Medicine and Health Sciences Commons^™

Discovery And Mechanistic Study Of Novel Pbd-Targeted Inhibitors Of Plk1 For Prostate Cancer Treatment, Danda Pani Chapagai

Theses and Dissertations

Polo-like kinase 1 (PLK1) is a central player in regulating entry into and progression through mitosis. Inhibition of sub-cellular localization and kinase activity of PLK1 through the Polo-box domain (PBD) is emerging as a viable alternative to ATP binding site directed drugs for which the development of resistant mutants and inhibition of closely related members of the PLK family (tumor suppressor roles) are primary concerns. I describe related novel non-peptidic PBD binding inhibitors, termed abbapolins, identified through successful application of the REPLACE strategy and demonstrate their potent antiproliferative activity in prostate tumors and other cell lines. Furthermore, the abbapolins show …

Homestead Vegetable And Poultry Production And Related Practices: An Assessment In Nepal, Shiva Bhandari

Theses and Dissertations

Consumption of nutrients-rich foods like diverse vegetables, eggs, and meat throughout a year remains a challenge in low- and middle-income countries due to poor availability, accessibility, and affordability. One important way to overcome the challenge is to promote households’ own production of these foods and encourage individuals to consume. Improving household production of the foods necessitates understanding whether active participation and performance of frontline workers in the communities and performing improved production-related practices can translate into improved production of nutrients-rich foods. This study had two specific aims. The first aim was to examine demographic, socio-economic, and programmatic determinants of active …

Testing Models Of Context-Dependent Outcome Encoding In Reinforcement Learning, William M. Hayes Iv

Theses and Dissertations

Previous studies of reinforcement learning (RL) have established that choice outcomes are encoded in a context-dependent fashion. Several computational models have been proposed to explain context-dependent encoding, including reference point centering and range adaptation models. The former assumes that outcomes are centered around a running estimate of the average reward in each choice context, while the latter assumes that outcomes are compared to the minimum reward and then scaled by an estimate of the range of outcomes in each choice context. However, there are other computational mechanisms that can explain context dependence in RL. In the present study, a frequency …

Perspectives About Food Safety In Diverse Low- And Middle-Income Countries, Sejla Isanovic

Theses and Dissertations

Concerns about unsafe food influence food choice, and consumption of unsafe foods increases morbidity and mortality, particularly in low- and middle-income countries. Actions to ensure safety of food are dominated by mitigation of biological and chemical hazards through supply-side risk management, disregarding individuals’ experiences and perspectives of food safety. We aimed to identify and categorize perspectives about food safety in five countries. Five Drivers of Food Choice projects provided transcripts from 17 focus groups discussions and 303 interviews in Kenya, Ghana, India, Guinea, and Vietnam. We analyzed transcripts using a priori and emergent codes. Individuals constructed meaning about food safety …

Assessing Identification Of Newly Diagnosed Breast Cancer Patients For Referral To Genetic Counseling, Corinne Marie Locke

Theses and Dissertations

Since 1998, the National Comprehensive Cancer Network (NCCN) guidelines have specified clinical indications for genetic testing for breast cancer susceptibility genes, but retrospective studies have shown that, despite meeting the NCCN criteria, patients are not always advised of the option of genetic testing. Further compounding this issue, studies have shown that cancer family history intake and documented family history can be incomplete even when taken by oncology providers. At this study site and other cancer centers in the country, patients with a new diagnosis of breast cancer are referred for genetic counseling by their cancer care team if they are …

Age-Dependent Increase In Tyrosine Level Depletes Tyrosyl-Trna Synthetase And Causes Neuronal Oxidative Dna Damage In Alzheimer’S Disease, Megha Jhanji

Theses and Dissertations

Alzheimer’s disease (AD) is the most common form of dementia, and it currently affects more than 50 million people worldwide. Much of the population develop late-onset AD after 65 and constitute more than 95% of the cases. Currently, there is no definitive cure or way to slow down the progression of this disease that addresses the neurodegeneration and loss of cognitive functions. Although the underlying cause of AD is still unknown, the “amyloid cascade hypothesis” attributed it to the aggregation of amyloid beta (AU+03B2) peptides and has been the focus for targeting most disease-modifying drugs in clinical trials. However, emerging …

Advancing Knowledge Of Exercise As A Therapeutic Management Strategy For Women With Polycystic Ovary Syndrome, Pamela J. Wright

Theses and Dissertations

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among premenopausal women with a prevalence that ranges 15-21%. The estimated financial burden in the United States for evaluating and treating premenopausal women with PCOS was over $8 billion in 2020. PCOS etiology is complex and poorly understood, as is the optimal treatment and management. Endocrine Society Clinical Practice Guidelines recommend exercise as first-line treatment. Yet, the optimal exercise type and “dosing” are not defined. As last reported for women with PCOS, less than 60% are regularly physically active and more than 25% are sedentary. Additionally, little to no published data …

Food Choice Decision-Making Among School-Going Adolescents Amidst The Nutrition Transition In Urban Accra, Ghana, Krystal Krsna Rampalli

Theses and Dissertations

Like many countries of the world, Ghana is experiencing a nutrition transition and rising non-communicable diseases. Adolescents are susceptible to diet-related health risks as they experience significant physical and psychological changes, which are happening in tandem with food environment changes, including widespread proliferation of large portion and package sizes of energy-dense, nutrient-poor foods. Both local and multinational food and beverage companies have encouraged consumption of their products through various marketing tactics targeted directly to adolescents. Some of these tactics include the use of characters or celebrity endorsement, promotional discounts, and appeal to sociocultural values, including messages about body size preferences. …

Real Time Neurochemical Analysis Of The Brain For Pharmacological Treatments In Mood Disorders And Neurodegeneration, Anna Marie Buchanan

Theses and Dissertations

The monoamine, serotonin, is an important modulator in the central nervous system. It is believed to participate in a variety of functions ranging from moderating stress, promoting brain plasticity, and regulating sleep and appetite. Dysfunction of the serotonergic system has also been implicated in mood disorders and neurodegenerative diseases. While serotonin is of great interest to the research community, real-time in vivo serotonin dynamics remain understudied. This is because direct measurement of fast serotonergic transmission is analytically challenging. In 2009, the Hashemi lab pioneered the direct measurement of endogenously evoked serotonin using a method called fast scan cyclic voltammetry (FSCV). …

Sex Differences And Neuroimmune Effects Of Microglial Response In The Mesolimbic Reward Pathway In Nicotine Substance Use Disorder, Erin Leigh Anderson

Theses and Dissertations

Smoking remains the leading cause of morbidity and mortality in the United States, with less than 5% of smokers attempting to quit succeeding. This is due to the unpleasant withdrawal symptomology, which includes affective symptoms, such as irritability, weight gain, anxiety, and severe craving among others, as well as the cognitive effects, such as difficulty concentrating. This low smoking cessation success rate is also thought to be due to the long-lasting sensitization of nicotinic acetylcholine receptors (nAChRs) leading to long-term neuroadaptations in the brain’s reward system and alterations in synaptic plasticity that occur following chronic nicotine exposure and withdrawal. Glial …

Impact Of Acetylcholine On Amygdala Network Oscillations, Joshua Xavier Bratsch-Prince

Theses and Dissertations

The ability to appropriately respond to and store memories of emotionally salient events is a critical feature of survival. The basolateral amygdala (BLA) is a temporal lobe structure that is essential in mediating emotional behaviors, learning, and memory. Important to circuit function are synchronized neuronal oscillations. Different oscillatory signatures are implicated in mediating different aspects of behavior and learning and memory processes: theta frequency (3-12 Hz) oscillations represent “online” states and are important for information encoding and learning, and sharp wave ripples (SWRs) represent more “offline” states that are important for the consolidation of memory. In the BLA, both of …

Hear My Voice: Qualitative Studies To Explore What Empowers Patients To Talk With Their Doctor And Participate In Making Health Care Decisions, Alicia Marie Oostdyk

Theses and Dissertations

Patients with fibromyalgia are faced with many decisions throughout the process of seeking and obtaining health care. For patients to feel empowered to take action, it is essential they feel as if they can play a role in making decisions up to their desired level of participation. However, it is unclear what constitutes empowerment in shared decision making between patients and providers. For patients with fibromyalgia, who deal with complex symptomology and individualized treatment choice, it is important to know what makes them feel empowered to participate in care. The objective of this dissertation is to create a patient-centered definition …

Pre-Exposure Prophylaxis (Prep) Knowledge, Willingness To Use & Uptake Among Black Heterosexual Men, Akeen Lowell Hamilton

Theses and Dissertations

INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a pill, taken orally, that has been shown to be effective at reducing the chance that someone who is HIV-negative and at-risk for HIV will contract the disease during sexual intercourse with someone who is living with HIV. One demographic group that has been under-researched is Black heterosexual men. This dissertation presents research on evaluating the heterosexual Black men’s awareness of, prior use, and network of friends/family’s perceived interest in learning more about PrEP.

METHODS: Two-hundred and six Black heterosexual men living in Brooklyn, New York City, were surveyed about their sexual behaviors and PrEP …

Utilization Of Remote Sensing To Analyze Aedes Mosquito Egg Abundance With Combined Weather Variables In Two Southeastern Coastal Cities, Danielle M. Johnson

Theses and Dissertations

Several vector-borne diseases have recently resurfaced, and many have suddenly spread to new areas in the United States (U.S.) due to climate change and tropicalization. Two vectors of public health importance are Aedes aegyptiand Aedes albopictus. The Southeastern region of the U.S. appears to be a preferential ecological niche for both Aedes species. Aedes aegyptiand Aedes albopictus are highly susceptible to environmental conditions, such as humidity, precipitation, temperature. Remote sensing technology has proven to be useful for estimating vector populations. Miami-Dade County is an established hotspot for disease transmission. Charleston County is newly vulnerable due to similar …

Evaluating The Health Impact Of Centeringpregnancy Program Versus Traditional Prenatal Care In Midland Obstetric Clinics And Validating Selected Item On Birth Certificate, Oluwatosin A. Momodu

Theses and Dissertations

The primary focus of this dissertation is to evaluate the health impact of the CenteringPregnancy (CP) program versus traditional prenatal care (TPNC) on important maternal outcomes of pregnancy. This is looked at in two outcomes-gestational weight gain (GWG) and pregnancy induced hypertension (PIH). The specific aims are to examine the: (1) effects of CenteringPregnancy program versus traditional prenatal care on gestational weight gain (GWG); (2) effects of CenteringPregnancy program versus traditional prenatal care on pregnancy induced hypertension (PIH).

Birth certificate (BC) data were linked to hospital discharge records of women who delivered in midland’s obstetric clinics of South Carolina between …

Dysbiosis-Related Medications And The Association With Cognitive Decline, Cognitive Impairment, And Dementia, Nicholas Victor Resciniti

Theses and Dissertations

The main objectives of this dissertation were to quantitatively assess whether there is an association between medications (e.g., antibiotics, PPIs, antipsychotics) and cognitive performance over time, conduct a causal mediation analysis to evaluate the role of inflammation (C-reactive protein) in the association between medications and subsequent cognitive decline, and examine if dysbiosis-related medications (DRM) are associated with a greater risk of dementia for participants that were cognitively normal and had MCI at baseline.

The Health and Retirement Study (HRS) was used to conduct a secondary data analysis that used longitudinal data from 2004 to 2016. The HRS is an ongoing, …

Neighborhood Socioeconomic Status, Green Space, And Walkability And Risk For Falls And Fracture Among Postmenopausal Women: The Women’S Health Initiative, Marilyn Elizabeth Wende

Theses and Dissertations

The purpose of this study was to assess whether neighborhood socioeconomic status (SES), walkability, and green space impacts fall and fracture incidence among postmenopausal women, and to assess important modifiers for these relationships, such as fall history, physical activity, physical impairment, race/ethnicity, and rurality. Data from the Women’s Health Initiative study from 1993 to 2012 (N=161,808) was used.

SES had a significant relationship with falling after adjustment (intermediate vs low SES OR=0.99, p=0.0309; high vs low SES OR=0.99, p=0.1192). Study arm participation and fall frequency at baseline significantly modified this relationship. Walkability had a significant relationship with falling incidence after …

Applying Health Stigma Framework To Examine The Mechanisms Of Hiv-Related Stigma On Clinical Outcomes, Chengbo Zeng

Theses and Dissertations

Background: HIV clinical outcomes including CD4 count, viral suppression, and health-related quality of life (HRQoL), are important indicators reflecting immunologic functioning, treatment efficacy, and overall health quality. However, due, in part, to HIV-related stigma, many people living with HIV (PLWH) experience suboptimal clinical outcomes. The Health Stigma Framework introduced the potentially distinct mechanisms underlying internalized, anticipated, enacted stigma and health outcomes through psycho-behavioral pathways. Based on this framework, this dissertation investigated the impacts and mechanisms of HIV-related stigma on clinical outcomes among PLWH in Guangxi, China from a longitudinal perspective. Methods: Data at baseline, 6-, 12-, 18- month follow-ups …

An Analysis Of Mental State Verbs In Children With Hearing Loss, Morgan Vachio

Theses and Dissertations

Mental state verbs (MSV) require unique cognitive and linguistic knowledge compared to lower level function words (Shatz et al., 1983). These cognitive and linguistic demands are thought to be difficult for children with hearing loss (CHL) due to deficits in word learning (Werfel, 2017; Lund, 2016), limited depth of vocabulary knowledge (Walker et al., 2018) and deficits in complex syntax (Werfel et al., 2021). The present study recruited 73 preschool children (23 CHLCI, 22 CHL-HA and 28 CNH) to participate. Our analysis examined the frequency, lexical diversity and use of MSV within required complex syntax structures.

Verbal Fluency In Women With The Fmr1 Premutation And The Broad Autism Phenotype, Emily Szabo

Theses and Dissertations

Women who carry a premutation allele on the FMR1 gene can experience limitations due to their genetic status, including executive function deficits. These subtle deficits are often shared by women who possess the broad autism phenotype (BAP). Poor understanding and limited research on the extent of these executive functioning deficits has led to limited clinical management of these two groups. The current study aimed to clarity whether there is a difference in verbal fluency abilities in mothers that possess the FMR1 premutation, mothers of children with autism who are at risk for the BAP, and mothers of typically developing children, …

Lexical Properties Of Perceptual Errors Made By Younger And Older Adults Listening To Speech In Multitalker Babble, Hannah Blythe Vickery

Theses and Dissertations

Purpose: The purpose of this error analysis was to analyze the lexical properties of misperceptions made when listening to speech in multitalker babble.

Methods: Twenty young adults with normal hearing (YNH), 20 older adults with normal hearing (ONH), and 22 older adults with hearing impairment (OHI) completed a speech-in-babble task. Participants were asked to repeat the final word in 25 high and 25 low context sentences. On each trial, participants either responded with the correct target word, a misperception error, or skipped the trial response. Misperceptions were compiled and analyzed according to their lexical properties.

Results: Results of this study …

Intersection Of Maternal Disability Status, Prescription Opioid Use Before And During Pregnancy, And Adverse Birth Outcomes, Chelsea Lynes Richard

Theses and Dissertations

Nationally, individuals with disability, like those with chronic health conditions, have higher rates of opioid use and misuse and are prescribed higher dosages than those without disability. Because opioid agonists and antagonists can cross the placenta rapidly, there is biological plausibility that they may have an impact on birth outcomes. Therefore, monitoring prescription opioid use, particularly among pregnant women, is of great public health importance. While evidence for the impact of opioid use on preterm birth and low birthweight are conflicting; findings are consistent that opioid use during pregnancy is associated with a higher risk of small for gestational age, …

Examining The Cost And Quality Relationship In Medicare, Alexandria Fleming Delage

Theses and Dissertations

Purpose.

The purpose of this study is to evaluate the cost and quality of care dynamic among physicians billing under Medicare Fee for Service in 2018 to examine the relationship between quality and total cost of care at the physician level. Examining this relationship will advance scientific knowledge regarding the impact of increasing high value service use on healthcare costs and will provide insight in terms of expected cost outcomes of quality programs for healthcare policymakers (Salmond and Echevarria 2017; Williams, Brown, and Healy 2018).

Methods.

The study used publicly available data sets provided by the Center for Medicare and …

Household Food Security, Lifestyle Factors, And Glycemic Control Among Youth And Young Adults With Diabetes, Lauren A. Reid

Theses and Dissertations

The purpose of this study was to assess the associations between household food insecurity (HFI) and glycemic control, physical activity, and diet quality in youth and young adults (YYA) with type 1 diabetes (T1D) and type 2 diabetes (T2D). Among older adults, HFI has been shown to complicate diabetes management due to the essential role of diet in diabetes management and the financial stress associated with HFI. Although HFI is more prevalent among YYA with diabetes than the general population, there are only a handful of studies that have focused on this population and, studies that include YYA with T2D …

Race Is Not A Risk Factor: Examining The Influence Of Models Of Care, Race, And Discrimination On Racial Disparities In Maternal Outcomes, Curisa Mae Tucker

Theses and Dissertations

Maternal health outcomes are worst for racial and ethnic minority patients in the United States. There are disparities in pregnancy-related death and severe maternal morbidities where Black women suffer the most disparate outcomes. However, much of the previous scholarly work in this arena has charged that race is a risk factor for adverse maternal outcomes in which this dissertation refutes.

To better understand this phenomenon, we first conducted a scoping review of literature. Our aim was to examine the current state of literature on group prenatal care and its impact on maternal outcomes and racial disparities in adverse maternal outcomes. …

Towards Understanding Therapy Response In Chronic Aphasia, Sigfus Kristinsson

Theses and Dissertations

It remains largely unclear what factors determine who responds to aphasia therapy and to what degree. The current study sought to ameliorate this issue by addressing three aims: 1) To identify baseline predictors that dissociate between therapy responders and nonresponders, 2) to identify predictors of degree of treated recovery in therapy responders, and 3) to examine the generalizability of predictors identified under Aims 1 and 2 in randomly selected subsamples of study participants.

Method: Stroke survivors (N = 102; 43 females; age = 60.5y +/- 11.0y) with chronic aphasia (>12m post-stroke) were recruited as part of a multisite trial. …

A Contextual Evaluation Of The Fresh Fruit And Vegetable Program In South Carolina And Related Child Health Behaviors, Kathryn Irene Hoy

Theses and Dissertations

Children in vulnerable communities are at increased risk for poor diet.1,2 The Fresh Fruit and Vegetable Program (FFVP) is a United States Department of Agriculture (USDA) child nutrition program that increases vulnerable children’s access to and consumption of fruits and vegetables.3,4 FFVP is inherently flexible,5 has few regulations, and helps identify and develop best practices for individual schools to increase fruit and vegetable consumption among low-resource children.6 Flexibility built into the FFVP at the federal level naturally results in a variation of program adoption and implementation at both the state and school-levels.7 These variations affect outcomes in complex health promotion …

A Cost Effectiveness Analysis Of The Nutritious Eating With Soul Study, Mary Jones Wilson

Theses and Dissertations

PURPOSE Historically, African Americans (AA) have been underrepresented in nutritionrelated behavioral research despite their disproportionate higher risk of cardiovascular disease (CVD). The Nutritious Eating with Soul (NEW Soul) Study is one of the first of its kind to recruit an AA only study group to examine CVD prevention via a clinical trial to examine changes in CVD risk factors across two cohorts who are randomly assigned to a plant-based, soul food vegan diet or low-fat omnivorous (omni) diet. The purpose of cost effectiveness analysis (CEA) is to inform clinical and policy decisions and the costs of interventions that society is …

Nurses’ And Patients’ Perceptions Of The Availability Of Post-Hospital Instrumental Support As A Predictor Of 30- And 60-Day Acute Care Utilization, Beth E. Schultz

Theses and Dissertations

Social support is now part of the social determinants of health objective in Healthy People 2030. Positive social support improves health and well-being. Social support is concerned with people having the support they need within the community, including interacting and communicating with others on a regular basis. Instrumental support is a type of social support that is action oriented, involving one person directly assisting another person. A concept analysis of instrumental support was completed and revealed that the concept is well defined, but the terms used to describe it vary. Other terms in the research literature, most commonly “tangible support”, …

Neural Synchrony During Naturalistic Language Perception In Listeners With Aphasia, Lisa Johnson Norris

Theses and Dissertations

Neural synchrony across listeners during language processing has been found to be associated with successful comprehension in neurotypical adults. At initial presentation of auditory-visual stimuli, neural responses appear to oscillate in different rhythms across brain regions. As the stimulus progresses, the time course of neural activity synchronizes across listeners, particularly in primary auditory and visual processing regions. This phenomenon, which we refer to as ‘neural entrainment,’ has been observed in neurotypical individuals attending to the same stimulus. Neural synchrony occurs due to the inherent neural response elicited by a stimulus and has been shown to be consistent across participants in …