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USF Tampa Graduate Theses and Dissertations

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Cardiovascular Disease Risk Scores And Novel Risk Factors In Relation To Race And Gender, Johanna Wilson Jun 2016

Cardiovascular Disease Risk Scores And Novel Risk Factors In Relation To Race And Gender, Johanna Wilson

USF Tampa Graduate Theses and Dissertations

The use of cardiovascular risk scores remains the foundation for risk stratification to guide clinical management. Clinicians have access to several cardiovascular risk scores in practice settings. While having several risk scores with different risk factors may provide more information, it does not imply accuracy of the cardiovascular risk score used to calculate individual patient cardiovascular risk. The objective of this study was to compare the Framingham Risk score, Reynolds Risk scores, and the Pooled Cohort Risk Equation (3 commonly used equations) scores with respect to ability to predict cardiovascular events in a diverse ethnic population. Additionally, the potential predictive …


Statistical Analysis And Modeling Health Data: A Longitudinal Study, Bhikhari Prasad Tharu Jun 2016

Statistical Analysis And Modeling Health Data: A Longitudinal Study, Bhikhari Prasad Tharu

USF Tampa Graduate Theses and Dissertations

Lung cancer has been considered one of the leading causes of deaths while cancer re- mains the second most common cause of deaths in the USA. Understanding the behavior of a disease over time could yield important information to make decisions about the disease. Statistical models could provide crucial clues and help to make a decision about the dis- ease, budget allocation, evaluation, and implement prevention. Longitudinal trend analysis of the diseases helps to understand long term effects and nature. Cholesterol level is one of the most contributing risk factors for Coronary Heart Disease. Studying cholesterol statistically helps to know …


Determining The Effectiveness Of Soil Treatment On Plant Stress Using Smart-Phone Cameras, Anurag Panwar Jun 2016

Determining The Effectiveness Of Soil Treatment On Plant Stress Using Smart-Phone Cameras, Anurag Panwar

USF Tampa Graduate Theses and Dissertations

Plants are vital to the health of our biosphere, and effectively sustaining their growth is fundamental to the existence of life on this planet. A critical aspect, which decides the sustainability of plant growth is the quality of soil. All other things being fixed, the quality of soil greatly impacts the plant stress, which in turn impacts overall health. Although plant stress manifests in many ways, one of the clearest indicators are colors of the leaves. In this thesis, we conducted an experimental study in a greenhouse for detecting plant stress caused by nutrient deficienceies in soil using smartphone cameras, …


Statistical Modeling Of Carbon Dioxide And Cluster Analysis Of Time Dependent Information: Lag Target Time Series Clustering, Multi-Factor Time Series Clustering, And Multi-Level Time Series Clustering, Doo Young Kim Jun 2016

Statistical Modeling Of Carbon Dioxide And Cluster Analysis Of Time Dependent Information: Lag Target Time Series Clustering, Multi-Factor Time Series Clustering, And Multi-Level Time Series Clustering, Doo Young Kim

USF Tampa Graduate Theses and Dissertations

The current study consists of three major parts. Statistical modeling, the connection between statistical modeling and cluster analysis, and proposing new methods to cluster time dependent information.

First, we perform a statistical modeling of the Carbon Dioxide (CO2) emission in South Korea in order to identify the attributable variables including interaction effects. One of the hot issues in the earth in 21st century is Global warming which is caused by the marriage between atmospheric temperature and CO2 in the atmosphere. When we confront this global problem, we first need to verify what causes the problem then we …


A Comparative Analysis Of Demographics And Reported Preferential Learning Modes Of Florida And Non-Florida Osher Lifelong Learning Institutes Members, Jung Min Lee Jun 2016

A Comparative Analysis Of Demographics And Reported Preferential Learning Modes Of Florida And Non-Florida Osher Lifelong Learning Institutes Members, Jung Min Lee

USF Tampa Graduate Theses and Dissertations

This research examined demographic factors and reported preferential learning mode among a sample of Florida Osher Lifelong Learning Institute (OLLI) members compared to a national sample profile of OLLI members. This study was prompted by an earlier study of OLLI members conducted by the National Resource Center (NRC) for OLLIs, which produced a national profile describing OLLI members. Although there was a national profile for OLLI members, there were no existing profiles of Florida OLLI members that could be used by OLLI administrators and instructors.

This study employed an online survey to compare data between the national OLLI member profile …


Smoking By Restrained Eaters Following A Food Prime In The Context Of An Alternative Distractor, Michelle Kovacs May 2016

Smoking By Restrained Eaters Following A Food Prime In The Context Of An Alternative Distractor, Michelle Kovacs

USF Tampa Graduate Theses and Dissertations

Prior research found that female smokers with elevated dietary restraint (“high-restrainers”) smoked more after a disinhibiting food event (Kovacs, Correa, & Brandon, 2014). The current study aimed to determine if high-restrainers smoked merely to distract themselves from eating, or if the appetite/weight-control aspects of smoking played a role. Female smokers (N = 128) attended a laboratory session and were randomized to receive a milkshake prime (Prime condition) or not (No-Prime condition). All participants then received ad-lib access to tempting foods, cigarettes, and a computer tablet with internet access. Our main aims were to test the effect of the prime on …


An Exploration Of Adolescent Obesity Determinants, Anastasia King Smith May 2016

An Exploration Of Adolescent Obesity Determinants, Anastasia King Smith

USF Tampa Graduate Theses and Dissertations

In 2010, approximately two-thirds of adults and one-fifth of the adolescent population in the United States were considered either overweight or obese, resulting in the United States having the highest per capita obesity rate among all OECD countries. A considerable body of literature regarding health behavior, health outcomes, and public policy exists on what the Centers for Disease Control and Prevention considers an obesity epidemic. In response to the growing problem of childhood obesity, the Child Nutrition and WIC Reauthorization Act of 2004 (CNRA), which required that schools participating in the National School Lunch Program and/or School Breakfast Program have …


Exploring The Relationship Between Severity Of Illness And Human Milk Volume In Very Low Birth Weight And Extremely Low Birth Weight Infants Over Six Weeks, Shannon Leigh Morse Apr 2016

Exploring The Relationship Between Severity Of Illness And Human Milk Volume In Very Low Birth Weight And Extremely Low Birth Weight Infants Over Six Weeks, Shannon Leigh Morse

USF Tampa Graduate Theses and Dissertations

Very low birth weight and extremely low birth weight neonates have tremendous risk of mortality. This is a grave concern; however, survival alone is not the goal of neonatal intensive care. Survival, along with a reduction or elimination of life long morbidity is the aim of neonatal intensive care.

Human milk is known as the best nutrition for babies and a growing body of evidence supports that human milk is critical in helping these fragile neonates mitigate the overwhelming risks they face. Therefore, the purpose of this study was to examine the relationship between neonatal severity of illness and human …


An Altered Sense Of Magnitude: Exploring How The Visual Presentation Of Time, Space, And Numbers Can Influence Consumer Judgments And Behaviors, Marisabel Romero Apr 2016

An Altered Sense Of Magnitude: Exploring How The Visual Presentation Of Time, Space, And Numbers Can Influence Consumer Judgments And Behaviors, Marisabel Romero

USF Tampa Graduate Theses and Dissertations

Consumers are constantly evaluating quantitative information, such as the prices of different products, the time spent on an activity, or the distance covered during one day. Substantial research in psychology has demonstrated that judgments of quantity in one dimension (e.g., numbers) influence subsequent judgments on another dimension (e.g., time). The present research contributes to a growing body of work by exploring how the shared representation of time, space, and numbers affects consumer perceptions and behaviors.

My first dissertation essay explores how the organization of time on a spatial plane affects temporal judgments, product evaluations, and intertemporal discounting (i.e., time-space interaction). …


Spiritual Frameworks In Pediatric Palliative Care: Understanding Parental Decision-Making, Lindy Grief Davidson Apr 2016

Spiritual Frameworks In Pediatric Palliative Care: Understanding Parental Decision-Making, Lindy Grief Davidson

USF Tampa Graduate Theses and Dissertations

Parents of seriously ill children are charged with making complicated medical decisions, and many of those decisions are made during their children’s hospitalizations. As medical staff seek to support parents, it is important for them to understand what resources parents are drawing upon for decision-making. This project explored parental decision-making by examining the following research questions: RQ1: What resources do parents draw upon to make medical decisions for their seriously ill children? RQ2: How do parents enact their spiritual or religious frameworks in clinical settings when faced with medical decisions for their seriously ill children? Methods of research included ethnographic …


Evaluation Of Pulmonary Function Among Workers Engaged In The Manufacture Of Hydraulic Fracking Ceramic Proppant, Humairat H. Rahman Apr 2016

Evaluation Of Pulmonary Function Among Workers Engaged In The Manufacture Of Hydraulic Fracking Ceramic Proppant, Humairat H. Rahman

USF Tampa Graduate Theses and Dissertations

Workers involved in hydraulic fracking processes are exposed to various types of chemicals and dusts in their workplaces, such as proppants, which hold open the fissures created in the fracking process. Recently, ceramic proppants have been developed that may be less hazardous to workers than traditional proppants. Pulmonary function testing of workers producing ceramic proppant was used to assess the potential inhalation hazards of ceramic proppant. Male workers (n = 100) from a producer of ceramic proppant were evaluated with pulmonary function test data collected and evaluated using The American Thoracic Society (ATS) acceptability criteria. A comparison group was selected …


The Change In Nutritional Status In Traumatic Brain Injury Patients: A Retrospective Descriptive A Retrospective Descriptive Study, Dina A. Masha'al Apr 2016

The Change In Nutritional Status In Traumatic Brain Injury Patients: A Retrospective Descriptive A Retrospective Descriptive Study, Dina A. Masha'al

USF Tampa Graduate Theses and Dissertations

There is a high prevalence in malnutrition among traumatic brain injury (TBI) due to the hypermetabolism and hypercatabolism which develop post injury. Traumatic brain injury patients are different, even among themselves, in their energy requirements and response to nutritional therapy. This implies that there are other factors that affect the energy intake of these patients and enhance the incidence of malnutrition.

This dissertation study examines the nutritional status of TBI patients upon admission to the intensive care unit (ICU) and during their hospital stay to describe baseline status, detect changes in nutritional status over 7 days, and identify the factors …


Costumbres, Creencias, Y “Lo Normal”: A Biocultural Study On Changing Prenatal Dietary Practices In A Rural Tourism Community In Costa Rica, Allison Rachel Cantor Apr 2016

Costumbres, Creencias, Y “Lo Normal”: A Biocultural Study On Changing Prenatal Dietary Practices In A Rural Tourism Community In Costa Rica, Allison Rachel Cantor

USF Tampa Graduate Theses and Dissertations

This study explores the relationship between tourism, the nutrition transition, and prenatal dietary practices in the Monteverde Zone, Costa Rica. This rural tourism community, located in the central highlands of Costa Rica, has seen rapid growth and development since the tourism boom in the early 1990s, leading to changes in the local food system and increased food insecurity. This investigation added to this work by identifying the ways that prenatal dietary practices have shifted over time in the context of increased tourism and the concomitant nutrition transition, and by describing the relationship between food insecurity and nutritional status among pregnant …


The Household Water Management System In The Village Of Falifah, Gambia: A Case Study In Sustainable Local Development, Baboucar Jobe Mar 2016

The Household Water Management System In The Village Of Falifah, Gambia: A Case Study In Sustainable Local Development, Baboucar Jobe

USF Tampa Graduate Theses and Dissertations

Access to safe and clean water is a problem in many countries in the world, especially sub-Saharan Africa. The urgency of the was recognized by the United Nations through its 2008 Millennium Development Goals, which were recently replaced by the new Sustainable Development Goals. Lack or poor access to clean water not only creates conflicts and rifts among the people, but also makes them more susceptible to a wide assortment of water borne diseases.

The purpose of this dissertation is to complete a pilot study of ways of thinking and actions of a small group of people from Falifah, a …


Exploration Of The Pregnancy-Related Health Information Seeking Behavior Of Women Who Gave Birth In The Past Year, Laura Kathleen Merrell Mar 2016

Exploration Of The Pregnancy-Related Health Information Seeking Behavior Of Women Who Gave Birth In The Past Year, Laura Kathleen Merrell

USF Tampa Graduate Theses and Dissertations

Background: Pregnancy is a significant period of time for individual women. Promoting optimal health behaviors and supporting individuals during critical periods of health (such as pregnancy) is an important aspect of public health research and practice. One way of supporting individuals in promoting positive health behaviors and outcomes is by increasing their health literacy. The ability to find appropriate health information is the first step in the health literacy process. This process of finding information in health contexts is called Health Information Seeking Behavior (HISB). Whereas, HISB has been extensively studied in chronic health contexts, little research has been conducted …


Global Leadership Competencies In Selected Adult Education Graduate Programs From The United States And Western Europe, Arthur Ray Mccrory Mar 2016

Global Leadership Competencies In Selected Adult Education Graduate Programs From The United States And Western Europe, Arthur Ray Mccrory

USF Tampa Graduate Theses and Dissertations

Researchers in the field of global leadership have reported a growing need for leaders able to perform from a global perspective, and the lack of qualified leadership candidates to fulfill these responsibilities. Adult education graduate programs represent a unique pool of aspirants to help fill this gap. In 2008, the Commission of Professors of Adult Education (CPAE) published Standards for Graduate Programs in Adult Education. Two of these standards addressed the incorporation of globalization and leadership studies into the planning, administration, and evaluation of adult education graduate programs. This study sought to explore the connection between the phenomenon of …


Sizing An Anaerobic Digester In A Rural Developing World Community: Does Household Fuel Demand Match Greenhouse Gas Production?, Ronald Keelan Greenwade Mar 2016

Sizing An Anaerobic Digester In A Rural Developing World Community: Does Household Fuel Demand Match Greenhouse Gas Production?, Ronald Keelan Greenwade

USF Tampa Graduate Theses and Dissertations

Anaerobic digestion is the process by which organic carbon is converted into biogas in the form of carbon dioxide (CO2) and methane (CH4). Both of these products are greenhouse gases that contribute to global warming. Therefore if anaerobic reactors are improperly maintained and biogas is leaked or intentionally released into the atmosphere because biogas production exceeds household demand, these reactors may become generators of greenhouse gas emissions instead of sustainable energy producers. The objective of this research was to develop a framework to assess if the demand for biogas by a rural adopter of an anaerobic …


Adoption Of The Sawyer Water Filter In Peru, Stephanie D. Paredes Mar 2016

Adoption Of The Sawyer Water Filter In Peru, Stephanie D. Paredes

USF Tampa Graduate Theses and Dissertations

In Peru, lack of water, sanitation, and hygiene (WASH) results in 6,600 deaths per year that represents approximately 3.9% of total deaths. Three thousand and nine hundred of these deaths were due to diarrheal diseases (Prüss-Üstün et al., 2008). Systematic reviews suggest that interventions to improve microbial quality of drinking water are successful in reducing diarrheal diseases (Fewtrell et al., 2005; Clasen et al., 2007; Fry et al., 2013). Interventions for household water treatment and safe storage to ensure safe drinking water reduce diarrhea by 31-52% (WHO/UNICEF, 2013).

The SAWYER PointONE filter, a portable and adaptable membrane filtration device as …


An Assessment Of Elementary School Children’S Diet And Physical Activity Levels, Karen Tamara Serrano Arce Mar 2016

An Assessment Of Elementary School Children’S Diet And Physical Activity Levels, Karen Tamara Serrano Arce

USF Tampa Graduate Theses and Dissertations

With prevalence rates of obesity among children and adolescents steadily rising, childhood obesity and overweight has become a public health concern. Publically funded elementary schools are in a unique position to provide children with opportunities regarding the promotion of physical activity and healthy nutritional behaviors. Purpose: The purpose of this study was to conduct exploratory research to investigate the dietary habits of elementary school students enrolled in four Hillsborough County Out-of-School Time (HOST) care programs. Methods: The study utilized a quantitative, non-experimental study design. The instruments that were used in this research included a new questionnaire that was titled “All …


Does Physical Fitness Predict The Reading Achievement Of Fifth-Grade Students? The Interaction With Gender, Courtney Lynn Mar 2016

Does Physical Fitness Predict The Reading Achievement Of Fifth-Grade Students? The Interaction With Gender, Courtney Lynn

USF Tampa Graduate Theses and Dissertations

States across the nation are facing pressure to meet standards for high stakes testing which is resulting in a decrease in the amount of time allotted to physical education (Ennis, 2006). Although the U.S. Department of Health and Human Services (2008) recommends children engage in 60 minutes or more of physical activity a day, on average, children only receive 30 minutes per day of aerobic exercise (Epstein et al., 2001). Despite this decrease in physical activity, research has shown that physical activity is associated with academic achievement (Ardoy et al., 2013). In addition, physical activity is positively related to physical …


Anti-Fat Attitudes And Weight Bias Internalization: An Investigation Of How Bmi Impacts Perceptions, Opinions And Attitudes, Laurie Schrider Mar 2016

Anti-Fat Attitudes And Weight Bias Internalization: An Investigation Of How Bmi Impacts Perceptions, Opinions And Attitudes, Laurie Schrider

USF Tampa Graduate Theses and Dissertations

Americans hold negative and judgmental attitudes towards obese and overweight individuals and these anti-fat attitudes and weight stigma have become a damaging form of discrimination. The internalization of weight bias and anti-fat attitudes contributes to negative health outcomes including: feelings of devalue, self-hate, anxiety, depression, body dissatisfaction and eating disturbances. The purpose of this study was to investigate weight bias internalization in individuals who perceive themselves as overweight as well as to examine differences in anti-fat attitudes among normal and overweight individuals. A sample of 202 male and females completed an online survey that assessed anti-fat attitudes via the Anti-Fat …


Effects Of Delay To Reinforcement On Selections For High-Tech And Low-Tech Leisure Items, Yuram Kim Mar 2016

Effects Of Delay To Reinforcement On Selections For High-Tech And Low-Tech Leisure Items, Yuram Kim

USF Tampa Graduate Theses and Dissertations

Many children are exposed to excessively technology. Such use of technology may lead to health issues including obesity, attention deficits, and sleep disorders. Research has shown that parameters of reinforcement, such as quality and delay, may influence how children allocate their preferences. One way to drive preference away from high-tech toys may be to arrange delays to reinforcement following such selections and immediate reinforcement for an alternative response. In Experiment 1, four subjects who preferred high-tech leisure items over low-tech leisure items were identified through the pair-stimulus preference assessments. The results of Experiment 2 indicated that all subjects were sensitive …


Image-Based 3d Morphometric Analysis Of The Clavicle Intramedullary (Im) Canal, Jazmine Aira Mar 2016

Image-Based 3d Morphometric Analysis Of The Clavicle Intramedullary (Im) Canal, Jazmine Aira

USF Tampa Graduate Theses and Dissertations

Midshaft clavicle fractures are very common. Current treatment of choice involves internal fixation with superior or anterior clavicle plating, however their clinical success and patient satisfaction are slowly decreasing. The design of intramedullary (IM) devices is on the rise, but data describing the IM canal parameters is lacking. The aim of this study is to quantify morphometry of the clavicle and its IM canal, and to evaluate the effect of gender and anatomical side. This study used 3-dimensional (3D) image-based models with novel and automated methods of standardization, normalization and bone cross-section evaluation. The data obtained in this thesis presents …


The Effect Of Exercise Order On Body Fat Loss During Concurrent Training, Tonya Lee Davis-Miller Mar 2016

The Effect Of Exercise Order On Body Fat Loss During Concurrent Training, Tonya Lee Davis-Miller

USF Tampa Graduate Theses and Dissertations

While the benefits of both cardiovascular exercise and resistance training have been well documented, there is a lack of evidence for the order of exercise that is most effective when both are done in the same day. This study was designed to look at two groups of participants performing both resistance (R) and cardiovascular (C) training in the same day to determine if their order, resistance before cardiovascular (R-C) or cardiovascular before resistance (C-R), matter with regard to changes in body composition, maximal strength, and maximal aerobic capacity. The participants were 17 women between the ages of 30 and 55 …


Concerns Of Water Scarcity And Water Quality Among Two Andean Communities In Peru, Kelsey Anne Anderson Mar 2016

Concerns Of Water Scarcity And Water Quality Among Two Andean Communities In Peru, Kelsey Anne Anderson

USF Tampa Graduate Theses and Dissertations

This thesis sought to explore the perceptions and experiences of Andean women regarding water quality, water scarcity, and health among two communities in Carhuaz province of Ancash, Peru. Household surveys (n=25), semi-structured interviews (n=10), unstructured interviews (n=2), and participant observation were conducted with local women to investigate their concerns and perceptions of water and health. An additional two unstructured interviews were conducted with a local water authority and doctor in order gain another perspective on the issues of water security and health.

The pressure of a changing climate and of a problematic water governance system in Andean Peru create an …


"But Our Hands Are Tied": Assessing School Gardening Efforts At Title I Elementary Schools In Pinellas County, Florida, Alexandra Grace Lancey Mar 2016

"But Our Hands Are Tied": Assessing School Gardening Efforts At Title I Elementary Schools In Pinellas County, Florida, Alexandra Grace Lancey

USF Tampa Graduate Theses and Dissertations

This research was designed to understand current school gardening efforts in Pinellas County, Florida. School gardens have become an important aspect of experiential learning and nutrition education in schools throughout the United States. Many not-for-profit organizations have attempted to increase the prevalence and efficacy of school garden programs as a means of providing educational opportunities and working to curb diet-related health issues in children. Most of these organizations are seen as apolitical in nature, because they access mainly private sector funding sources and volunteer support. This provides flexibility for these social projects, but also takes pressure off of the state …


In Vitro And In Vivo Antioxidant Capacity Of Synthetic And Natural Polyphenolic Compounds Identified From Strawberry And Fruit Juices, Marvin Abountiolas Mar 2016

In Vitro And In Vivo Antioxidant Capacity Of Synthetic And Natural Polyphenolic Compounds Identified From Strawberry And Fruit Juices, Marvin Abountiolas

USF Tampa Graduate Theses and Dissertations

Strawberries can be considered a functional food because their consumption has been associated with several health benefits. They are important sources of bioactive compounds, such as vitamins and polyphenolic compounds, with recognized antioxidant capacity (AOC). However, strawberry overall quality and bioactive content are greatly affected by environmental conditions during pre- and post-harvest and, little is known about the stability of its bioactive compounds, specifically ascorbic acid (AA) and polyphenolics compounds. Furthermore, additional research that addresses the impact of polyphenolic compounds on in vitro and in vivo models is needed to understand the mechanisms behind their potential health benefits. Therefore, the …


Investigating Alternative Subsistence Strategies Among The Homeless Near Tampa, Florida, Matthew Peter Rooney Mar 2016

Investigating Alternative Subsistence Strategies Among The Homeless Near Tampa, Florida, Matthew Peter Rooney

USF Tampa Graduate Theses and Dissertations

Modern homelessness is one of the most pressing social and political problems of our time. Several hundred thousand people experience homelessness in the United States each year, and the U.S. Department of Housing, which attempts to count those people, has admitted that their statistics are conservative estimates at best. A recent archaeological study (Zimmerman et al 2010) examining material culture associated with homeless communities in Indianapolis has suggested that those who are considered chronically homeless have generally abandoned wage labor and are instead pursuing urban foraging as a subsistence strategy. In order to better understand the structures of homeless communities, …


Modeling The Extent Of Virus Removal In Waste Stabilization Ponds To Support Reuse Of Wastewater, Kelly James Vannoy Mar 2016

Modeling The Extent Of Virus Removal In Waste Stabilization Ponds To Support Reuse Of Wastewater, Kelly James Vannoy

USF Tampa Graduate Theses and Dissertations

Waste stabilization ponds (WSPs) are one of the most prevalent types of domestic wastewater treatment technologies employed worldwide, and global stressors such as urbanization, population growth, climate change, and water scarcity have increased the demand for reusing treated wastewater. The safe reuse of treated wastewater in agriculture can ease water scarcity, aid in food production, and reduce environmental degradation from the discharge of wastewater effluent to surface waters. The ability to predict virus concentrations in wastewater effluent is an important criterion for determining whether wastewater is suitable for discharge to the environment or for reuse in agriculture. However, many uncertainties …


Metabolic Therapy For Age-Dependent Impaired Wound Healing, Shannon Lynn Kesl Mar 2016

Metabolic Therapy For Age-Dependent Impaired Wound Healing, Shannon Lynn Kesl

USF Tampa Graduate Theses and Dissertations

Chronic wounds represent an under-acknowledged socioeconomic epidemic, affecting 1.8 million new patients per year and costing the US health care system upwards of $25 billion annually. This substantial cost is rapidly growing due to a disproportionate occurrence in the ever-aging population. Key features associated with age-related impairment of wound healing include limited energy and nutrient exchange, unremitting inflammations, increased reactive oxygen species (ROS), and diminished blood flow. Most chronic wound therapies target specific molecular mechanisms; however, there are often multiple mitigating factors that prevent normal wound closure. This is likely one reason most wound therapies are minimally effective. In the …