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2019

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Coy Arjate Adrusted Response Adaptive Randomization Designs With Targeted Learning, Hai Zhu Dec 2019

Coy Arjate Adrusted Response Adaptive Randomization Designs With Targeted Learning, Hai Zhu

Dissertations and Theses (Open Access)

Since Food and Drug Administration (FDA) issued the very first draft guidance in 2010, adaptive designs have been considered to be one of the most promising approaches to make drug development more efficient and less costly. Two approaches, covariate-adjusted response-adaptive (CARA) randomization and adaptive seamless phase II/III design (ASD) have garnered growing attention recently. However, most of the CARA designs are based on parametric models and suffered from model misspecification. The research of incorporating CARA into ASD is also limited and whether type I error rate can be controlled has not been answered. In this dissertation, a new family of …

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Association Between Childhood Maltreatment And Type 2 Diabetes Mellitus: A Retrospective Cohort Study In The United States, Diep N. Poulos Dec 2019

Association Between Childhood Maltreatment And Type 2 Diabetes Mellitus: A Retrospective Cohort Study In The United States, Diep N. Poulos

Dissertations and Theses (Open Access)

This retrospective cohort study analyzed self-reported and biological data collected from MIDUS in 2004-2006 to understand the association between the types of childhood maltreatment (CM) and Type 2 Diabetes Mellitus (T2DM). The central hypothesis of this study is that childhood maltreatment is positively associated with adult onset diabetes (T2DM). CM has been associated with lifelong morbidity and an increased risk in chronic diseases such as diabetes and heart disease (Bernstein RE, 2013). In this study, CM was defined by the Childhood Trauma Questionnaire (CTQ). The CTQ has three types of abuse: physical, sexual, emotional, and two types of neglect: physical …

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The Potential Impact Of Restricting The Sale Of Tobacco At Tobacco Retail Outlets Surrounding Schools Across Major Metropolitan Areas Of Texas On Tobacco Advertisements, Udoka C. Obinwa Dec 2019

The Potential Impact Of Restricting The Sale Of Tobacco At Tobacco Retail Outlets Surrounding Schools Across Major Metropolitan Areas Of Texas On Tobacco Advertisements, Udoka C. Obinwa

Dissertations and Theses (Open Access)

Retail outlets that sell tobacco (ROST) are the leading channel of advertisements and promotional efforts for tobacco companies. Tobacco companies strategically target youth, young adults, racial and ethnic minorities and individuals in lower SES areas with more advertisements, which in turn influences their tobacco use behavior. Researchers have proposed instituting place-based restriction strategies as a way to control tobacco use. This dissertation examined the potential impact of i) restricting the sale of tobacco at ROST within 1000ft of schools and 2000ft of colleges and ii) restricting the sale of tobacco at ROST within 500ft of other ROST, on the number …

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Studying The Properties Of Seamless Phase Ii/Phase Iii Clinical Trials Under Covariate Adaptive Randomization, Garrett Miller Dec 2019

Studying The Properties Of Seamless Phase Ii/Phase Iii Clinical Trials Under Covariate Adaptive Randomization, Garrett Miller

Dissertations and Theses (Open Access)

Covariate adaptive randomization is an allocation procedure used in clinical trials that seeks to balance treatment groups. While this method has been shown to reduce bias due to imbalanced treatment groups, the effects of covariate adaptive randomization have not been studied under seamless Phase II/Phase III clinical trials that incorporate short-term endpoint information and treatment selection. Therefore, this analysis sought to determine whether these adaptive randomization methods can be applied to seamless Phase II/Phase III trials while preserving Type I error. In addition, this analysis sought to create R-packages that employ seamless Phase II/Phase III techniques to provide analysis tools …

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Patient-Perceived Patient-Centered Medical Home Characteristics And Healthcare Utilization, Expenditure And Quality, Alissa Ratanatawan Dec 2019

Patient-Perceived Patient-Centered Medical Home Characteristics And Healthcare Utilization, Expenditure And Quality, Alissa Ratanatawan

Dissertations and Theses (Open Access)

The patient-centered medical home (PCMH) model is a care delivery model which patient treatment is coordinated through their primary care physician to ensure they receive the necessary care when and where they need it, in a manner they can understand with the aims to improve healthcare quality while keeping healthcare cost growth under control. The objective of this study was to analyze health service utilization, expenditure and quality of civilian noninstitutionalized US adult population in healthcare facilities that have 3 domains of PCMH features, which are comprehensive care, patient-centered care, and accessible care, using patient’s perspective from the 2016 Medical …

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Clinical And Demographic Factors Associated With Peg-Asparaginase-Related Toxicities In Patients With Acute Lymphoblastic Leukemia, Priyadarshani Dharia Dec 2019

Clinical And Demographic Factors Associated With Peg-Asparaginase-Related Toxicities In Patients With Acute Lymphoblastic Leukemia, Priyadarshani Dharia

Dissertations and Theses (Open Access)

Introduction: Polyethylene glycol (PEG)-asparaginase is one of the first-line drugs in pediatric ALL treatment. Although a complete and prolonged treatment with PEGasparaginase has been instrumental in improving the survival of ALL patients, it is associated with four common toxicities: hypersensitivity, hyperbilirubinemia, pancreatitis, and venous thromboembolism (VTE). PEG-asparaginase-related toxicities may require modifications and delays in treatment, which often leads to poor treatment outcomes. Previous studies of PEG-asparaginase-related toxicities have mainly focused on individual toxicities. Further, these studies were conducted in study populations which were predominantly self-reported non-Hispanic whites. Therefore, there is a gap in the knowledge regarding the cumulative burden of …

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Quantifying The Financial & Clinical Impact Of Annual Vs. Biennial Mammography Screening, Danmeng Huang Dec 2019

Quantifying The Financial & Clinical Impact Of Annual Vs. Biennial Mammography Screening, Danmeng Huang

Dissertations and Theses (Open Access)

Current guidelines for screening mammography recommend different start ages and intervals for women with average cancer risk. Longer intervals between mammograms allow more time for a tumor to grow, to become symptomatic and clinically detectable, and more likely to be at advanced stage. Existing literature on the associations between mammography screening frequency and risk of more advanced breast cancer have mixed results. Studies have showed that advanced breast cancer costs more to treat, but real-world cost estimates following different mammography screening frequencies are unavailable. To fill the gaps, this dissertation aimed to quantify the clinical and financial impact following annual …

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Characterizing Risk & Burden Of Lower Cranial Neuropathy (Lcnp) As Late Effect Among Oropharyngeal Cancer Survivors, Puja Aggarwal Dec 2019

Characterizing Risk & Burden Of Lower Cranial Neuropathy (Lcnp) As Late Effect Among Oropharyngeal Cancer Survivors, Puja Aggarwal

Dissertations and Theses (Open Access)

Background: Lower cranial neuropathy (LCNP) is a rare but potentially disabling late effect of radiotherapy (RT) and other head and neck cancer therapies. Survivors who develop late LCNP may experience profound functional impairment with deficits in swallowing, speech, and voice. The aims of this research were: 1) to quantify the cumulative incidence of late LCNP and identify clinical predictors of late LCNP; 2) to investigate the impact of late LCNP on severity of cancer treatment-related symptoms, general functional impairment (GFI), and single item scores of the most severe symptoms; and 3) to quantify the association of late LCNP with swallowing-related …

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Moving Beyond The Single Gene: Integrative Gene Set Analysis For Rna-Seq, Andrew Richard Aschenbrenner Dec 2019

Moving Beyond The Single Gene: Integrative Gene Set Analysis For Rna-Seq, Andrew Richard Aschenbrenner

Dissertations and Theses (Open Access)

RNA-seq is the next-generation sequencing technology for gene expression and while many tools have been developed to assess differential expression, most focus on gene-level statistics. Gene-level statistics implicitly ignore any dependence among genes. In order to directly incorporate correlation into testing for differential expression, genes are sorted into networks using Ingenuity Pathway Analysis (IPA) and the gene expression of each network is modeled using Generalized Estimating Equations (GEE). Since the gene network data often exhibits correlation structures containing positive and negative values, a new intermediate correlation structure is developed. This structure provides a compromise between an exchangeable (one parameter for …

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Physical Activity Among Preschool-Aged Children: Considerations For Waking Activity Patterns And Health, Erin Dooley Dec 2019

Physical Activity Among Preschool-Aged Children: Considerations For Waking Activity Patterns And Health, Erin Dooley

Dissertations and Theses (Open Access)

With nearly one-quarter (23%) of U.S. preschool children (ages 3-5 years) having overweight or obesity, supporting healthy growth and development is paramount. Hispanic children have the highest prevalence within this age group (15.6%) and a large projected population growth. Energy expenditure through physical activity is one way to combat excess development of obesity and poor health outcomes. Yet there is limited evidence about the correlates associated with physical activity and health within this population. The three studies of this dissertation examined sociodemographic-, cultural-, and context-related factors related to waking activity patterns and the subsequent impact on health indicators. The overall …

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Quantifying The Financial & Clinical Impact Of Annual Vs. Biennial Mammography Screening, Danmeng Huang Dec 2019

Quantifying The Financial & Clinical Impact Of Annual Vs. Biennial Mammography Screening, Danmeng Huang

Dissertations and Theses (Open Access)

Current guidelines for screening mammography recommend different start ages and intervals for women with average cancer risk. Longer intervals between mammograms allow more time for a tumor to grow, to become symptomatic and clinically detectable, and more likely to be at advanced stage. Existing literature on the associations between mammography screening frequency and risk of more advanced breast cancer have mixed results. Studies have showed that advanced breast cancer costs more to treat, but real-world cost estimates following different mammography screening frequencies are unavailable. To fill the gaps, this dissertation aimed to quantify the clinical and financial impact following annual …

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Epidemiological Evaluation Of The National Sickle Cell Screening Program In The Republic Of Uganda, Arielle G. Hernandez Dec 2019

Epidemiological Evaluation Of The National Sickle Cell Screening Program In The Republic Of Uganda, Arielle G. Hernandez

Dissertations and Theses (Open Access)

Sickle cell anemia contributes substantially to childhood morbidity and mortality in sub-Saharan Africa, where there are scarce health resources and inadequate awareness among healthcare providers and the community. Without early diagnosis and initiation of preventive treatments, most infants will die of acute complications before their fifth birthday. Information on the mortality associated with sickle cell anemia is excluded from global statistical summaries due to the lack of accurate data, making sickle cell anemia an invisible killer of children on the African continent. Information from long-term large-scale sickle cell screening efforts is not yet available in Africa; therefore, a mixed-methods study …

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The Associations Between Fat And Clinical Outcomes Among Lung Cancer Patients: Dietary Intake And Genetic Determinants, Fang Yu Lin Dec 2019

The Associations Between Fat And Clinical Outcomes Among Lung Cancer Patients: Dietary Intake And Genetic Determinants, Fang Yu Lin

Dissertations and Theses (Open Access)

Higher dietary fat intake and alterations in fatty acid metabolism may affect cancer development and progression. This dissertation conducted a series of studies examining whether dietary fat intake and genetic variants in fatty acid metabolism genes have an impact on clinical outcomes among non-Hispanic whites newly diagnosed with non-small cell lung cancer (NSCLC). First, a cohort of 2,262 NSCLC patients was prospectively examined for intakes of total, saturated, monounsaturated, and polyunsaturated fat in relation to overall survival and recurrence. Dietary fat intake at diagnosis was assessed with a previously validated food frequency questionnaire and categorized by Dietary Reference Intakes. Multivariable …

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External Environmental Dimensions And Financial Performance Of Major Teaching Hospitals In The U.S, Karima Lalani Dec 2019

External Environmental Dimensions And Financial Performance Of Major Teaching Hospitals In The U.S, Karima Lalani

Dissertations and Theses (Open Access)

Background: Teaching hospitals have a unique mission to not only deliver graduate medical education, but to also provide both inpatient and ambulatory care, and to conduct clinical and medical research; therefore, they are under constant financial pressure, and it is important to find out what types of external environmental components affect their financial performance. No recent studies have been comprehensively conducted for all major teaching hospitals in the U.S. to examine if there is an association between the external environmental dimensions based upon Resource Dependence Theory (Munificence, Uncertainty, Complexity) and the short-term financial performance, measured by days cash on hand …

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Access To Antibiotics Without Prescription For Travelers And Colombian Citizens At Community Pharmacies In Bogota, Colombia, Marie Kasbaum Dec 2019

Access To Antibiotics Without Prescription For Travelers And Colombian Citizens At Community Pharmacies In Bogota, Colombia, Marie Kasbaum

Dissertations and Theses (Open Access)

The misuse of antibiotics has been shown to exacerbate the global antibiotic resistance crisis, which could have major consequences on public health worldwide (Auta et al., 2018). In Bogotá, Colombia, the non-prescription sale of antibiotics still occurs in pharmacies despite national regulations requiring a prescription from a physician or health agency before dispensing antibiotics to a patient (Vacca et al., 2011). The purpose of this study was to investigate the non-prescription sale of antibiotics in community pharmacies to foreign travelers and Colombian citizens in Bogotá, Colombia. Trained Simulated Clients (SCs) gathered experimental data in pharmacies distributed throughout 20 geographic districts …

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Examining Differences In Physical Activity By Socio-Demographics, Employment, And Social Support Among U.S. Adolescents, Ashleigh Marie Johnson Dec 2019

Examining Differences In Physical Activity By Socio-Demographics, Employment, And Social Support Among U.S. Adolescents, Ashleigh Marie Johnson

Dissertations and Theses (Open Access)

The overall decline in physical activity levels during adolescence supports the examination of intrapersonal-, interpersonal-, and behavior-level factors that may influence physical activity behavior among this population. The three papers within this dissertation aimed to examine associations of socio-demographics and socio-environmental factors with physical activity among U.S. adolescents. Papers 1 and 3 used data from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Paper 1 examined differences in adolescent physical activity by gender and race/ethnicity, and examined modification by grade and socioeconomic status (SES). Paper 3 examined the association of parent- and adolescent-reported parental social support with adolescent …

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Nonlinear Functional Models On Causal Inference, Rong Jiao Dec 2019

Nonlinear Functional Models On Causal Inference, Rong Jiao

Dissertations and Theses (Open Access)

Statistical analysis has experienced significant progress on association study, but it remains elusive to understand the etiology and mechanism of complex phenotypes. As a major analytical platform, association analysis may hamper the theoretic development of biomedical science and its application. Thus, many researchers suggest making the transition from association to causation. The mainstream of research in genetics and epigenetics data analysis focuses on statistical association or exploring statistical dependence between variables. Despite significant progress in dissecting the genetic architecture of complex diseases by genome-wide association studies (GWAS), the signals identified by association analysis can only explain a small proportion of …

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Understanding The Relatlonships Between Survivorship Care Plans And Survivor Level Outcomes Among Breast And Colorectal Cancer Survivors, Jessica Danielle Austin Dec 2019

Understanding The Relatlonships Between Survivorship Care Plans And Survivor Level Outcomes Among Breast And Colorectal Cancer Survivors, Jessica Danielle Austin

Dissertations and Theses (Open Access)

PURPOSE: Cancer survivors have complex journeys following the completion of active treatment. The Institute of Medicine and other high-profile organizations have recommended and mandated the use of a survivorship care plan (SCP) despite mixed evidence supporting the impact of SCPs on key survivor-level outcomes. The purpose of this dissertation was to understand the complex relationship linking the delivery of SCPs and to relevant survivorlevel outcomes. STUDY GROUP: This dissertation focuses on breast and colorectal cancer survivors because they comprise nearly 30% of the entire cancer survivor population in the US and are the two most prevalent cancers in men and …

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2019 Winter Undergraduate And Graduate Commencement, Belleville Campus, Lindenwood University Dec 2019

2019 Winter Undergraduate And Graduate Commencement, Belleville Campus, Lindenwood University

Commencement Programs

Lindenwood University, Belleville commencement program.

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2019 Winter Undergraduate Commencement, Lindenwood University Dec 2019

2019 Winter Undergraduate Commencement, Lindenwood University

Commencement Programs

Lindenwood University Commencement program.

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Modeling Of Characteristics On Artificial Intelligence Iq Test: A Fuzzy Cognitive Map-Based Dynamic Scenario Analysis, Fangyao Liu, Yayu Peng, Zhengxin Chen, Yong Shi Dec 2019

Modeling Of Characteristics On Artificial Intelligence Iq Test: A Fuzzy Cognitive Map-Based Dynamic Scenario Analysis, Fangyao Liu, Yayu Peng, Zhengxin Chen, Yong Shi

Information Systems and Quantitative Analysis Faculty Publications

This research article uses a Fuzzy Cognitive Map (FCM) approach to improve an earlier proposed IQ test characteristics of Artificial Intelligence (AI) systems. The defuzzification process makes use of fuzzy logic and the triangular membership function along with linguistic term analyses. Each edge of the proposed FCM is assigned to a positive or negative influence type associated with a quantitative weight. All the weights are based on the defuzzified value in the defuzzification results. This research also leverages a dynamic scenario analysis to investigate the interrelationships between driver concepts and other concepts. Worst and best-case scenarios have been conducted on …

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Maximizing Your Personal Virtual Presence, Michael L. Williams, Alan R. Dennis, C. Brad Crisp Dec 2019

Maximizing Your Personal Virtual Presence, Michael L. Williams, Alan R. Dennis, C. Brad Crisp

Management Sciences

Drawing upon recent research, this article offers practical advice on two key elements of working in virtual settings: managing your digital profile and learning to focus at a distance. The first offers insights on how to create and reinforce a trustworthy identity with people who do not know you well. The second examines how you can overcome barriers to effective collaboration with physically distant others. Both elements attempt to overcome the challenges of being known and present to others in a digital age.

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Case Study Analysis Of Shared Visual Arguments And Propaganda Techniques Of Russian Propaganda Posters And Russian Internet Memes, Cindy D. Vasquez Dec 2019

Case Study Analysis Of Shared Visual Arguments And Propaganda Techniques Of Russian Propaganda Posters And Russian Internet Memes, Cindy D. Vasquez

Communication Theses - Archive

Rhetoric, the study of argument using logic, has been studied for centuries. However, there is some disagreement among scholars on whether or not argumentation can be applied to visual imagery. Images are noted to have more emotional appeal than text does. Visual propaganda was mass produced in the form of propaganda posters, most popularly in the early 20th century. In more recent times, the sharing of images has moved to social media, popularly through memes. This paper analyzes two Soviet propaganda posters produced by one Soviet publishing house, Litizdat, and two memes created by the Russian organization the Internet Research …

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“Making A Way Out Of No Way”: The Oblate Sisters Of Providence Pursue Higher Education Under Jim Crow, Diane Batts Morrow Dec 2019

“Making A Way Out Of No Way”: The Oblate Sisters Of Providence Pursue Higher Education Under Jim Crow, Diane Batts Morrow

Journal of the Black Catholic Theological Symposium

Organized in the slave-holding city of Baltimore, Maryland in 1828, the Oblate Sisters of Providence dedicated themselves as “a Religious society of Coloured Women . . . [who] renounce the world to consecrate themselves to God, and to the Christian education of young girls of color.” Early in the sisterhood’s existence Oblate co-foundress Mother Mary Elizabeth Lange had explicitly articulated their consciousness of their exceptionalism as “persons of color and religious at the same time” who nevertheless sought “the respect which is due to the state we have embraced and the holy habit which we have the honor to wear” …

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Priestly Formation And Sexual Abuse In The Roman Catholic Church: In Dialogue With The Nigerian Church, Simonmary Asese Aihiokhai Dec 2019

Priestly Formation And Sexual Abuse In The Roman Catholic Church: In Dialogue With The Nigerian Church, Simonmary Asese Aihiokhai

Journal of the Black Catholic Theological Symposium

Reading the signs of the times today cannot be done legitimately without a critical look at the current sex abuse crisis perpetuated by the clergy of the Roman Catholic Church. To deny the fact that the Church has a crisis on its hands is to trivialize the pain and sorrow experienced by all in the Church, and most especially by the victims of the crisis. This work provides an x-ray vision of some of the factors shaping this crisis and boldly offers some interventions that can help the Church to navigate its way out of the crisis. There is an …

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The Effect Of Adverse Childhood Experiences On Psychosocial Wellbeing, Gabrielle C. Yundt Dec 2019

The Effect Of Adverse Childhood Experiences On Psychosocial Wellbeing, Gabrielle C. Yundt

Doctor of Psychology (PsyD)

As a result of adversity, trauma, or maltreatment, a child’s primary defense is to engage in self-blame in order to maintain a belief in a safe world. Without intervention, these adaptive strategies may continue to shape the way survivors relate to themselves and make meaning out of negative events. This study hypothesized that participants with adversity in childhood have an increased likelihood of low self-compassion (indicating tendencies towards self-judgment, overidentification, and isolation). This study further hypothesized a positive correlation between posttraumatic growth, resilience and hardiness. Participants in this study were adults recruited from three online sites (social networking, online forum, …

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An Experimental Comparison Of Visual And Statistical Analyses, Stevie A. Collini Dec 2019

An Experimental Comparison Of Visual And Statistical Analyses, Stevie A. Collini

Dissertations

Visual analysis is the favored method for analyzing single-subject research data in more traditional behavior analysis programs of study; however, some critics of the practice argue that it should not be the only method used to analyze data given the previous research demonstrating significant inconsistencies in conclusions drawn based on the practice (Bulté & Onghena, 2012; Campbell & Herzinger, 2010; Kazdin, 2011). Supporters of statistical analysis have argued that although statistical analyses are not free from subjectivity and bias, the decision-making processes and criteria are more straightforward than those offered by the complexities involved in visual analysis (Kazdin, 2011). It …

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Behavioral Skills Training And Literacy: Supporting Reading Instructors In Adult Education Centers, Mya L. Hernandez Dec 2019

Behavioral Skills Training And Literacy: Supporting Reading Instructors In Adult Education Centers, Mya L. Hernandez

Dissertations

The present study evaluates the effects of a behavioral skills training package (BST) on training adult literacy tutors to implement the steps of BST when teaching parents with low literacy. Four adult literacy tutors participated in the study along with one parent with low literacy. The primary dependent variable was the percentage of steps of the BST package implemented correctly during tutor training probe measures. Secondary measures were taken on the parent’s performance of each step of the literacy activities on which they were trained. In baseline, all tutors were provided with instructions for performing two literacy activities and tutors …

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“Called Forth By Imminent Dangers”: The American Gothic In Mysteries Of Detection And Detective Fiction (1799-1929), Keli Masten Dec 2019

“Called Forth By Imminent Dangers”: The American Gothic In Mysteries Of Detection And Detective Fiction (1799-1929), Keli Masten

Dissertations

The period from 1799 through 1929 marks a remarkable era of development for gothic themes in American mystery and investigative fiction. From early “mysteries of detection” through more structurally formalized detective stories, this project examines the differences in the gothic modes and devices employed by Charles Brockden Brown, Edgar Allan Poe, Anna Katharine Green, Mark Twain, and Dashiell Hammett, and their significant contributions to the progression of the popular gothic detective genre. Through the study of each author’s specific style and focus, there is much to learn about literary development and cultural influence. All of the authors mentioned here address …

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Scalable Algorithms And Hybrid Parallelization Strategies For Multivariate Integration With Paradapt And Cuda, Omofolakunmi Elizabeth Olagbemi Dec 2019

Scalable Algorithms And Hybrid Parallelization Strategies For Multivariate Integration With Paradapt And Cuda, Omofolakunmi Elizabeth Olagbemi

Dissertations

The evaluation of numerical integrals finds applications in fields such as High Energy Physics, Bayesian Statistics, Stochastic Geometry, Molecular Modeling and Medical Physics. The erratic behavior of some integrands due to singularities, peaks, or ridges in the integration region suggests the need for reliable algorithms and software that not only provide an estimation of the integral with a level of accuracy acceptable to the user, but also perform this task in a timely manner. We developed ParAdapt, a numerical integration software based on a classic global adaptive strategy, which employs Graphical Processing Units (GPUs) in providing integral evaluations. Specifically, ParAdapt …

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