Medicine and Health Sciences Commons^™

Mining High Impact Combinations Of Conditions From The Medical Expenditure Panel Survey, Arjun Mohan

Masters Theses

The condition of multimorbidity — the presence of two or more medical conditions in an individual — is a growing phenomenon worldwide. In the United States, multimorbid patients represent more than a third of the population and the trend is steadily increasing in an already aging population. There is thus a pressing need to understand the patterns in which multimorbidity occurs, and to better understand the nature of the care that is required to be provided to such patients.

In this thesis, we use data from the Medical Expenditure Panel Survey (MEPS) from the years 2011 to 2015 to identify …

Association Of Birth Weight And Preterm Birth With Subsequent Risk For Hypertension In Women From The Women’S Health Initiative, Christian P. Daniele

Masters Theses

Hypertension is a chronic disease with an estimated prevalence of nearly 50% in US adults. In addition to sociodemographic and lifestyle factors, evidence suggests that in utero and early life exposures may contribute to life-long risk of hypertension. This study aimed to investigate the potential associations between an individual’s birthweight and preterm birth status with their risk for hypertension in the Women’s Health Initiative (WHI) cohort. WHI is a large, multi-racial cohort of postmenopausal women. At study entry, birthweight and preterm birth status were self-reported by category (< 6 lbs., 6-7 lbs. 15 oz., 8-9 lbs. 15 oz., or ≥ 10 lbs.; ≥ 4 weeks premature or full term). Baseline and incident hypertension status were self-reported; mean systolic blood pressure, diastolic blood pressure, and 30-second pulse were also recorded at baseline by trained study staff. Linear, logistic, and Cox-proportional hazards regression models were used to generate crude and adjusted beta estimates, odds ratios, and hazards ratios, respectively. After adjusting for demographic and lifestyle factors, we found that participants born at a low birthweight had a higher mean systolic blood pressure than participants born at a normal birthweight and were at increased risk for both baseline and incident hypertension. Women born at a higher birthweight had a lower mean systolic blood pressure and were at lower risk for baseline and incident hypertension. When compared to participants born full term, participants born preterm were at increased risk for baseline and incident hypertension. These results support current research on early life exposures and health risks later in life. Long term follow-up or targeted counseling may be required for individuals born prematurely or at low birthweights to prevent and treat hypertension and associated cardiovascular outcomes.

Sexual Orientation Differences In The Association Between Cancer Diagnosis And Mental Health Outcomes, Pablo Fernandez

Masters Theses

Background: Since the early 1960s, survival rates among cancer survivors have been increasing. Surviving cancer can be a stressful experience due to the multifaceted changes that come with diagnosis, treatment, and recovery. Therefore, studying the mental health of cancer survivors is vital for their well-being. Among queer groups (including those identifying as gay, lesbian, or bisexual), poor mental health is more prevalent than among heterosexuals. However, cancer survivorship among queer populations is not well studied. This study examines the association between cancer survivorship and poor mental health, focusing on potential sexual orientation differences.

Methods: Data are from the 2019-2021 National …

Sexual Orientation Differences In The Association Between Physical Activity And Allostatic Load: Results From The National Health And Nutrition Examination Study, Natalia I. Putnam

Masters Theses

Higher levels of allostatic load (AL), a composite measure of the impact of chronic stress on the body, are found among socially marginalized groups compared to privileged groups. AL is associated with premature aging and death, as well as a variety of chronic health conditions that impact quality of life. Effects of AL may be offset by physical activity (PA). Queer populations (including those who identify as lesbian, gay, or bisexual) may be at risk for elevated AL due to repeated exposure to discrimination in the form of sexual minority stress. There is mixed literature on sexual orientation differences in …

Forecasting Covid-19 With Temporal Hierarchies And Ensemble Methods, Li Shandross

Masters Theses

Infectious disease forecasting efforts underwent rapid growth during the COVID-19 pandemic, providing guidance for pandemic response and about potential future trends. Yet despite their importance, short-term forecasting models often struggled to produce accurate real-time predictions of this complex and rapidly changing system. This gap in accuracy persisted into the pandemic and warrants the exploration and testing of new methods to glean fresh insights.

In this work, we examined the application of the temporal hierarchical forecasting (THieF) methodology to probabilistic forecasts of COVID-19 incident hospital admissions in the United States. THieF is an innovative forecasting technique that aggregates time-series data into …

Enhancing Long-Term Outcomes: Implementing Community Engaged Research To Augment Substance Use Disorder Treatment, Kevin M. Quinn

Masters Theses

The Universal Evaluation Tool is an intuitive self-assessment instrument to enhance long-term treatment outcomes for Guiding Light’s residential addiction rehabilitation program. Designed as a versatile method for collecting primary data, the Universal Evaluation Tool can be administered to clients at any point during the recovery program (i.e., intake to discharge). The data collected from the survey can be used as a framework to guide treatment decisions, develop personalized care plans, offer insight into a client’s progress, and collect baseline data (e.g., sociodemographic characteristics) on a treatment population for use in grant applications.

A pilot study to generate preliminary data was …

Effects Of Dietary Phytoestrogens On Spermatogenesis And Male Reproductive Tract In Mice, Trenton A. Dalm

Masters Theses

Increases in infertility over the past 50 years are linked to environmental exposures to endocrine disrupting chemicals (EDCs). One type of EDC is phytoestrogens, commonly found in soy-based diets and foods such as cauliflower, tofu, and broccoli. Phytoestrogens may bind estrogen receptors and have positive or negative effects on receptor signaling. The developing male reproductive tract is potentially susceptible to endocrine disruptors leading to changes in adult reproductive function and possibly infertility. We hypothesized that dietary phytoestrogen exposure would have a dose dependent effect with the high diet yielding the lowest sperm count and worst performance compared to the medium …

Black Bear Population Health Monitoring In The Southeast, Kathleen Elizabeth Riese

Masters Theses

Recent growth of the American black bear (Ursus americanus) population in the southeast raises concerns about the potential spread of density-dependent diseases among bears, particularly sarcoptic mange. However, research on the health of bears in this area is limited. We analyzed samples from 169 bears in the region. We performed Knotts tests, skin scrapes, fecal floats; Canine adenovirus (CAV), canine parvovirus (CPV), canine distemper virus (CDV), and Toxoplasma gondii serology, Trypanosoma, Rickettsia rickettsii, and apicomplexan PCR, and identified ecto- and endoparasites found grossly or histologically. We found that 69% (63 of 91) had microfilaria; genetic analysis identified …

Reintroducing Hemp (Rongony) In The Material Palette Of Madagascar: A Study On The Potential Of Hemp Clay Components And Its Impact On Social And Ecological Communities., Henintsoa Thierry Andrianambinina

Masters Theses

When mentioning the word hemp, especially in the local language of Madagascar, the literal translation does not set it apart from marijuana, as they are both called “rongony” - creating the stigma around hemp as the negative stereotype of marijuana. However, the material has been used by the ancestors of Madagascar, as well as across cultures, in its fibrous form to produce fabrication like textile goods and packaging. During colonization, the prohibition of hemp intensified, and since then, any activity related to either of these plants is prohibited and will end in severe punitive measures. This thesis explores the strengths …

Moving At The Speed Of Trust, Sun Ho Lee

Masters Theses

Moving at the Speed of Trust is a workbook of strategies — practices, definitions, and techniques — to nurture community-building in support of inbetweeners who live between power structures and cultures and are often left out. Inbetweeners are those individuals whose lives are in transition through recent immigration or forced translocation from Asia to America.

These strategies revolve around threads of trust: kin, giggles, vulnerability, and shared experience. With these threads, we can question power. We can preserve stories, expand the ways we connect, shift perspectives on what is “standard,” and cultivate a community rooted in understanding. To understand each …

The Meaning Of A Choice, Julie-Louise Zeitoun

Masters Theses

If you are disabled or disadvantaged, you will be dismissed and stifled. Few people will actively care for your struggles. As a person with autism, I was deeply fearful of the persecution I had faced throughout my life; it was a fear that followed me with terrifying determination. I desperately wanted to blend into society. So I designed myself to be devoid of any weakness, and productivity was the way I chose to conceal any difficulties I faced. It was a way to measure my success — a way to measure my normalcy.

Standard medical textiles are generic, cumbersome devices. …

Bridging Empathy, Qianwen Lu

Masters Theses

As a jeweler, ally, and sympathetic witness to the traumatic stories of survivors, my work aims to support the process of reconstruction and reintegration for victims and the greater community. To move beyond isolation, resentment, and debilitating helplessness requires care and support. I want my jewelry to act as catalysts in the healing process by straddling both sides of the trauma-induced situation, to create greater awareness and empathy. National Coalition Against Domestic Violence shows that women are more likely to become victims of domestic violence, sexual assault, or other forms of physical and psychological abuse in unhealthy emotional relationships. These …

Unearthing Complexity: Tangible Histories Of Water And Earth, Alexis Violet

Masters Theses

Unearthing Complexity investigates conceptions of time and surface through geological stories of the water and earth. Building on theories of deep time, hydrofeminism, critical zones, and grounding, I hope to foster a deeper awareness of time scales other than our own and a more tangible understanding of the embodied experience of matter in the universe. Working toward a new literacy of the water and earth in which they are recognized as living, changing bodies to which we are inherently tied at a molecular level, the site of this multiscalar inquiry occurs in the coastal zones of the Narragansett Bay where …

Unveiling Pain: Wearables For Objective Pain Measurement, Hanqing Tang

Masters Theses

">">Pain perception is a subjective experience that differs significantly among individuals, often leading to inconsistencies in assessment and management. A critical issue within this context is the gender bias in pain evaluation, which contributes to unequal treatment and perpetuates gender inequality within the healthcare system. This thesis presents an in-depth investigation of the problem and proposes the development of a wearable device for objective pain assessment. Physiological parameters — Electrocardiography (ECG) can be collected from cardiac sound signals auscultated by fabrics via nanometre-scale vibrations. Machine learning methods can accurately classify heart rate and acute pain intensity of participants. …

Enhancing Wellbeing In Public Landscape Through Light, Ruiqing Miao

Masters Theses

Close to half of Americans living in the U.S. Northeast and Midwest say they do not get enough sunshine throughout the year. That’s compared to less than a third of those living in the South or the West.

During the winter months, the days are shorter, with the sun rising later and setting earlier than during the summer months. This means there is less daylight for people to enjoy, and the reduced exposure to natural light can have a negative impact on mood and energy levels.

Public Health’s research demonstrates that constant stimuli of body senses plays an important role …

Migratory Material: Epigenetics & Weaving At The Us-Mexico Border, Valerie Navarrete

Masters Theses

Discourse often sutures the body shut, disallowing representations of identity to outgrow sociopolitical interests. This issue may originate from borders, but also from the unnamable pathology that generational colonial trauma transmits to the mind, body, and environment. Without a direct form of translatability, this thesis proposes a new materialism that deviates from any object-oriented ontology. Untethered and intra-active, epigenetics and weaving represent objects that transform typical ways of knowing and seeing. Their sensitivity to the environment, in addition to their mobility across generations of time, broaden the spatiotemporal loci of the body and its embodiment. Proposing new materials that expand …

Influences Of Chronic Stress On Irritable Bowel Syndrome, Anxiety, Depression, And The Microbiome, Julia A. Semaan

Masters Theses

IBS effects approximately 5% of the world’s population with symptoms ranging from unexplainable constipation to daily abdominal pain. Though treatment options are available and have been proven beneficial for certain individuals, discovering the root cause of IBS has been difficult to accomplish due to the variety of symptoms that differ from case to case. This study aims to increase understanding of the influence that chronic stress has on irritable bowel syndrome, anxiety, depression, and the microbiome in the college-age population since this group is likely to experience daily stressors, anxiety- and depressive-like thoughts, as well as IBS symptoms. Current research …

A Machine Learning Approach For Predicting Clinical Trial Patient Enrollment In Drug Development Portfolio Demand Planning, Ahmed Shoieb

Masters Theses

One of the biggest challenges the clinical research industry currently faces is the accurate forecasting of patient enrollment (namely if and when a clinical trial will achieve full enrollment), as the stochastic behavior of enrollment can significantly contribute to delays in the development of new drugs, increases in duration and costs of clinical trials, and the over- or under- estimation of clinical supply. This study proposes a Machine Learning model using a Fully Convolutional Network (FCN) that is trained on a dataset of 100,000 patient enrollment data points including patient age, patient gender, patient disease, investigational product, study phase, blinded …

Social Dominance Alters Stress-Induced Neural Activity And Generates Individual Differences In Stress Vulnerability, Jenna Lee Laymon

Masters Theses

Identifying the physiological and behavioral mechanisms that underlie stress vulnerability is a crucial step toward identifying novel targets for the prevention and treatment of stress-related disorders. Social status is a key environmental factor that contributes to individual variations in stress vulnerability. In particular, achieving a subordinate social status has been shown to produce susceptibility to anxiety-like and depressive-like behavior. In this project, our aim was to identify neural ensembles regulating how dominance status modulated stress-induced changes in avoidant behavior in male and female Syrian hamsters. Using a viral vector that codes for robust activity marker (RAM), we investigated whether stress-induced …

Leptospira Seroprevalence In Companion Animals In Tennessee, Kellie Anne Mccreight

Masters Theses

Leptospirosis is a re-emerging zoonotic disease in humans and animals. The bacteria Leptospira spp. causing this disease is maintained in the kidneys of animals such as rodents and cattle as well as in the environment. Animals harboring Leptospira spp. in the kidneys frequently shed the bacteria in their urine, contaminating the environment. Contact with contaminated soil and water may result in infection. Animals and humans may develop serious life threatening disease from Leptospira infection. Approximately 1 million new human cases and over 50,000 deaths are reported worldwide. Numerous animal species including rodents, cattle, and dogs may serve as reservoir …

Effect Of Amputation On Muscle Structure Properties In A Rabbit Model, Roy Caleb Stubbs

Masters Theses

After amputation, muscles in the residual limb are detached from their insertion points and no longer span the missing joints. Our objective was to quantify the effect of amputation-induced disuse on residual muscle structure, an indirect indicator of muscle force-generating capacity. One hind paw was surgically removed at the ankle joint of ten rabbits. At two weeks (n=5) and 4 weeks (n=5) post-amputation and for select muscles (gastrocnemius, soleus, tibialis cranialis, extensor digitorum, and flexor digitorum superficialis), we measured and computed several muscle structure properties. Additionally, we qualitatively assessed the muscle fiber appearance of histological samples at each timepoint. At …

Differential Toxicity Of Pm2.5 Components And Modified Health Effects Modeling: A Case Study In Nepal, Jeremy Brownholtz

Masters Theses

During the latter part of the 20^th century, a transition away from coal as a major energy source in developed countries was accompanied by a notable decrease in air pollution-related deaths in those countries. Currently the same phenomenon is being observed in developing nations like China and India. However, many areas that do still rely on coal for their energy production or industrial needs also reflect a gap in research on the effects of those specific processes on local populations. Located in Nepal at the foot of the Himalayan Plateau, Kathmandu represents one such location. The local economy of …

Asian Americans Perceptions Of Mental Health Help-Seeking, Austin Dye

Masters Theses

Mental health has critical importance in the development and functioning of an individual emotionally, psychologically, and socially throughout life. Thus, it is important for an individual to identify mental health issues when experiencing it and seek treatment. However, this understanding appears to differ across cultures and ethnic groups. For instance, Asians in the US have low mental health service utilization. Although researchers have sought to identify the reason, many of these studies are dated, and have not fully explored all the different factors that influence this behavior, nor explored if there are generational differences. In the current study, 102 Asians …

Development Of A Low-Dose Radiation Therapy Device For Acute Respritory Distress Syndrome, Thomas Heath Davis

Masters Theses

This research focuses on the development of a low dose radiotherapy (LD-RT) device for treatment of acute respiratory distress syndrome (ARDS), a respiratory illness that affects millions of people a year. The use of orthovoltage (200 – 500 keV) X-ray energy provides many advantages over traditional radiotherapy delivery with linear accelerators, such as low cost and greater accessibility. In addition, X-ray tubes have been shown throughout history to provide good treatment outcomes for pneumonia, and research has shown LD-RT to be just as effective with ARDS. This proposal summarizes my efforts in determining the dosimetric properties of a LD-RT system …

Pulsed Electromagnetic Field Therapy And Its Applications And Usage In The Equine Industry, Delaney R. Rostad

Masters Theses

Therapeutic modalities in the equine industry are constantly progressing due to evolving needs of horse owners who desire to make their horse perform at their best. Pulsed electromagnetic field (PEMF) therapy is a lesser understood modality when it comes to its use in horse. Despite its widespread use, there is little research pertaining to how or if PEMF therapy affects performance of the equine athlete and influences various equine medical conditions; however, PEMF therapy use in humans improves delayed onset muscle soreness, and increases stride rate and length which could possibly be applied to the equine athlete. The objective of …

Predicting Immunization Status At Arrival In Tennessee Stocker Calves, Claire E. Hunkler

Masters Theses

Bovine respiratory disease is a multifaceted disease with agent, host, and environmental factors. Stocker calves are at high risk of contracting the disease through many stressors like weaning, transportation, commingling, etc. The purpose of this project was to test if externally observed physical characteristics of calves on arrival at a stocker facility can be used to predict calfhood vaccination status determined based on antibody titer levels. Knowledge of highly correlated characteristics could allow stocker operators to reduce the occurrence of BRD through targeted management strategies, thus lowering morbidity, mortality, and treatment costs. Ear notches, blood, and visual characteristics were collected …

Comparison Of The Humoral Immune Response Following Both Bacterial Challenge And Rnai Of Major Factors On Proliferation Of Bartonella Quintana In The Human Louse, Jake Zina

Masters Theses

Human body lice, Pediculus humanus humanus, and head lice, Pediculus humanus capitis, have been hematophagous ectoparasites of humans for thousands of years. Despite being ecotypes, only body lice are known to transmit bacterial diseases to humans, and it appears that lower humoral and cellular immune responses allow body lice to possess a higher vector competence. We previously observed that the transcription level of the defensin 1 gene was up-regulated only in head lice following oral challenge of Bartonella quintana, a causative agent of trench fever, and also that body lice excreted more viable B. quintana in their …

Feasibility, Acceptability And Process Evaluation Of A Physical Activity Intervention In Toddler Aged Children: The Tap-A-Long Study, Luke M. Sudarsky

Masters Theses

Recent literature has suggested the importance of physical activity in early childhood such as during the toddler years (12 months - 3 years.) Despite this, most toddlers are not physically active. There is a need to determine the types of physical activity programs that would interest toddlers within the settings they spend a significant amount of time in (e.g., childcare center). Currently, data on the feasibility, implementation, and process evaluation of physical activity interventions in toddler age children attending childcare centers is lacking within the literature. Therefore, the purpose of the Toddler Activity Pilot (TAP-A-LONG) study was to examine the …

The Effects Of Footwear Longitudinal Bending Stiffness On The Energetics And Biomechanics Of Uphill Running, Justin Angelo Ortega

Masters Theses

There has been a prevalence of long-distance running footwear incorporating carbon-fiber plates within their midsoles, effectively increasing their longitudinal bending stiffness (LBS). This modification of modern racing footwear has occurred concurrently with large improvements in running times (Bermon et al., 2021), putting into question how these footwear components affect performance (Muniz-Pardos et al., 2021). The current literature has investigated this at level running, but with the increasing popularity of trail running, it is of interest to investigate whether the benefits found during level running translate to graded running. Therefore, the overall aim of this study was to investigate the effects …

Comparative Anatomical Study Of The Brachial Plexus Of Primates, Alison Leann Camero

Masters Theses

Old world monkeys, new world monkeys, and humans all originate from a common ancestor. Although humans and old world monkeys are phylogenetically more closely related, old world monkeys and new world monkeys have similar locomotion. A difference in muscle patterns exists between old world monkeys, new world monkeys, and humans. Different musculature may be due to differences in locomotive patterns and species-specific use of their forearms. Muscles in the forelimbs are innervated by the nerves of the brachial plexus. There are differences among the brachial plexuses of human and non-human primates as well as variability within the species.

In this …