neighborhood Factors On Hiv Transmission Risk Potential Among People With Hiv, Semiu Olatunde Gbadamosi

FIU Electronic Theses and Dissertations

HIV transmission risk significantly increases in late-diagnosed HIV and at HIV viral load (VL) >1500 copies/mL. The objective of this dissertation was to examine factors associated with HIV transmission risk potential for persons with HIV (PWH) using measures of time from HIV infection to diagnosis and trajectories of VL suppression. Additionally, we sought to determine whether a single yearly VL measure—the current standard to track the HIV epidemic in the United States—is reliable in assessing viral suppression for PWH. The first study estimated the distribution of time from HIV infection to diagnosis in Florida using a CD4 depletion model and …

A Machine Learning Framework For Identifying Molecular Biomarkers From Transcriptomic Cancer Data, Md Abdullah Al Mamun

FIU Electronic Theses and Dissertations

Cancer is a complex molecular process due to abnormal changes in the genome, such as mutation and copy number variation, and epigenetic aberrations such as dysregulations of long non-coding RNA (lncRNA). These abnormal changes are reflected in transcriptome by turning oncogenes on and tumor suppressor genes off, which are considered cancer biomarkers.

However, transcriptomic data is high dimensional, and finding the best subset of genes (features) related to causing cancer is computationally challenging and expensive. Thus, developing a feature selection framework to discover molecular biomarkers for cancer is critical.

Traditional approaches for biomarker discovery calculate the fold change for each …

The Impact Of Pre- And Post-Immigration Factors On The Depressive Symptoms And Alcohol Use Severity Of Young Adult Recent Latino/A Immigrants: Examining The Role Of Gender And Traditional Gender Roles, Vicky Rebecca Vazquez-Barrios

FIU Electronic Theses and Dissertations

Over the past decade, there has been a shift in Latino/a immigration patterns to the U.S. including steep increases in South and Central America immigrants. Seeking asylum from political and economic turmoil, many of these immigrants are disproportionately impacted by the compounding conditions of stress, trauma, depressive symptoms, and alcohol use severity (AUS). Most investigations on these conditions have been conducted among Mexican immigrants residing in the U.S. for an extended time period. Far less is known about the cumulative and intersecting effects of these conditions among a diverse group of recent Latino/a immigrants (RLIs) or how cultural factors such …

Physicians Perception Of The Impact Of E-Health Reform On The Saudi Arabian Health System, Saeed A. Alwadei

FIU Electronic Theses and Dissertations

The Ministry of Health (MOH) in the Kingdom of Saudi Arabia introduced E-health system reform in 2011. The national E-health plan has already been in action; the MOH expects to implement the system throughout the country by 2021. The MOH manages about 60% of the hospitals in Saudi Arabia. In 2016, the government of Saudi Arabia introduced vision 2030. One of the main objectives of the reform is to accelerate the implementation of primary and digital infrastructure projects. This research aims to evaluate the effectiveness of the E-health system reform in Saudi Arabia.

This research utilized a questionnaire to collect …

Therapeutic Approaches To Alter Mineral Formation And Growth In Vascular Calcification, Amirala Bakhshiannik

FIU Electronic Theses and Dissertations

Cardiovascular diseases represent the global leading cause of morbidity and mortality. Cardiovascular calcification is the most significant predictor of cardiovascular events, but no therapeutic options exist to prevent or treat mineral formation in the vasculature. The presence of bone-like mineral increases cardiac work required to move blood through systemic circulation and can lead to mechanical stress in atherosclerotic plaques, promoting plaque rupture events that cause heart attacks. Clinical trials correlated bisphosphonates (BiPs), common anti-osteoporosis pharmaceuticals, with contradicting cardiovascular outcomes. Here, we demonstrated the importance of treatment timing in BiP-induced mineral disruption or promotion. We showed that BiPs can alter morphological …

Examining The Effects Of Neighborhood Factors And Geography On Racial/Ethnic Disparities In Achieving Sustained Viral Suppression, Rahel Dawit

FIU Electronic Theses and Dissertations

Sustained viral suppression (all viral load tests/mL in a year) decreases the risk of HIV transmission and disease progression to AIDS for people with HIV. Racial/ethnic minorities living with HIV are particularly challenged by barriers, including neighborhood factors, to maintain viral suppression. This dissertation examined the contribution of neighborhood and geographic factors on racial/ethnic disparities in achieving sustained viral suppression. A cross-sectional analysis of secondary data collected in 2017 for 6491 clients enrolled in the Miami-Dade County Ryan White Program (RWP) was conducted.

The first study examined the moderating role of neighborhood level factors on the association between race/ethnicity and …

Sociocultural Factors Associated With Hpv Vaccine Uptake Among Hispanic Female Emerging Adults, Tanjila Taskin

FIU Electronic Theses and Dissertations

Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in the United States (U.S.). College students are at high risk of developing HPV-related diseases and play key roles in transmitting the infection. Fortunately, HPV-related cancers can be prevented through HPV vaccination.

A cross-sectional study was designed to collect data from convenience samples of Hispanic emerging adults from Florida International University (FIU) in Miami, Florida, and the University of Houston (UH) in Houston, Texas. Participants who were 18-26 years old, self-identified as Hispanic or Latino/a, able to read English, and enrolled in FIU or UH were included in the …

Effect Of Flow Phonation Voice Exercises On Vocal And Aerodynamic Measures In Undergraduate Student Singers, Jorge A. Diaz

FIU Electronic Theses and Dissertations

This study examined the effects of Flow Phonation Voice Exercises on vocal measures in undergraduate student singers. Whereas these exercises have provided positive outcomes in individuals with vocal hyperfunction, the use of these exercises in potentially enhancing the singing voice has not been explored. A total of 10 participants were randomly assigned into an experimental group (n = 6), that received 5 sessions of the Flow Phonation Voice Exercises across 5 weeks, and a control group (n = 4) which did not receive the treatment. Changes in auditory-perceptual, acoustic, subjective respiratory, quality-of-life and fatigue related measures compared across two groups. …

Examining The Role Of Knowledge And Cultural Values On Utilization Of Mammograms Among A Sample Of Saudi Women, Afrah Saif

FIU Electronic Theses and Dissertations

Breast cancer is the most frequent malignant tumor that threatens the lives of women globally. In Saudi Arabia, breast cancer incidence was observed among younger and premenopausal women due to diagnosis at advanced stages. The late diagnosis results in poor prognosis and poor outcomes. The survival rates in Saudi women with breast cancer are low. This can be attributed to several reasons such as lack of knowledge and barriers embedded in cultural values. However, low rates of breast cancer screening account for the increasing number of breast cancer detected at much higher stages in Saudi Arabia and resulting deaths, making …

Aptamer-Based Voltammetric Biosensing For The Detection Of Codeine And Fentanyl In Sweat And Saliva, Rosa Lashantez Cromartie

FIU Electronic Theses and Dissertations

Despite the many governmental and medicinal restrictions created to combat the opioid epidemic in the United States, opioid abuse and overdose rates continue to rise. The development of an aptamer-based voltammetric sensor and biosensor is described in this dissertation. The aim was to develop a low-cost, sensitive, and specific aptamer-based sensor for on-site, label-free determination of codeine and fentanyl in biological fluids. To do this, the surfaces of screen-printed carbon electrodes (SPCE) were modified with gold nanoparticles (AuNPs), followed by the addition of single-stranded DNA aptamers. These were covalently bound to the electrode surface. Operations of the sensors were collected …

The Impact Of Hiv-Related Stigma On The Racial/Ethnic Disparities Across The Hiv Care Continuum Among Adults Living With Hiv In Florida, Derrick James Forney

FIU Electronic Theses and Dissertations

Background: Florida currently has one of the highest rates of new HIV infections in the U.S. As of 2019, Black and Hispanic HIV-positive individuals in Florida were significantly less likely to receive HIV care, remain in care, and achieve viral suppression than white HIV-positive individuals. Several studies have linked HIV-related stigma to poor outcomes among people living with HIV (PLWH). This study examined the impact of distinct HIV-related stigma subtypes on linkage to care, retention in care, and viral suppression among PLWH in Florida and if these associations differed across race/ethnicity.

Methods: Data from the 2015-2017 Florida Medical Monitoring Project …

Mental Health, Intersectionality Of Religious Identity Struggles, And Islamophobia In Muslim Young Adults In South Florida: An Exploratory Study, Amani Othman

FIU Electronic Theses and Dissertations

This study extended prior research by Bandar Alsaif (2019) on Muslims in South Florida to identify their perceptions of health. Alsaif’s study found that young U.S.-born Muslim Americans reported higher mental distress and perception of being stereotyped and stigmatized than older Muslims. These results call for further investigation into the mental health of this population and exploration of their growing up experiences. Existing literature in this area is sparse. As such, this study aimed to explore the domains of identity struggle and perceptions of anti-Muslim attitudes (Islamophobia) as potential contributors to the reported poor mental health in young Muslim adults …

The Prediction Of Behavioral Health Outcomes In Adults With Sickle Cell Disease Using The Chronic Disease Outcomes Triad Model, Lisa G. Fryar

FIU Electronic Theses and Dissertations

The lifelong experience of acute and chronic pain associated with sickle cell disease (SCD) not only has damaging physiological sequelae, but it also can negatively impact affected persons psychologically and socioculturally. These triad of SCD sequelae have an inter-relational and interactional mind-body-social connection that impact the behaviors of adults with SCD. These physiological, psychological, and sociocultural domains comprise the triadic sequelae.

The purpose of this study was to investigate the inter-relational and interactional mind-body-social relationship of the triadic sequelae in SCD as predictors of behavioral health outcomes (i.e., sickle cell fatalism, perceived sickle cell prejudice, and SCD self-efficacy) based on …

Perceptions Of Speech-Language Pathologists On Childhood Bilingualism, Sherlie V. Paz

FIU Electronic Theses and Dissertations

A total of 320 Speech-Language Pathologists (SLPs) completed a survey stating their perceptions on childhood bilingualism for typically developing children and children with disabilities. Based on the number of significant responses, 292 participants were analyzed utilizing a binary logistic regression to identify whether SLPs thought childhood bilingualism was advantageous or neutral, while incorporating the predictors of bilingual status and bilingual education received. Additionally, a content analysis was conducted on 173 participants who chose to respond to an open-ended question stating their additional perceptions on childhood bilingualism. Results revealed that bilingual status did not predict the probability of an advantageous perception …

The Effect Of The Tyg Index On Liver Steatosis, Immune Activation, Oxidative Stress, Liver Fibrosis Pathways And Liver Fibrosis In The Miami Adult Studies On Hiv (Mash) Cohort, Colby S. Teeman

FIU Electronic Theses and Dissertations

The purpose of this study was to establish the Triglyceride-Glucose (TyG) Index Ln (fasting TG x fasting glucose/2) as a predictor of liver steatosis in People Living with HIV (PLWH) and determine the effect of increased TyG Index on biomarkers of immune activation, inflammation, oxidative stress, apoptosis, and liver fibrosis. Four-hundred and eighty participants were selected from the Miami Adult Studies on HIV (MASH) cohort, two-hundred and eleven were PLWH, and two-hundred and sixty-nine were uninfected controls. Biomarkers were analyzed from blood samples collected at the FIU Borinquen Clinic. Primary research outcomes were analyzed using multiple linear and logistic regression, …

Type I Topoisomerases As Potential Targets For Therapeutics, Ahmed Seddek

FIU Electronic Theses and Dissertations

DNA topoisomerases are universal enzymes that control the topological features of DNA in all forms of life. This study aims to find potential inhibitors of some of the DNA topoisomerases in bacteria and humans that can be developed into potential therapeutics.

The first aim of this study is to find potential inhibitors of bacterial topoisomerase I that can be developed into antibiotics. There is an urgent need to develop novel antibiotics to overcome the world-wide health crisis of antimicrobial resistance. Virtual screening and biochemical assays were combined to screen thousands of compounds for potential inhibitors of bacterial topoisomerase I. NSC76027 …