Digital Commons Network^™

Association Between Rheumatoid Arthritis Severity And Mental Health In A Prevalent Cohort Of American Adults, 2013-2022, Nicole-Anne Ballesteros

Public Health Theses

Objective/Purpose: The severity of rheumatoid arthritis and its association with depression and anxiety among a prevalent cohort of American adults has been neither well-researched nor backed by real-world data. This investigation seeks to test the hypothesis that there is an association between disease severity and the aforementioned psychological conditions, both of which are commonly observed in patients with rheumatoid arthritis.

Methods: Real-world data from OM1 Inc.’s rheumatoid arthritis registry (2013-2022) was used for this analysis. Disease severity (low, medium, and high), categorized using disease activity scores, was the main exposure, while depression and anxiety were the study’s two primary outcomes. …

Circadian Factors And Cancer Survivorship: A Mini Review, Jiaqi Cui

Public Health Theses

Circadian clocks are molecular clocks that govern the temporal control of physiology to preserve homeostasis. The disruption of the circadian rhythm is important in carcinogenesis and aids the development of cancer hallmarks. On the other hand, carcinogenic activities disrupt circadian rhythms directly. In cancer treatment, pharmacological regulation of core clock genes is a novel approach. The use of circadian biology in cancer research opens up new avenues for improving cancer treatment effectiveness. This mini-review provides an overview of relationship between circadian factors including circadian gene expression, circadian genotype, circadian disruption and circadian gene methylation and the cancer survivorship. The review …

“She Trusts Us To Love Her, You Know?”: Using A Love Ethic Framework To Explore Faith Navigation And Acceptance Processes Among Mormon Mothers Of Lgbtq+ Individuals, Nandini Milind Deo

Public Health Theses

Parental acceptance is a key factor in bolstering the health and well-being of LGBTQ+ individuals across their lifespan (Needham & Austin, 2010; Ryan, 2010; Jin, 2020; Clark et al., 2021). One factor known to influence parental acceptance is family religiosity, which has typically been associated with conflict and/or rejection (Ryan, 2010; Johns & Hanna, 2012; Roe, 2017). The purpose of this study was to better understand faith navigation and acceptance processes among active Mormon mothers of LGBTQ+ individuals in an effort to inform public health engagement with highly religious parents of sexual and gender minority children. In-depth qualitative interviews were …

The Role Of Childhood Trauma In Intergenerational Trauma (Igt), Audrey Huang

Public Health Theses

Emerging research has focused on the intersection of personal and parental trauma within intergenerational trauma (IGT) transmission, specifically offspring adverse childhood experiences due to trauma-related parenting behaviors. However, the role that offspring childhood trauma and its various subtypes may play in moderating or mediating IGT transmission, as well as the impact of caregiver sex, are still remains largely understudied. We examined how the transmission of PTSD between survivors of the 1994 genocide to their offspring might be either (a) mediated by overall and subtypes of offspring childhood trauma, or (b) moderated by overall and subtypes of offspring childhood trauma, and …

Comparing Dog And Owner Pfas Exposures Using Fresh Air Samplers, Emily Elizabeth Johnson

Public Health Theses

Per- and polyfluoroalkyl substances (PFAS) have gained attention given their prevalence and persistence in the environment and in our bodies. PFAS have been detected in water, food products, and consumer products. Furthermore, companion animals may be exposed to elevated PFAS levels due to sources from pet products as well as household items. A growing number of studies have been conducted to better understand the toxicological and public health impacts of legacy PFAS resulting from ingestion and dermal exposure pathways in both humans and domesticated animals. As alternative replacement PFAS emerge in the market, these compounds are shorter chain which allows …

Xylazine In The Drug Supply: Emerging Threat In Connecticut And Lessons Learned From Philadelphia, Thomas A.G. Quijano

Public Health Theses

Background: Xylazine, a sedative analgesic drug approved as an animal tranquilizer but not for human use, has become an adulterant in the supply of heroin/fentanyl.(Greene & Thurmon, 1988) Between 2019 and 2020, prevalence of xylazine in overdose death reports increased by 44.8% nationally.(Friedman et al., 2021) The three jurisdictions in 2020 with the highest prevalence of xylazine were Philadelphia (25.8%), Maryland (19.3%), and Connecticut (10.2%).(Friedman et al., 2021) Not much is known about how xylazine’s impacts on service provider’s practices and the people they serve.

Objectives: Use a multiple methods approach to understand xylazine’s presence and impact in Connecticut, and …

Per- And Polyfluoroalkyl Substances (Pfass) In Household Dust From North China: Occurrence, Contribution, And Human Exposure, Yakun Zhou

Public Health Theses

Measurements and analysis of an emerging contaminant of poly- and perfluoroalkyl substances (PFAS) and adverse health effects associated with PFAS have received increasing attention around the world. In this study, 64 participants’ household dust were collected in Jinan, China during September 2018 and January 2019, conducted as part of the Biomarkers of Air Pollutants Exposure in the Chinese aged 60-69 (China BAPE) study. Concentrations and composition profiles of 7 individual PFASs were determined and estimated daily intakes of PFASs via dust ingestion for children and adults were calculated. By using a dimension reduction method − principal component analysis (PCA) and …

Show, Attend And Detect: Towards Fine-Grained Assessment Of Abdominal Aortic Calcification On Vertebral Fracture Assessment Scans, Syed Zulqarnain Gilani, Naeha Sharif, David Suter, John T. Schousboe, Siobhan Reid, William D. Leslie, Joshua R. Lewis

Research outputs 2022 to 2026

More than 55,000 people world-wide die from Cardiovascular Disease (CVD) each day. Calcification of the abdominal aorta is an established marker of asymptomatic CVD. It can be observed on scans taken for vertebral fracture assessment from Dual Energy X-ray Absorptiometry machines. Assessment of Abdominal Aortic Calcification (AAC) and timely intervention may help to reinforce public health messages around CVD risk factors and improve disease management, reducing the global health burden related to CVDs. Our research addresses this problem by proposing a novel and reliable framework for automated “fine-grained” assessment of AAC. Inspired by the vision-to-language models, our method performs sequential …

Instrumental And Emotional Social Support Intention And Utilization Among Pregnant And Postpartum Women During The Covid-19 Pandemic, Gracie Minks

All Master's Theses

Postpartum depression impacts 1 in 7 women across the U.S. As a whole population, between 10-16% of women are impacted by maternal depression during pregnancy or the first year postpartum. Those who experience postpartum depression are at risk for repeated depressive episodes and a lower quality of life over time. The postnatal period may reflect the most vulnerable time for mental health concerns such as anxiety and depression. Fear, judgment, and perceived criticism are commonly named as barriers that delay the mobilization of support.

There is a prevailing perception that postpartum depression is a normal part of motherhood which may …

Effect Of Care Environment On Educational Attainment Among Orphaned And Separated Children And Adolescents In Western Kenya, Dorothy Apedaile, Allison Delong, Edwin Sang, David Ayuku, Lukoye Atwoli, Omar Galárraga, Paula Braitstein

Internal Medicine, East Africa

Background: There are approximately 140 million orphaned and separated children (OSCA) around the world. In Kenya, many of these children live with extended family while others live in institutions. Despite evidence that orphans are less likely to be enrolled in school than non-orphans, there is little evidence regarding the role of care environment. This evidence is vital for designing programs and policies that promote access to education for orphans, which is not only their human right but also an important social determinant of health. The purpose of this study was to compare educational attainment among OSCA living in Charitable …

The Association Between Metabolically Healthy Obesity And Coronary Heart Disease Among Regards Study Participants, Kiara N. Aaron

All ETDs from UAB

A major obstacle to the advancement of our understanding of the metabolically healthy obesity (MHO) phenotype is the inconsistent definition of metabolic health and obesity among studies. A harmonized definition of MHO in adults has been proposed based on the diagnosis of obesity (BMI > 30 k/m2) and meeting the cardio-metabolic criteria for triglycerides, high-density lipoprotein (HDL) cholesterol, systolic blood pressure (SBP), diastolic blood pressure (DBP), no antihypertensive treatment, fasting blood glucose, and no drug treatment with glucose-lowering agents. In addition, waist circumference can be associated with increased disease risk when WC is >94 cm in men and >80 cm in …

Evaluation Of Ventilation Performance And Respirable Particles In Food Trucks, Dong Lee Yang

All ETDs from UAB

Background: The food truck industry in the U.S. has rapidly expanded, with an average growth of 7.9 % from 2017 to 2022. Food truck workers are potentially exposed to harmful airborne contaminants such as particulate matter (PM) and aldehydes produced during cooking process. Kitchen exhaust hoods are designed to capture the cooking emissions, but it is not well understood whether the commercial kitchen exhaust hoods in food trucks are properly, efficiently operated to reduce the workers' exposure to such harmful contaminants. The purpose of the study was to evaluate food truck workers' exposure to respirable particulates generated from cooking process …

Socioeconomic Status, Hbb, And Ttr Variants, And Cardiorenal Outcomes: The Regards Study, Onika E. Abrams

All ETDs from UAB

Blacks are disproportionately affected by heart failure (HF) and end-stage renal disease (ESRD). While poorer health outcomes in Blacks have been associated with social determinants of health, there are some biological differences worth noting, namely genetic risk variants for both TTR and HBB. These genetic risk variants are known to confer additional risk in the development of heart failure and end-stage renal disease, respectively. While we understand these genetic variants aren’t fully penetrant, and genetics and are not deterministic, we aimed to examine additional factors and mechanisms responsible for the increased risk in HF and ESRD in Blacks. Neighborhood socioeconomic …

Association Between Regional Covid-19 Vaccine Hesitancy And Reported Positive Covid-19 Cases In The Southern United States, Orielle Caudle

All ETDs from UAB

The use of vaccinations has been shown to be beneficial in pandemics in the past, and in some cases, it has led to elimination of a particular disease (i.e. polio). The COVID-19 vaccination can also serve the same purpose, however, vaccine hesitancy within specific regions of the country may prevent and/or dilute the effectiveness of the vaccine. Vaccine hesitancy can be defined as a delay in acceptance, or refusal despite the availability of vaccine services. Southern regions have consistently had the lower vaccination rates compared to its other regional counterparts, even as the pandemic progressed and death rates increased over …

Desired Resources For Changing Diet Among Persons With Multiple Sclerosis: Qualitative Inquiry Informing Future Dietary Interventions, Stephanie L Silveira, Emma V Richardson, Robert W Motl

Faculty, Staff and Student Publications

BACKGROUND: There are approximately 1 million adults in the United States with multiple sclerosis (MS). Persons with MS are interested in diet as a second-line therapy for improving MS symptoms and disease progression. Examination of desired resources regarding diet among persons with MS is necessary for supporting behavior change.

METHODS: Twenty-five adults with MS completed 1-on-1, online semistructured interviews. An inductive, 6-phase, semantic thematic analysis was applied to identify themes associated with participant preferences for dietary behavior change.

RESULTS: The research team crafted 4 key themes from the data that encompassed participants' desired resources for dietary behavior change. Theme 1, …

Perceptions Of Physical Activity Guidelines Among Wheelchair Users With Multiple Sclerosis, Stephanie L Silveira, Brenda Jeng, Gary Cutter, Robert W Motl

Faculty, Staff and Student Publications

BACKGROUND: Physical activity guidelines provide prescriptive resources for population-level promotion of behavior change to improve health outcomes. The National Multiple Sclerosis Society (NMSS) recently created and disseminated physical activity guidelines for persons with multiple sclerosis (MS) across the disease spectrum.

OBJECTIVE: This study aimed to assess perceptions of the updated NMSS Physical Activity Guidelines among wheelchair users with MS.

METHODS: One hundred thirty-four wheelchair users with MS participated in a cross-sectional study examining health behaviors. Outcomes were measured using an online questionnaire that included items related to demographic and clinical characteristics and a battery of questions regarding perceptions of the …

Application Of Artificial Intelligence And Machine Learning For Hiv Prevention Interventions, Yang Xiang, Jingcheng Du, Kayo Fujimoto, Fang Li, John Schneider, Cui Tao

Faculty, Staff and Student Publications

In 2019, the US Government announced its goal to end the HIV epidemic within 10 years, mirroring the initiatives set forth by UNAIDS. Public health prevention interventions are a crucial part of this ambitious goal. However, numerous challenges to this goal exist, including improving HIV awareness, increasing early HIV infection detection, ensuring rapid treatment, optimising resource distribution, and providing efficient prevention services for vulnerable populations. Artificial intelligence has had a pivotal role in revolutionising health care and has shown great potential in developing effective HIV prevention intervention strategies. Although artificial intelligence has been used in a few HIV prevention intervention …

The Neighborhood Environment And Hispanic/Latino Health, Natalia I Heredia, Tianlin Xu, Minjae Lee, Lorna H Mcneill, Belinda M Reininger

Faculty, Staff and Student Publications

PURPOSE: Hispanic/Latino adults on the Texas-Mexico border have high rates of chronic disease. Neighborhoods can influence health, though there is a limited research on neighborhood environment and health in Hispanics/Latinos. The purpose of this study was to assess the relation of neighborhood environment with health variables in Hispanic/Latino adults, including physical activity [PA], depression, anxiety, and lab-assessed conditions (type 2 diabetes, metabolic syndrome, and chronic inflammation).

METHODS: Participants were randomly-selected from a Hispanic/Latino cohort on the Texas-Mexico border. Neighborhood environment, self-reported PA, anxiety, and depression were assessed through questionnaires. Laboratory values determined Type 2 diabetes, metabolic syndrome, and C-reactive protein …

Covid-19 Outcomes In Myasthenia Gravis Patients: Analysis From Electronic Health Records In The United States, Youngran Kim, Xiaojin Li, Yan Huang, Minseon Kim, Aziz Shaibani, Kazim Sheikh, Guo-Qiang Zhang, Thy Phuong Nguyen

Faculty, Staff and Student Publications

BACKGROUND: Myasthenia gravis (MG) is an autoimmune, neuromuscular condition and patients with MG are vulnerable due to immunosuppressant use and disease manifestations of dyspnea and dysphagia during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS: We conducted a retrospective cohort study using the Optum® de-identified COVID-19 Electronic Health Record (EHR) dataset. Primary outcomes, such as hospitalization, ventilator use, intensive care unit (ICU) admission, and death in COVID-19 patients with MG, were compared with those of COVID-19 patients without MG: the subgroups of non-MG included those with rheumatoid arthritis (RA), systemic lupus (SLE), and multiple sclerosis (MS). We further analyzed factors affecting …

Guideline For Feedback Of Individual Genetic Research Findings For Genomics Research In Africa, Alice Matimba, Stuart Ali, Katherine Littler, Ebony Madden, Patricia Marshall, Sheryl Mccurdy, Victoria Nembaware, Laura Rodriguez, Janet Seeley, Paulina Tindana, Aminu Yakubu, Jantina De Vries, H3africa Ethics And Community Engagement Working Group

Faculty, Staff and Student Publications

As human genomics research in Africa continues to generate large amounts of data, ethical issues arise regarding how actionable genetic information is shared with research participants. The Human Heredity and Health in Africa Consortium (H3Africa) Ethics and Community Engagement Working group acknowledged the need for such guidance, identified key issues and principles relevant to genomics research in Africa and developed a practical guideline for consideration of feeding back individual genetic results of health importance in African research projects. This included a decision flowchart, providing a logical framework to assist in decision-making and planning for human genomics research projects. Although presented …

Multi-Omics Insights Into The Biological Mechanisms Underlying Statistical Gene-By-Lifestyle Interactions With Smoking And Alcohol Consumption, Timothy D Majarian, Amy R Bentley, Vincent Laville, Michael R Brown, Daniel I Chasman, Paul S De Vries, Mary F Feitosa, Nora Franceschini, W James Gauderman, Casey Marchek, Daniel Levy, Alanna C Morrison, Michael Province, Dabeeru C Rao, Karen Schwander, Yun Ju Sung, Charles N Rotimi, Hugues Aschard, C Charles Gu, Alisa K Manning, Charge Gene-Lifestyle Interactions Working Group

Faculty, Staff and Student Publications

Though both genetic and lifestyle factors are known to influence cardiometabolic outcomes, less attention has been given to whether lifestyle exposures can alter the association between a genetic variant and these outcomes. The Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium's Gene-Lifestyle Interactions Working Group has recently published investigations of genome-wide gene-environment interactions in large multi-ancestry meta-analyses with a focus on cigarette smoking and alcohol consumption as lifestyle factors and blood pressure and serum lipids as outcomes. Further description of the biological mechanisms underlying these statistical interactions would represent a significant advance in our understanding of gene-environment …

Integrated Molecular And Affiliation Network Analysis: Core-Periphery Social Clustering Is Associated With Hiv Transmission Patterns, Kayo Fujimoto, Dimitrios Paraskevis, Jacky C Kuo, Camden J Hallmark, Jing Zhao, Andre Hochi, Lisa M Kuhns, Lu-Yu Hwang, Angelos Hatzakis, John A Schneider

Faculty, Staff and Student Publications

This study investigates the two-mode core-periphery structures of venue affiliation networks of younger Black men who have sex with men (YBMSM). We examined the association between these structures and HIV phylogenetic clusters, defined as members who share highly similar HIV strains that are regarded as a proxy for sexual affiliation networks. Using data from 114 YBMSM who are living with HIV in two large U.S. cities, we found that HIV phylogenetic clustering patterns were associated with social clustering patterns whose members share affiliation with core venues that overlap with those of YBMSM. Distinct HIV transmission patterns were found in each …

Pathway Lasso: Pathway Estimation And Selection With High-Dimensional Mediators, Yi Zhao, Xi Luo

Faculty, Staff and Student Publications

In many scientific studies, it becomes increasingly important to delineate the pathways through a large number of mediators, such as genetic and brain mediators. Structural equation modeling (SEM) is a popular technique to estimate the pathway effects, commonly expressed as the product of coefficients. However, it becomes unstable and computationally challenging to fit such models with high-dimensional mediators. This paper proposes a sparse mediation model using a regularized SEM approach, where sparsity means that a small number of mediators have a nonzero mediation effect between a treatment and an outcome. To address the model selection challenge, we innovate by introducing …

In Utero Exposure To 17Α-Hydroxyprogesterone Caproate And Risk Of Cancer In Offspring, Caitlin C Murphy, Piera M Cirillo, Nickilou Y Krigbaum, Barbara A Cohn

Faculty, Staff and Student Publications

BACKGROUND: 17α-hydroxyprogesterone caproate is a synthetic progestogen initially approved in the 1950s to treat gynecologic and obstetrical conditions. Despite continued concerns about safety and short-term efficacy regarding the use of 17α-hydroxyprogesterone caproate for the prevention of preterm birth in pregnant women, little is known about the long-term effects of 17α-hydroxyprogesterone caproate on the health of the offsprings.

OBJECTIVE: To examine the association between in utero exposure to 17α-hydroxyprogesterone caproate and the risk of cancer in the offspring.

STUDY DESIGN: The Child Health and Development Studies was a population-based cohort of >18,000 mother-child dyads receiving prenatal care in the Kaiser Foundation …

Dna Methylation Pattern Of Cpg Site In The Promoter Region Of Calca-Alpha Gene As A Putative Epigenetic Biomarker In Neonatal Sepsis- A Prospective Observational Study In South India, Rudra Rupesh Reddy Narsapurapu, Deepti Thandaveshwara, Anshu Kumar Yadav, Akila Prashant

Digital Journal of Clinical Medicine

Background: Recently, several studies have been reported on epigenetic modifications of DNA as a predisposing factor for several diseases among neonates and adults. Here we aimed to study the changes in the DNA methylation pattern in the promoter region of the CALCA gene among the neonates suspected to have sepsis in a tertiary care hospital.

Methodology: All the neonates suspected to have sepsis based on the inclusion criteria during the study period were included in the study as cases. Normal healthy neonates were included in the study as controls. Positive cases were isolated from suspected cases based on …

Healthcare Equity For Transgender Individuals, Mollie Staggs

DSW Capstone Projects

In the field of social justice and integrity, Social Work has dedicated itself to improving the welfare of the world, in which we all participate and interact. There are countless issues in our society that warrant professional attention for the fundamental purpose of positively impacting the livelihood of subcategories of people. For this particular Capstone Project, the focus is on transgender individuals’ systemic healthcare barriers that cisgender people within the United States do not similarly experience. The purpose is to unveil these disparities to then pose progressive alterations within the healthcare system to make the navigation and accessibility better for …

Voices Of The Often Unheard: The Environmental Impacts Of Catastrophic Wildfire Events On Individuals With Developmental Disabilities, Mary Madison Mckenzie

Graduate Student Theses, Dissertations, & Professional Papers

The Thomas Fire for a time was the largest wildfire in California history, burning 281,893 acres and destroying 1,063 structures. Within three years, the August Complex Fire, at 1,032,649 acres, almost quadrupled that record. Climate related disasters such as these have impelled social science researchers to heed calls for a paradigm shift in understanding the risks climate change poses to the social world, in particular, disaster risks for vulnerable groups. Existing research tends to focus on disasters such as hurricanes, featuring risks for vulnerable populations by race, class, and/or individuals with disabilities in general, but not for individuals with developmental …

The Syndemic Landscape: A New Paradigm For Montana Suicide Prevention Grounded In Agricultural Renewal, Emory Chandler Padgett

Graduate Student Theses, Dissertations, & Professional Papers

Montana has had one of the highest suicide rates in the nation for half a century, and since 2000, it has risen almost 50%. Despite suicide’s alarming persistence in the state, there has been minimal academic study of suicide or mental health specifically in Montana, so this thesis attempts to answer a few questions: Why does Montana have such a high suicide rate? Is there something culturally, historically, or socially unique about Montana that contributes to suicide? Are current prevention efforts helpful, harmful, or lacking? Could a consideration of culture and land benefit an understanding of suicide in Montana? What …

Racial Disparities In Treatments And Mortality Among A Large Population-Based Cohort Of Older Men And Women With Colorectal Cancer, Xianglin L Du, Lulu Song

Faculty, Staff and Student Publications

BACKGROUND: There were racial disparities in treatment and mortality among patients with colorectal cancer, but few studies incorporated information on hypertension and diabetes and their treatment status.

PATIENTS AND METHODS: The study identified 101,250 patients from Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database in the United States who were diagnosed with colorectal cancer at age ≥65 years between 2007 and 2015 with follow-up to December 2016.

RESULTS: There were substantial racial and ethnic disparities in the prevalence of hypertension and diabetes in patients with colorectal cancer, in receiving chemotherapy and radiation therapy, and in receiving antihypertensive and antidiabetic treatment. …

Comorbidities, Health-Related Quality Of Life, Health-Care Utilization In Older Persons With Hemophilia-Hematology Utilization Group Study Part Vii (Hugs Vii), Randall Curtis, Marilyn Manco-Johnson, Barbara A Konkle, Roshni Kulkarni, Joanne Wu, Judith R Baker, Megan Ullman, Duc Quang Tran, Michael B Nichol

Faculty, Staff and Student Publications

PURPOSE: We compare the impact of hemophilia on comorbidities, joint problems, health-related quality of life (HRQoL) and health-care utilization between two age groups: 40-49 years and ≥50 years.

PATIENTS AND METHODS: The HUGS VII study recruited persons with hemophilia A or B age ≥40 years. Participants completed surveys to collect data on sociodemographic and clinical characteristics, hemophilia treatment regimen, pain, joint problems, comorbidities, HRQoL, depression and anxiety, at baseline and 6-months later. Clinical chart reviews documented hemophilic severity and treatment.

RESULTS: The sample includes 69 males, 65.2% aged ≥50 years, 75.4% with hemophilia A. Individuals ≥50 years were more likely …