Medicine and Health Sciences Commons^™

Co-Creating A Social, Emotional, And Mental Health Well-Being Group For College Students With Disabilities And/Or Chronic Health Conditions And Are Registered With Disability Support Services, Consuelo A. Click Copeland

All ETDs from UAB

ABSTRACT Nearly one in four adults in the United States report living with a disability (Centers for Disease Control and Prevention, 2024). According to the National Center for Educational Statistics (2023), approximately 21 percent of undergraduate students and 11 percent of postbaccalaureate students report having a disability. Students with disabilities in college encounter considerable obstacles that can adversely affect their mental health, academic performance, and general well-being. These obstacles encompass social isolation, stigma, and insufficient personalized support services, resulting in increased levels of anxiety, depression, and dropout rates compared to students without disabilities. Despite the critical need, there is a …

Optimizing Recruitment Strategies, Outcome Measures, And Intervention In Clinical Research With Adults With Multiple Sclerosis: Insights From The Tele-Exercise And Multiple Sclerosis (Teams) Study, Tracy Flemming Tracy

All ETDs from UAB

Background: Recruiting people with multiple sclerosis (PwMS) into research can be a significant challenge. This is often due to limited awareness of the research objectives, lack of accessibility, and restrictive inclusion criteria. In addition to a general reluctance to participate, assessing multiple sclerosis (MS) and assigning appropriate interventions can be challenging due to the heterogeneity of symptoms. Identifying outcome measures that accurately reflect a participant’s perception and functional performance, while remaining sensitive to change across different levels of disability, poses a challenge. Methods: Data from the Tele-Exercise and Multiple Sclerosis (TEAMS) trial was analyzed to identify effective recruitment strategies (Study …

Platal Expansion Using The Invisalign Palatal Expander "Ipe", Hassan Chihab

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Palatal expansion has been used in orthodontics to treat a narrow maxilla and to primarily correct posterior dental crossbites. In younger patients, palatal expansion can readily be achieved through opening of the mid-palatal suture, as it is not fused at that age. As the mid-palatal suture matures, expansion will gradually be difficult to achieve, and more dental expansion is obtained rather than skeletal. In addition, there is a tendency to get more dental tipping. Palatal expansion has been recommended not only to correct crossbites but also to improve breathing in patients with sleep disorders such as obstructive sleep apnea (OSA). …

Effect Of Pre-Treatment Lab-Based Comorbidities On Treatment Related Outcomes Among Patients With Cancer, Jeffrey Alan Franks

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Cancer is one of the leading causes of mortality and morbidity in the United States. In addition to their cancer, nearly 50% of individuals have a comorbid condition. This adds complexity to the treatment of these patients as it may delay cancer diagnosis or treatment or prevent treatment all together. Lab-values are an important tool to measure comorbidities and end-organ damage as they are routinely captured as part of standard of care and the basis of clinician decision making. However, despite the widespread multimorbidity and how crucial they are to decision making, few studies assess the association of lab abnormalities …

The Impact Of Transportation Insecurity On No-Show Appointments And Acute Care Utilization In Pediatric Sickle Cell Patients, Seabrook Hannah Jeffcoat

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Sickle cell disease (SCD) patients experience high levels of transportation insecurity. Missed or delayed medical care due to transportation barriers can result in worsened clinical outcomes and increased hospital admissions and emergency department (ED) visits. We hypothesized that the relationship between transportation insecurity and acute care utilization is partially mediated by no-show appointments. This retrospective cohort study included 101 SCD patients aged ≤ 21 treated through the Pediatric Sickle Cell Clinic at Children’s of Alabama (COA) hospital from 2023 to 2024 and completed a social determinants of health (SDoH) questionnaire. Negative binomial or Poisson regression was used to model ED …

Optic Nerve Head Remodeling In Experimental High Myopia, Mahmoud Khalafallah

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Myopia is a global health concern, with projected estimates that nearly half of the world's population will be myopic by 2050. While its refractive aspect can be corrected, the heightened susceptibility to sight-threatening comorbidities, particularly with high myopia, remains a challenge. Among these comorbidities, glaucoma is a major concern, with myopia recognized as an independent risk factor. However, the mechanistic link between myopia and glaucoma remains poorly understood. This dissertation investigates the multiscale remodeling changes in experimental high myopia and their potential implications for increased risk of glaucoma later in life. Using a multimodal approach, this dissertation investigates: (1) neural …

"The Association Between Serious Psychological Distress And Life Satisfaction Among U.S Adults With Hypertension", Kellen Michael Lenz

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Purpose: Given the observed link between psychosocial and physical health outcomes, this study investigates the association between serious psychological distress and life satisfaction among U.S adults with hypertension. Methods: A cross-sectional study using 2021 National Health Interview Survey data among U.S adults was conducted to investigate the association between serious psychological distress and hypertension and assess the role of life satisfaction in modifying this relationship. Hypertension (diagnosed, undiagnosed), serious psychological distress (≥ 13 on the Kessler 6 nonspecific distress scale), and life satisfaction (Very satisfied, Satisfied, Dissatisfied, Very dissatisfied) were self-reported by participants. Ordinal logistic regression was used to investigate …

Accuracy Of 3d Printed Models With Various Range Of Crowding Created By Dlp Printer With Different Designs Of Model Base, Chih Yen Liu

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Objective: Treatment planning and appliance fabrication depend on the accurate representation of dentition. Research on the accuracy of digital light processing (DLP) printed models with different base designs across various levels of dental crowding remains limited. This study aims to evaluate the fidelity of DLP printed models and the suitability of different base designs for representing dentition with mild, moderate, and severe crowding. Materials and Methods: The objective is to determine the optimal base designs for DLP-printed models to address varying degrees of dental crowding. A two-way ANOVA was used to compare root mean square (RMS) error across different base …

Molecular Imaging Of Triple-Negative Breast Cancer: Characterization And Modulation Of The Tumor Microenvironment, Shannon E. Lynch

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Triple-negative breast cancer (TNBC) is an aggressive, heterogeneous subset of breast cancer which currently has no targeted therapies available due to lack of molecular therapeutic targets. Importantly, various radiopharmaceuticals can be imaged via positron emission tomography (PET) to quantify cellular and molecular features of the tumor microenvironment including glucose metabolism, receptor status, and immune activation. Somatostatin receptor subtype 2 (SSTR2) is G-protein coupled receptor overexpressed in neuroendocrine tumors (NETs) which can be imaged and targeted for theranostics via FDA-approved radiotherapy. SSTR2 expression is increased in hormone positive breast cancer but is expressed at low or variable levels in TNBC. However, …

Evaluating Multiparametric Imaging Biomarkers For Guiding Targeted Therapies In Her2+ Breast Cancer, Ameer Mansur

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Human epidermal growth factor receptor 2 positive (HER2+) breast cancer is a biologically diverse disease, in which intratumoral heterogeneity plays a significant role in tumor progression. Advanced medical imaging and image processing techniques offer the potential to noninvasively characterize the underlying intratumoral biology. Capturing these complex changes can allow for assessing therapeutic response and eventually guiding personalized therapeutic strategies. This work evaluates single and multiparametric imaging biomarkers to characterize tumor biology, identify treatment-induced changes, and predict response to targeted therapies. First, the utility of 3’-Deoxy-3’-[18F]Fluorothymidine positron emission tomography ([18F]FLT-PET) was assessed as a biomarker of proliferation for monitoring response to …

Investigating Potential Therapeutic Vulnerabilities And Elucidating Molecular Mechanisms For The Tumor Suppressors Nfkbia And Anxa7 In Diffuse Gliomas, Aran Merati

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Gliomas, and especially diffuse gliomas, can be a devastating disease when attempting treatment in the clinic. Diffuse gliomas are typically malignant and pose definitive problems with respect to patient care predominantly due to their ability to exist outside of the bulk tumor by invading into the surrounding brain parenchyma. Consequently, not every cancerous cell can be fully removed by surgical resection and therapeutic resistance, so the stem-like population left behind can repopulate a recurrent tumor from a single cell. There is a desperate need for pinpointing novel therapeutic vulnerabilities in diffuse gliomas, which could potentially involve the targeting of key …

Maternal Immune Activation Causes Oligodendrocyte Deficits In The Hypothalamus, Kate Miller

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Maternal immune activation (MIA) refers to the occurrence of an inflammatory immune response during any stage of pregnancy. This manifests as the upregulation of proinflammatory cytokines and can be caused by air pollution, obesity, or viral infection. When this occurs during the first trimester in humans, it increases the offspring’s susceptibility to developing neuropsychiatric disorders such as autism (ASD) and schizophrenia (SZ), in males more commonly than females. In addition to behavioral manifestations of neuropsychiatric disorders, metabolic syndrome (MetS) is a common comorbidity, defined as the co-occurrence of three or more symptoms including but not limited to hyperlipidemia, hypertension, and …

Exploring The Impact Of Returning To Office Work Post-Pandemic On The Mental Health Of Workers: A Cross-Sectional Analysis, Jasmine M. Nelson

All ETDs from UAB

This study examines the association between work settings and mental health outcomes among Black working-aged women, with a focus on racial disparities and the role of self-care. Using data from the U.S. Census Bureau's 2024 Household Pulse Survey, this cross-sectional analysis includes responses from 196,293 employed women aged 18–65. Mental health outcomes, including anxiety, worry, lack of interest, and depressive symptoms—were assessed through self-reported measures. Work settings were categorized as telework (hybrid/remote) or in-office, and logistic regression models were used to assess associations between work setting and mental health outcomes, adjusting for demographic and socioeconomic factors. Findings indicate that Black …

Exploring Gaps In Hiv Prevention: Hiv Pre-Exposure Prophylaxis Awareness, Attitudes, Utilization, Coverage, Hiv Testing And Risk Perception Among Sub-Saharan African College Students In The United States, Ikenna Obasi Odii

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This dissertation focuses on increasing HIV awareness and contributing to efforts at reducing new HIV infections among Sub-Saharan African (SSA) college students. It begins with an introductory chapter one and ends in the concluding chapter five. Chapter two presents a systematic review identifying key gaps in HIV Pre-Exposure Prophylaxis (PrEP) knowledge, attitudes, and utilization among Black college students in the United States (U.S). The review synthesizes findings from four studies, revealing that a third of participants demonstrated adequate PrEP knowledge, while PrEP utilization remained under-utilized at three percent. Key barriers to PrEP uptake included fear, low self-perceived HIV risk, infrequent …

Everyday Decision-Making Involvement Among Hispanic & Latinx Dementia Caregivers And Its Associations With Daily Anxiety And Daily Depressive Symptoms, Abigail Poe

All ETDs from UAB

Background: Hispanic and Latinx (H&L) caregivers of individuals living with Alzheimer’s disease and related dementias (ADRD) experience elevated caregiving burden and poorer mental health outcomes compared to caregivers from other racial and ethnic groups. Limited research has examined H&L caregivers’ involvement in everyday decision-making for persons living with dementia (PLWD), particularly how this involvement may relate to daily mental health symptoms such as anxiety and depression. Purpose: This study examined baseline decision-making involvement (DMI), its associations with individual-level factors, and its relationship with daily anxiety and depressive symptoms in H&L ADRD caregivers. Methods: A secondary analysis was conducted using data …

Prevalence Of Meibomian Gland Dysfunction In A Young Adult Population, Tyler Thomas

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Background Meibomian gland dysfunction (MGD) varies in prevalence depending on the demographic and can significantly impact quality of life. There is a lack of research on MGD in young adult, professional student populations. Professional students often experience high levels of stress, reduced sleep, and increased electronic device use, which may elevate their risk for developing MGD. Specific Aims This cross-sectional clinical analysis has two specific aims: (1) to determine the prevalence of MGD in a young adult, professional student population, and (2) to identify potential risk factors and clinical assessments correlated with MGD. Methods A total of 147 professional students …

Adapting The Minority Stress Model Among Middle-Aged And Older Adults With And Without Hiv: Understanding The Interplay Between Minority Stress, Mental Health, And Sexual Risk Behaviors, Alexis R Long Thompson

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This dissertation aims to adapt Meyer’s Minority Stress Model to understand the interplay between minority stress, mental health, and sexual risk behaviors among middle-aged and older adults with and without HIV. The study utilizes data from the MACS WIHS Combined Cohort Study, focusing on adults aged 40 and older. It examines the relationships between perceived stress, psychosocial factors (depression, substance use, social support), and sexual risk behaviors, considering the impact of minority identities such as race, gender, sexual orientation, and HIV status. The findings highlight significant differences in perceived stress, depressive symptoms, substance use, and social support across different intersectional …

Stigma In Interactions Between Adolescents With Functional Seizures (Fs) And Healthcare Providers, Arzoo Charania, Shujiya Fatima, Caroline Watson, Aaron D. Fobian

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2024 Fall Expo Online Poster Presentation

• Social & Behavioral Sciences

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Examining Daily-Self Weighing As A Stand-Alone Intervention For Obesity Management, Ashley Parish

All ETDs from UAB

Obesity is an epidemic that has substantial implications for both individuals with the disease as well as the healthcare system in the United States. Individuals with obesity are at increased risk for developing associated co-morbid conditions such as cardiovascular disease, type 2 diabetes, and some forms of cancer, which can affect quality of life and lead to mortality. There are many health behavior interventions which target weight loss, maintenance of weight loss, or weight gain prevention in those with obesity; however, interventions have unique barriers that can vary based on personal, environmental, and social factors. Primary care (PC) settings, which …

Understanding Biopsychosocial Influences On Physical Activity And Quality Of Life In Breast Cancer Survivors, Erica A. Schleicher

All ETDs from UAB

Receiving a breast cancer diagnosis and subsequent treatment can be life-altering, presenting numerous challenges. Breast cancer treatments are effective at allowing women to live longer, but often impose long-term side-effects that survivors must manage for years. Exercise is an effective way to address many long-term side-effects of breast cancer treatment, yet 63-83% of breast cancer survivors do not meet recommended physical activity (PA) guidelines. Due to the complexity of cancer and treatment options, cancer-related factors have potential biopsychosocial impacts that can influence exercise habits, attitudes toward PA (i.e., social cognitive theory (SCT) constructs), and potentially quality of life (QoL). It …

The Effect Of Progranulin On Lysosomal Function In Bv2 Cells, Michelle Park

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Neurodegenerative diseases afflict nearly 7 million people in United states, constituting a significant portion of the 600 known neurological disorders. Characterized by the gradual loss of neurons and axons within the central nervous system (CNS), these conditions stem from chronic inflammatory activation of the brain. Chronic inflammation disrupts important processes such as autophagy lysosome pathway, a self-degradative process that eliminates protein aggregates and damaged organelles. Trehalose, a non-reducing disaccharide that triggers autophagic flux in neuronal cells and promotes the clearance of protein aggregates; however, without understanding the mechanism behind how trehalose affects these functions, it lacks value. In our study, …

Oral Administration Of Alpha-Cyclodextrin Corrects Diabetes Induced Retinopathy And Bone Marrow Pathology By Modulation Of The Gut-Retina Axis., Yvonne Adu-Agyeiwaah

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Diabetic retinopathy represents a common complication of diabetes, exerting a significant financial burden globally across nations, particularly impacting the working-age population and thereby affecting productivity. Extensive investigations have unveiled its multifaceted etiology, implicating a convergence of diverse causative factors. Notably, seminal studies such as the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study have underscored the pivotal role of cholesterol dysregulation and dyslipidemia in the pathogenesis of diabetic retinopathy. This dysregulation stems from an imbalance characterized by heightened cholesterol production coupled with deficient cholesterol efflux or removal mechanisms. Liver X receptors (LXRs), ligand-activated nuclear receptors function in transcriptional …

The Association Between Social Connectedness And Opioid Reuse Among Vulnerable Groups Receiving Medication For Opioid Use Disorder, Jolanda Lynn Hudson

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THE ASSOCIATION BETWEEN SOCIAL CONNECTEDNESS AND OPIOID REUSE AMONG VULNERABLE GROUPS RECEIVING MEDICATION FOR OPIOID USE DISORDER JOLANDA L. HUDSON PUBLIC HEALTH ABSTRACT Introduction: Opioid Use Disorder (OUD) is a serious illness that continues to persist despite the many efforts of researchers, physicians, government agencies, state, and local programs, to eliminate the mortality rate associated with this disease. Although manageable, OUD is still taking the lives of citizens due to illegal opioid misuse. Understanding the dynamics of the disease and the contributing factors in various populations may inform researchers in successful intervention outcomes. Methods: A retrospective secondary data analysis utilizing …

Changes In Drug And Alcohol Behaviors Before And After An Educational Intervention Among At-Risk Adults And Youth, Isabel Cuellar Acker

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Introduction: Substance abuse is defined as the excessive use of a drug in a way that is detrimental to oneself, society, or both. Gender is important to examine because it is becoming more common for females to develop substance use disorders and for their substance use to be more severe. This study will address the role of an education-based intervention on substance abuse in an area that is at the intersection of rural and urban geography with a unique pool of participants. Methods: This is a longitudinal cohort study that has a pre-post intervention design. A linear model was used …

Effects Of Probiotic Lactobacilli On Candida Albicans: Implications For Early Childhood Caries, Leena Unnikrishnan Menon

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Purpose: Probiotic Lactobacillus species are shown to have beneficial effects against early childhood caries (ECC). On the other hand, the wide use of probiotic Lactobacillus spp. in dairy foods is believed to underline the global increase in ECC prevalence. Candida albicans has been frequently detected in children with ECC and has shown cariogenic potential in animal models of dental caries. The objective of this study was to determine the interactions between lactobacilli and C. albicans in growth competition, biofilm formation and acid production. Methods: Growth competition between C. albicans SC5314 and probiotic L. rhamnosus GG or caries-associated L. rhamnosus M72-26 …

A Five-Year Review Of State Dental Board Disciplinary Actions, Phorum Desai

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Introduction: Ethical violations not only tarnish the reputation of dental professionals but also compromise the trust patients place in the dental field. A review of documented legal violations provides valuable insights into the common ethical transgressions and potential deficiencies in dental ethics education. This study aims to identify common violations reported by state dental boards and trends of violations over five years. Material and Methods: After a broad preliminary search, nine state dental boards with fully accessible records from January 2017 to December 2021 were selected for a thorough review: California, Iowa, Kentucky, Maine, Minnesota, Nebraska, New Jersey, South Dakota, …

Factors Associated With Early Onset Anal Cancer And Facilitators And Barriers To Screening Among Men Living With Hiv And Their Providers In The Deep South: A Mixed Methods Investigation, Anna Junkins

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For my dissertation work, I aimed to 1) determine the occurrence of early onset (diagnosis at <50 years) anal cancer and the impact of HIV infection and other risk factors, and 2) utilize a mixed methods research approach to identify and explain factors associated with screening among men living with HIV (MLHIV) and their providers. In Aim 1, I used logistic regression to estimate the odds of early onset cancer by sociodemographic and clinical characteristics among anal cancer patients in the Alabama cancer registry from 2012-2018. Among 519 patients, 17.7% were diagnosed at <50 years. Male sex, Black race, and HIV infection were associated with younger age at diagnosis. Black patients had a 4-fold increased odds of early onset anal cancer compared to White patients and disproportionately lived in areas with higher social vulnerability. In Aim 2, I used logistic regression to estimate the odds of anal cancer screening by sociodemographic and sexual risk characteristics among MLHIV using retrospective survey data from 1917 Clinic in 2018. Among 1,114 men, 52% had received an anal pap within one year of completing the survey. Men who were screened were more likely to have multiple sexual partners. Heterosexual men had lower odds and men who reported unprotected anal sex had higher odds of screening. Older Black men were less likely to be screened. In Aim 3, I used thematic analyses to identify themes related to health beliefs, barriers and facilitators, and perceived and evaluated need of screening using in-depth interviews among MLHIV and their providers. Benefits of screening among MLHIV were early detection and awareness about one’s body. Suggestions for overcoming barriers to screening among providers included screening guidelines, patient education, inclusion of screening into routine care, and self-collection. Among men that were aware of HPV-associated cancers, there was perceived risk and desire to receive HPV vaccination. Individuals who are male, Black, or living with HIV may be at increased risk of developing anal cancer younger. Among MLHIV, improving education about HPV-associated cancer, and offering self-collected screening as part of routine care could facilitate screening in the South.

Cross-Sectional Retrospective Study To Determine The Prevalence Of Periodontal Bone Loss As A Function Of Age In The Predoctoral Clinic Patient Population, Lincoln Nguyen

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Age has a significant effect on the body’s ability fight off disease, recover, and maintain collagen structures, and it has been observed that older adults have a higher prevalence of periodontal diseases. Studies have shown that age is a risk factor for alveolar bone loss. However, there is a lack of research done looking at if this is a linear progression or if there is a specific age that susceptibility increases. The aim of this study is to investigate (1) changes in radiographic bone loss in varying age groups in the University of Alabama patient population and (2) to evaluate …

Improving Direct Oncolytic Effect Of Oncolytic Hsv To Overcome Therapeutic Resistance Of Brain Tumors, Sam Edward Gary

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Central nervous system tumors, especially malignant brain tumors, account for the most years of potential life lost in adults and children with cancer. Malignant brain tumors are typically fatal cancers due to their highly aggressive nature, inability to obtain gross total resection, location in sensitive brain areas, and intra- and intertumoral heterogeneity, making therapeutic targeting difficult. High-grade glioma (HGG), malignant brain tumors of glial cell origin invariably recur due to intrinsic and adaptive resistance mechanisms against standard therapies. Therefore, novel treatments that overcome therapeutic resistance are desperately needed. One promising approach is oncolytic viruses (OVs), which achieve tumor regression by …

Investigating Molecular Mechanisms Behind Neuronotypic Gba1 Mutations In Lewy Body Dementias, Casey Mahoney-Crane

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Nonmotor deficits are present in nearly all Parkinson’s disease (PD) patients, with ~80% of these patients developing dementia. Importantly, expression of the severe GBA1 L444P heterozygous mutation increases the risk for Parkinson’s disease devel-opment by 5.43 times compared to mild mutation carriers. Currently, many PD treat-ments predominately focus motor symptoms, while treatments for nonmotor symptoms, such as visual-spatial difficulties and dementia, focus on symptom management and continue to remain elusive. Therefore, understanding the molecular mechanisms behind these nonmotor symptoms is essential for the development of effective therapeutics leading to slower disease progression. The work presented in this dissertation sought to …