Exploring Sexual Orientation Disparities Regarding The Interplay Of Childhood Sexual Abuse, Self-Reported Diabetes Status, And Depression Among Adults In The United States, Sumaita Choudhury, Paul G Yeh, Kaitlyn L Zajack-Garcia, Christine M Markham

Faculty, Staff and Student Publications

Previous research has revealed a strong link between the experience of childhood sexual abuse (CSA) and diabetes in adulthood. Moreover, research has shown that sexual minorities (SM) are exposed to adverse childhood experiences (ACEs) (i.e. CSA) and experience depression at higher rates than their heterosexual counterparts. Thus, it is imperative to further investigate the role of depression and the differential associations of exposure to ACEs with diabetes prevalence by sexual orientation. We explored sexual orientation disparities regarding the relationship between CSA and diabetes and examined the moderating role of depression. A total of 29,903 participants from the 2021 Behavioral Risk …

Circulating Sphingolipids In Relation To Cognitive Decline And Incident Dementia: The Cardiovascular Health Study, Kristine F Moseholm, Héléne T Cronjé, Manja Koch, Annette L Fitzpatrick, Oscar L Lopez, Marcia C De Oliveira Otto, W T Longstreth, Andrew N Hoofnagle, Kenneth J Mukamal, Rozenn N Lemaitre, Majken K Jensen

Faculty, Staff and Student Publications

INTRODUCTION: Whether circulating levels of sphingolipids are prospectively associated with cognitive decline and dementia risk is uncertain.

METHODS: We measured 14 sphingolipid species in plasma samples from 4488 participants (mean age 76.2 years; 40% male; and 25% apolipoprotein E (

RESULTS: Higher plasma levels of sphingomyelin-d18:1/16:0 (SM-16) were associated with a faster cognitive decline measured with 3MSE, in contrast, higher levels of sphingomyelin-d18:1/22:0 (SM-22) were associated with slower decline in cognition measured with DSST. In Cox regression, higher levels of SM-16 (hazard ration [HR] = 1.24 [95% confidence interval [CI]: 1.08-1.44]) and ceramide-d18:1/16:0 (Cer-16) (HR = 1.26 [95% CI: 1.10-1.45]) …

Variant Of The Lactase Lct Gene Explains Association Between Milk Intake And Incident Type 2 Diabetes, Kai Luo, Guo-Chong Chen, Yanbo Zhang, Jee-Young Moon, Jiaqian Xing, Brandilyn A Peters, Mykhaylo Usyk, Zheng Wang, Gang Hu, Jun Li, Elizabeth Selvin, Casey M Rebholz, Tao Wang, Carmen R Isasi, Bing Yu, Rob Knight, Eric Boerwinkle, Robert D Burk, Robert C Kaplan, Qibin Qi

Faculty, Staff and Student Publications

Cow's milk is frequently included in the human diet, but the relationship between milk intake and type 2 diabetes (T2D) remains controversial. Here, using data from the Hispanic Community Health Study/Study of Latinos, we show that in both sexes, higher milk intake is associated with lower risk of T2D in lactase non-persistent (LNP) individuals (determined by a variant of the lactase LCT gene, single nucleotide polymorphism rs4988235 ) but not in lactase persistent individuals. We validate this finding in the UK Biobank. Further analyses reveal that among LNP individuals, higher milk intake is associated with alterations in gut microbiota (for …

Dynamic Risk Score Modeling For Multiple Longitudinal Risk Factors And Survival, Cuihong Zhang, Jing Ning, Jianwen Cai, James E Squires, Steven H Belle, Ruosha Li

Faculty, Staff and Student Publications

Modeling disease risk and survival using longitudinal risk factor trajectories is of interest in various clinical scenarios. The capacity to build a prognostic model using the trajectories of multiple longitudinal risk factors, in the presence of potential dependent censoring, would enable more informed, personalized decision making. A dynamic risk score modeling framework is proposed for multiple longitudinal risk factors and survival in the presence of dependent censoring, where both events depend on participants' post-baseline clinical progression and form a competing risks structure. The model requires relatively few random effects regardless of the number of longitudinal risk factors and can therefore …

Health Behaviors Predicting Risk Of Obesity In Us Adults: What Does A Healthy Lifestyle Look Like?, Jacqueline Vernarelli, Jessica R. Kiel, Christopher D. Coleman, Satya S. Jonnalagadda

Public Health Faculty Publications

Objective

The purpose of this study was to examine the association between lifestyle factors and body weight in a nationally representative sample of US adults and to evaluate the association between a novel “Healthy Habits Composite Score (HHCS)” and risk of obesity.

Methods

This cross-sectional study included data from 4870 adults who participated in the 2017–2018 National Health and Nutrition Examination Survey (NHANES). The HHCS was developed based on 4 factors: diet, physical activity, sedentary time, and sleep, all of which were measured during the NHANES. A “healthy lifestyle” was defined as meeting ≥3 of the 4 established criteria. Data …

Alopecia As An Early Clinical Marker For Azathioprine Induced Myelosuppression: A Case Report, Nilanjana Dutta , Final Year Mbbs, Dr. M Suresh Babu , Professor, Dr. Subramanian Ramaswamy , Professor, Dr. Mahabaleshwar Mamadapur , Assistant Professor

Digital Journal of Clinical Medicine

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for …

Alkaptonuria Presenting With Back Pain: A Diagnostic Dilemma, Arnav Salar, Dyuksha Arora, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Alkaptonuria is a rare inborn error of metabolism due to a deficiency of homogentisate 1,2 dioxygenase, resulting in homogentisic acid accumulation in tissues. It is characterised by homogentisic aciduria, ochronosis, and arthritis. We hereby discuss a 46-year-old male who presented with progressive lower back pain and polyarthralgia for ten years, initially diagnosed as ankylosing spondylitis. Characteristic skin pigmentation, ochronosis, and radiological findings led to the correct diagnosis of alkaptonuria. This case highlights the importance of considering alkaptonuria as a differential diagnosis for chronic back pain and arthritis, mainly when sacroiliac joints are spared, and ochronosis is present. While no cure …

Transforming Children's Oral Health: The Impact Of Oral Healthcare Policies On Virginia Medicaid Dental Health Outcomes., Anita M. Kumar

Theses and Dissertations

Abstract: Transforming Children's Oral Health: The Impact of Oral Healthcare Policies on Virginia Medicaid Dental Health Outcomes.

Objectives: This dissertation uses Department of Medical Assistance Services (DMAS) administrative files at the individual and provider level from fiscal years (FY) 2011 to 2021 to systematically study the effect of recently implemented oral health policies (EBD guidelines on sealants, CMS updated quality measures, expansion of Medicaid oral healthcare for qualifying pregnant women) on oral health outcomes of Virginia Medicaid-enrolled children.

Methods: The studies employ a difference in differences regression methods (negative binomial, Poisson, and logistic) to examine the effects of oral health …

Longitudinal Analysis Of Maternal Depression, Physical Work Demand, And Working Hours Before, During, And After Pregnancy On Offspring Blood Pressure Trajectories, Medhin Tsegaye Haile

Theses and Dissertations

Overall Abstract

Background: Pediatric high blood pressure (BP) is a growing global concern, with 1 in 7 adolescents in the U.S. experiencing elevated BP or hypertension. Maternal lifestyle factors, including depressive symptoms, physically demanding work, and work hours during pregnancy, may influence offspring BP trajectories. However, prior studies often focus on single time points or specific age groups, limiting understanding of long-term effects. This study investigates the associations between maternal depressive symptoms, physically demanding work-related factors, and work hours before, during, and after pregnancy with offspring systolic blood pressure (SBP) trajectories from early childhood to adolescence.

Methods: We utilized …

The Genetic Architecture Of Cervical Change During Pregnancy: From Modeling To Mechanism — Does The Cervix Mediate Maternal Risk For Spontaneous Preterm Birth?, Hope M. Wolf

Theses and Dissertations

This project leverages clinical data and biospecimens from a prospective longitudinal cohort of pregnant women to study the genetic and phenotypic relationships between cervical shortening and the duration of pregnancy. Sonographic cervical length (CL) was measured throughout pregnancy in a cohort of 5,160 Black/African American women in Detroit, Michigan. Maternal DNA samples were sequenced with a next-generation low-pass whole genome platform. The heritability of cervical change during pregnancy and its genetic correlation with gestational age at delivery (GAD) were estimated using Genome-Wide Complex Trait Analysis. These estimates suggest that cervical change is heritable (h²CL = 51%) and highly polygenic trait. …

Screening For And Addressing Social Determinants Of Health In Hospitals Participating In Accountable Care Organizations, Heather Lee

All ETDs from UAB

There is a growing recognition among hospitals, payers, and policymakers in the United States that addressing social needs of patients is important to improving quality of care, patient outcomes, and lowering health care spending. Accountable care organizations (ACOs) may be especially incentivized to address social needs of patients to meet population health goals related to patient outcomes and costs. This cross-sectional study used data from the American Hospital Association Annual Survey to explore to explore how hospitals participating in or leading ACOs are screening for and addressing individual-level HRSNs of patients and to understand the extent to which ACOs are …

Understanding Disparities In Hypertension Treatment Cascade And Validating Blood Pressure Measurement Among Persons Living With Or At Risk For Hiv, Jessica Blair

All ETDs from UAB

In the United States, 44% of adult women >18 years have hypertension. Although non-Hispanic Black adults were more likely to be aware of and treated for hypertension compared to non-Hispanic White adults, Black individuals had the highest prevalence of uncontrolled hypertension. Persons living with HIV have a higher prevalence of hypertension, which is a major modifiable risk factor for cardiovascular disease. Similar to the geographic distribution of hypertension in the US, people living in the South have higher incidence of both hypertension and HIV diagnoses compared to other US regions. Furthermore, accurate diagnosis of hypertension and initiation of treatment is …

Using Focus Groups To Explore Older Black Men's Perception Of Dietary Interventions., Ashley R Shaw, Eric D Vidoni, Mickeal N Key, Brandon A Yates, Roland Thorpe

Faculty, Staff and Student Publications

Older Black men are underrepresented in research despite being disproportionately affected by Alzheimer’s disease (AD) and cardiovascular (CV) risk factors related to AD compared with non-Hispanic Whites. Although dietary interventions have shown promise to reduce modifiable CV risk factors related to AD, Black Americans have lower adherence likely due to lack of cultural considerations. Using a noninterventional convergent parallel mixed-methods approach, this study examined the cultural contexts that inform perceptions of dietary interventions among older Midwestern Black men. All participants completed an online demographic and dietary habit survey prior to focus group discussions. Two focus group discussion sessions were conducted …

Association Of Cancer Diagnosis With Disability Status Among Older Survivors Of Colorectal Cancer: A Population-Based Retrospective Cohort Study, Shiming Zhang, Lin-Na Chou, Michael D Swartz, Hemalkumar B Mehta, James S Goodwin, Yong-Fang Kuo, Sharon Hermes Giordano, Carole A Tucker, Karen M Basen-Engquist, Elizabeth J Lyons, Brian Downer, Susan K Peterson, Tru Cao, Maria C Swartz

Faculty, Staff and Student Publications

BACKGROUND: Older cancer survivors likely experience physical function limitations due to cancer and its treatments, leading to disability and early mortality. Existing studies have focused on factors associated with surgical complications and mortality risk rather than factors associated with the development of poor disability status (DS), a proxy measure of poor performance status, in cancer survivors. We aimed to identify factors associated with the development of poor DS among older survivors of colorectal cancer (CRC) and compare poor DS rates to an age-sex-matched, non-cancer cohort.

METHODS: This retrospective cohort study utilized administrative data from the Texas Cancer Registry Medicare-linked database. …

Factors Associated With Infant Sex And Preterm Birth Status For Selected Birth Defects From The National Birth Defects Prevention Study, 1997–2011, Eva M Williford, Wei Yang, Meredith M Howley, Chen Ma, Ronnie T Collins, Kari A Weber, Dominique Heinke, Julie M Petersen, A J Agopian, Natalie P Archer, Andrew F Olshan, Lindsay A Williams, Marilyn L Browne, Gary M Shaw

Faculty, Staff and Student Publications

Background: Birth defects and preterm birth co-occur, with some overlapping risk factors. Many birth defects and preterm births tend to have a male preponderance. We explored potential risk factors impacting sex and preterm (< 37 weeks of gestation) birth differences among infants with selected birth defects delivered from 1997 to 2011 using data from the National Birth Defects Prevention Study (NBDPS).

Methods: The NBDPS was a large multisite, population-based case-control study. Using random forests, we identified important predictors of male preterm, female preterm, and male term, each compared with female term births for each birth defect. Using logistic regression, we estimated odds ratios for associations between important predictors and sex-preterm birth status by birth defect.

Results: We examined 11,379 infants with nine specific birth defects. The top …

Traditional Chinese Medicine And The Argument For Future Application In The United States, Kylie Nicole Frohlich

Graduate Student Theses, Dissertations, & Professional Papers

No abstract provided.

A Comparative Study Of Venezuelan Immigrants’ Pre- And Post-Migration Concerns For Their Children In The United States And Colombia, Aigerim Alpysbekova, Pablo Montero-Zamora, Mary H Soares, Carolina Scaramutti, Sumeyra Sahbaz, Maria Duque, Tara Bautista, Maria Fernanda Garcia, Christopher P Salas-Wright, Mildred M Maldonado-Molina, Melissa M Bates, Augusto Pérez-Gómez, Juliana Mejía Trujillo, Eric C Brown, Seth J Schwartz

Faculty, Staff and Student Publications

Research suggests that forced migration may lead to cultural stress and psychological distress. However, little is known about immigrant parents' pre- and post-migration concerns for their children's welfare. The present study examined the concerns of Venezuelan parents who migrated to the United States versus those who migrated to Colombia, and whether post-migration concerns were related to cultural stressors, mental health, and cultural identity. A sample of 609 Venezuelan immigrants completed surveys and responded to an open-ended prompt asking about pre- and post-migration concerns for children's welfare. Lack of safety was the most common pre-migration concern for Venezuelans in the U.S., …

Joint Problem-Solving Orientation, Mutual Value Recognition, And Performance In Fluid Teamwork Environments, Michaela Kerrissey, Zhanna Novikov

Faculty, Staff and Student Publications

INTRODUCTION: Joint problem-solving orientation (JPS) has been identified as a factor that promotes performance in fluid teamwork, but research on this factor remains nascent. This study pushes the frontier of understanding about JPS in fluid teamwork environments by applying the concept to within-organization work and exploring its relationships with performance, mutual value recognition (MVR), and expertise variety (EV).

METHODS: This is a longitudinal, survey-based field study within a large United States healthcare organization

RESULTS: Our results affirm a moderated mediation model wherein JPS enhances performance, both directly and through MVR; EV serves as a moderator in the JPS-MVR relationship. JPS …

Plasma Per-And Polyfluoroalkyl Substance (Pfas) Mixtures And Maternal Cardiometabolic Health, Yuting Wang

Dartmouth College Ph.D Dissertations

Food is a common exposure pathway to per- and polyfluoroalkyl substances (PFAS) but dietary factors related to PFAS concentrations in pregnant people have not been adequately evaluated. PFAS have been linked to the increased risk of gestational hypertension, preeclampsia, and adiposity. However, less is known regarding the effect of PFAS mixtures on blood pressure (BP) trajectories in normotensive pregnancies or weight retention postpartum. We used data from the New Hampshire Birth Cohort Study (NHBCS) to examine dietary intake and PFAS concentrations and associations of PFAS with BP trajectories and postpartum weight retention. PFAS concentrations were measured in plasma collected at …

Sleep, Sedentary Time, And Physical Activity In Heart Failure Subtypes: Multi-Ethnic Study Of Atherosclerosis (Mesa), Demi M. Nott

UNF Graduate Theses and Dissertations

INTRODUCTION: Previous studies have examined the associations between physical activity (PA), sedentary time (ST), and sleep on the risk of heart failure (HF). The primary aim of this study was to examine PA, ST, and sleep quality (SQ) in those diagnosed with preserved ejection fraction HF (HFpEF) and reduced ejection fraction HF (HFrEF). The secondary aim of this study was to examine these relationships in those with and without HF, independent of sub-type.

METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) collected data from 6,814 adults from a diversified cohort who range in age from 45 to 84. Subjects were classified …

Predictive Modeling Using Clinical Data And Compositional Microbiome Data, Li Zhang

All ETDs from UAB

This dissertation focuses on developing predictive modeling using data from two areas: clinical data and microbiome data. Compositional data in real life are mainly represented by relative proportions. With the advancement of next-generation sequencing (NGS) technology, researchers can now collect a large volume of metagenomic sequencing data, which is valuable for investigating associations between the microbiome and host diseases. Current methods for dealing with such data are either constrained by generalization or limited by application. In the first part, to address this, we propose Bayesian compositional generalized linear models for analyzing microbiome data (BCGLM). This model incorporates a structured regularized …

Using Hope To Cope: Chronic Stress, Religious Coping, And Masked Hypertension In African American Adults: The Jackson Heart Study, Miriam Miles

All ETDs from UAB

USING HOPE TO COPE: CHRONIC STRESS, RELIGIOUS COPING, AND MASKED HYPERTENSION IN AFRICAN AMERICAN ADULTS: THE JACKSON HEART STUDY ABSTRACT Chronic stress experienced at home or work has been associated with acute increases in blood pressure (BP) measured in the doctor’s office. Few data are available on the association of chronic stress with BP measured outside of the office setting. Religious coping, applying religious beliefs to adapt to stressful situations, and functional and structural social support may protect against MHT by promoting active coping behaviors and increasing emotional well-being. High levels of religious involvement and high social support have been …

The Association Between Cardiovascular Disease Risk And Fractures In Postmenopausal Women, Rafeka Hossain

All ETDs from UAB

Background: Fragility fractures pose a significant healthcare and economic burden in the United States. While age and bone mineral density (BMD) are the primary established risk factors for fragility fractures, the relationship between cardiovascular disease (CVD) and fractures remains underexplored. The primary objective of this analysis was to estimate the association of CVD risk with fractures in postmenopausal women. Methods: Utilizing 30 years of data from the WHI, Atherosclerotic Cardiovascular Disease (ASCVD) risk scores were computed using baseline age, race, systolic blood pressure, total cholesterol, high-density lipoprotein, diabetes, anti-hypertension medications, and smoking. Fracture outcomes encompassed any clinical fracture, major osteoporotic …

Setting The Foundation For A Lifetime Of Oral Health, Samuel Blanchard Dds, Ms

The Journal of the Michigan Dental Association

In this Children’s Dental Health Month article, the Michigan Academy of Pediatric Dentistry emphasizes the crucial role of relationships and trust in pediatric dentistry. Highlighting the significance of collaborative efforts between dental societies, the commentary discusses the impact of professional connections on patient care. The author shares personal insights on transitioning in their career, underscoring the value of cultivated relationships. The age-1 dental visit is highlighted as a powerful preventive measure to establish rapport and empower parents with oral health knowledge. The article emphasizes the enduring benefits of building connections in promoting lifelong oral health.

My World's On Fire, How 'Bout Yours? An Investigation Of How Privilege Fosters And Maintains Climate Denial, Morgan A. Chester

Antioch University Dissertations & Theses

The present study investigates the phenomenon of climate denial through a new theoretical framework of privilege. The analysis utilizes a feminist orientation that builds on a historical interpretation through the lens of colonialism. Through the dissection of current multidisciplinary understandings of climate denial and new concepts discovered in the review of academic literature and popular media, a compilation of theory, relationship, and connection is made. Systems of power and privilege are examined and connected to the mechanisms and maintenance of climate denial. The resulting analysis illuminates that settler colonialism, supported by connected ideologies of White supremacy, ableism, and patriarchy inform …

The Benefits Of Prenatal Education Via Virtual And Mobile Applications Before, During, And After Pregnancy: A Quality Improvement Project, Lindsay Farland

Master's Theses and Capstones

Background: The advancements of technology has led to a substantial increase in the use of pregnancy applications among expecting parents. Studies indicate that a majority of pregnant individuals utilize virtual education platforms for various purposes, including accessing information on nutrition, exercise, baby development, and pregnancy symptoms. Despite the potential benefits, participation in these platforms remains low, emphasizing a need for enhanced resources and engagement strategies. Research shows that engagement with antenatal education through mobile applications can lead to improved maternal and fetal outcomes, such as reduced rates of caesarean births and fewer complications related to hypertension or preeclampsia.

Methods: …

Social Networks As Predictors Of Musculoskeletal Injury In U.S. Army Soldiers (Snap-Mski), Kristen L. Zosel

Theses and Dissertations

INTRODUCTION: Musculoskeletal injuries (MSKIs) are the leading cause of medical non-readiness among U.S. Army Soldiers, costing the Military Health System an estimated $4.7 billion annually in direct and indirect costs. Current MSKI mitigation efforts focus on individual attributes such as body mass index and gender. However, emerging research highlights the significance of social ties on health outcomes and behaviors. This study examined the patterns of MSKI within military social networks and how social interactions, along with health behaviors such as sleep, physical activity (PA), and diet, co-occur in Soldiers with and without MSKI. METHODS: Phase 1 involved a cross-sectional sociocentric …

Prevalence And Patterns Of Cardiovascular Risk Factors In Young Hypertensive Patients, *Raghu V S R Tanuku Dr., Major Venkata Shree Krishna Dr., Sreedhar Tanuku Dr

Digital Journal of Clinical Medicine

Hypertension ranks among the top ten causes of mortality, with around 4% attributed to hypertensive complications. High salt intake, Type 2 diabetes, smoking, elevated serum lipids, a sedentary lifestyle, a diet heavy in saturated fat, genetic predisposition, as well as stress are among the factors that contribute to hypertension. Hypertension affects about 1 billion people worldwide, with considerable differences between populations and ethnic groups [2]. The Framingham Heart Study indicates that a person's lifetime risk of developing hypertension is 90% if they are normotensive at age 55. According to the NHANES IV (4th National Health and Nutrition Examination Survey), the …

“The Study Of Correlation Of Diet Pattern And Anemia In Pregnant Women In A Tertiary Care Hospital In Mysuru-A Prospective Study”, Soniya Pal, Dr Mamatha S Professor And Head Of The Department, Shiva S Dr, Anupama Marnal B A Dr

Digital Journal of Clinical Medicine

No abstract provided.

Assessing Discharge Knowledge For Caregivers Of Newborn (Using Video Discharge Instructions As An Adjunct To Standard Written Instructions) In Covid Period – A Randomized Controlled Trial, Jayesh Yadav, Khyati Gupta, Vishal D. Sawant

Digital Journal of Clinical Medicine

Background: Studies have demonstrated that caregivers of newborn frequently face challenges in comprehending the instructions provided to them upon discharge. Video discharge instructions provide a clear and concise message and can potentially alleviate factors which have an impact on comprehension of caregivers like illiteracy, communication barriers and limited physician time. We aim to assess the impact of incorporating video-based discharge instructions on caregivers' comprehension of newborn care and post-discharge follow-up, specifically in the context of the COVID-19 pandemic.

Methods: Caregivers of newborn in the COVID times were randomized into written only and written with video discharge instruction groups; …