Medicine and Health Sciences Commons^™

The Characterization Of The Subcellular Localization Of Bile Acid Coa: N-Acyltransferase, Nathan Allen Styles

All ETDs from UAB

The liver plays a central role in metabolism. It controls protein metabolism through deamination and transamination of amino acids, removal of ammonia through urea synthesis, synthesis of non-essential amino acids and synthesis of the majority of plasma proteins such as albumin. The liver regulates blood glucose levels through glyconeogenesis and glyconeolysis of glycogen, as well as gluconeogenesis from amino acids. It regulates fat metabolism through oxidation of triglycerides and fatty acids, as well as synthesis of cholesterol, lipoproteins, and phospholipids. Furthermore, the liver is the only site of formation of bile acids and their conjugates, physiologically important compounds that solubilize …

Bacillus Anthracis Spore-Host Interactions, Melissa K. Swiecki

All ETDs from UAB

The use of Bacillus anthracis as a bioweapon depends on the dispersal of its spores into the environment, entrance into the body, spore uptake by human host cells, germination of the spores in the host and the pathological consequences of the virulence factors produced by the vegetative cells. Prior to 2001, very little was known about the mechanisms of spore entry into the host, including targeting cell types at airway, digestive and skin surfaces, potential spore receptors on these cells and spore encounters with cellular and humoral elements of the innate and adaptive immune systems. To this end, we have …

Relaxation Rate-Based Magnetic Resonance Imaging Quantification Of Myocardial Infarction, Pal Suranyi

All ETDs from UAB

Ischemic heart disease is the leading cause of mortality in western societies. Treatment needs to be tailored for each individual, which requires accurate assessment of the underlying pathology. Magnetic Resonance Imaging (MRI) is a relatively young modality in the field of cardiovascular imaging, and boasts with the lack of harmful radiation, excellent soft tissue contrast, and high spatial-temporal resolution. The very foundation of the concept of MRI was the finding that pathology causes changes in the relaxation rates of tissues. Measurement of relaxation rates is more time consuming than generating simple signal intensity images weighted by the longitudinal or transverse …

Genetic And Epigenetic Regulation Of Dihydropyrimidinase And Beta-Ureidopropionase In Individuals With Altered Uracil Catabolism And Normal Dihydro Pyrimidine Dehydrogenase Enzyme Activity, Holly Reed Thomas

All ETDs from UAB

There remain a number of patients presenting with 5-fluorouracil (5-FU) toxicity despite normal dihydropyrimidine dehydrogenase (DPD) enzyme activity, suggesting possible deficiencies in the two enzymes downstream of DPD in the uracil catabolic pathway: dihydropyrimidinase (DHP), encoded by the DPYS gene, or β-ureidopropionase (BUP-1), encoded by the UPB1 gene. Unlike DPD, which is expressed in peripheral blood mononuclear cells (PBMCs), DHP and BUP-1 enzyme activity is detected in only the liver and kidney, thus requiring an invasive biopsy for determination of activity. This dissertation, therefore, focuses on the role of the genetic and epigenetic regulation of DPYS and UPB1. The genetic …

Effects Of Optical Blur On Visual Performance And Comfort Of Computer Users, Ferial M. Zeried

All ETDs from UAB

Background. The study examined the effects of optical blur on the visual performance and comfort of computer workers. Since most workers have significant degrees of optical blur, the study may elucidate improved methodology for workplace comfort and function. Methods. Since young and old workers experience blur from different sources, the study incorporated two different designs. The study examined the correction of optical blur using a randomized, double-blind, placebo-controlled, crossover design. The primary outcomes of the study were visual comfort and productivity. In study one, subjects were required to be 19-35 yrs of age, have at least 0.50D uncorrected refractive error …

Barrier Membranes For Ridge Augmentation - Is There An Optimal Pore Size?, Rajesh Gutta

All ETDs from UAB

Background: - Alveolar bone loss is often a sequelae of edentulism. However, several reconstruction procedures with bone grafts and barrier membranes are used to restore the lost bony architecture. The value of titanium mesh barriers has been shown to be reliable both in vertical and horizontal ridge augmentation procedures. However, there is a paucity of literature supporting the role of pore size of barrier membranes in preventing soft tissue ingrowth during ridge augmentation procedures. There are multiple reports describing a layer of soft tissue with varying thickness beneath the mesh and adhering to the newly regenerated bone. The objective of …

Visually Impaired Caregivers: Perspectives From Patient Focus Groups, Bethany Surrey Martinez

All ETDs from UAB

Purpose: We typically think of those with severe visual impairment as having to receive care or assistance for tasks in everyday living. However, with the aging of the population, more persons who are severely visually impaired are now caring for a spouse of significant other. Very little is known about visually impaired (VI) caregivers. Thus, the purpose of this qualitative study is to learn more about this vulnerable population of VI caregivers. Methods: Focus groups and one-on-one interviews were conducted with English speaking adults who were legally blind (U.S. definition) and served as informal caregiver of an adult family member. …

Using Genetic Admixture And Lipo Protein Lipase Polymorphisms To Explain Variations In Plasma Triglycerides And High Density Lipoprotein Cholesterol In Premenopauasal African And European American Females, Nihal Omar Natour

All ETDs from UAB

Although African Americans (AA) are well known to be more obese and more in-sulin resistant than European Americas (EA), several studies have shown that AA have lower plasma triglyceride (TG) and higher high density lipoprotein cholesterol (HDL-C). The reasons for these levels of TG and HDL-C are not understood, and scientists have suggested a role of lipoprotein lipase (LPL), a key regulator of TG rich lipoproteins me-tabolism that is also thought to indirectly affect HDL-C metabolism. To investigate the extent to which these observed differences in TG and HDL-C are due to genetic makeup, we investigated the role of genetic …

Development And Testing Of Feed - A Feedback Expert System For Ems Documentation, Devashish Saini

All ETDs from UAB

Emergency Medical Services (EMS) are delivered in a chaotic, dynamic, unpre-dictable, and therefore error-prone environment. Deviations from protocol are common and some may be severe enough to cause harm to the patient. EMS personnel, like all healthcare providers, can benefit from feedback, continued education and medical over-sight. A Feedback Expert system for EMS Documentation (FEED) was developed for providing feedback to EMS personnel after the ambulance run is completed and docu-mented electronically. FEED’s knowledge base was derived from Alabama State EMS Protocols and discussions with two EMS faculty members from UAB School of Medi-cine. FEED is rule-based and uses confidence …

Surface Reproducibility Of Impression Materials, Amit Shah

All ETDs from UAB

The inability to absorb or release moisture limits the ANSI/ADA specification 19 stainless steel mold from accurately mimicking tooth structure and oral conditions while evaluating in vitro detail reproduction of elastomeric impression materials. Moreover, studies utilizing this mold have been graduated at room temperature, not normal mouth temperature. Bovine teeth, being similar to human teeth in microstructure and composition, are the closest substitutes that can be used to evaluate surface detail reproducibility of impression materials. The objectives of this study were (1) to develop a new bovine in vitro test model at controlled temperature and humidity in order to simulate …

In Vitro Compressive Fracture Resistance Of The Human Maxillary First Premolar With Different Mod Cavity Design And Restorative Materials, Wen-Chou Wu

All ETDs from UAB

Cuspal failures of MOD (mesial-occlusal-distal) restored teeth have been constantly observed in clinic especially those restored with amalgam. As the pulpal depth and isthmus width of the preparation increases, the strength decreases. A number of studies have investigated the adhesive technique which is intended to increase the fracture resistance by bonding the tooth structure. The results of the studies are controversial because of the differences of research design among studies. The purpose of this study is to evaluate the fracture resistance of the human maxillary first premolar restored with condensable composite (Surefil, Dentsply) and CEREC 3D ProCAD leucite-reinforced ceramic inlays …

The Role Of Cd5 In Experimental Autoimmune Encephalitomyelitis, Robert C. Axtell

All ETDs from UAB

The regulation of activation, differentiation and persistence of effector T-cells are critical for the development of Experimental Autoimmune Encephalomyelitis (EAE), the animal model of Multiple Sclerosis. Until now, the function of CD5 was accepted to be a negative regulator of T-cell activation. This dissertation reports that CD5 has an addi-tional role in T-cell responses, which is to promote cell survival. Observations from EAE experiments revealed that mice deficient in CD5 exhibited decreased disease severity which was associated with the inability of activated T-cells to survive. Moreover, block-ing the engagement of CD5 in mice led to enhanced activation induced cell death …

Cd8+ T-Lymphocytes And The Control Of Cytomegalovirus Infection Of The Newborn Central Nervous System, Glenn Robert Burgner Bantug

All ETDs from UAB

Congenital HCMV infection of the developing brain is the leading viral cause of mental retardation and sensorineural hearing loss. To elucidate the pathogenesis of congenital HCMV CNS infections, we developed a small animal model of CMV infection where newborn Balb/c mice are peripherally inoculated with murine cytomegalovirus. In this model we observed transient deficits in cerebellar/hindbrain development as well as the recruitment of peripheral immune effector cells to the CNS parenchyma. CD8+ T-lymphocytes were the predominant mononuclear cellular infiltrates in the brain and immune-depletion of CD8+ cells resulted in increased viral genome copy numbers in the CNS. CD8+ T-lymphocytes exhibited …

Impact Of Immunosuppression On The Incidence And Clearance Of Human Papillomavirus In Hiv-Infected Women In Alabama, Madhav P. Bhatta

All ETDs from UAB

Persistent infection with certain “high-risk” types of human papillomavirus (HPV) infection is central to the development of cervical cancer. Human immunodeficiency virus (HIV)-infected women are at a higher risk of HPV infection, high grade cervical intraepithelial lesions, and cervical cancer. This study examined type-specific distribution of prevalent and incident HPV infections, clearance rates, and associated factors using novel molecular assays for HPV detection and genotyping in a cohort of 280 HIVinfected women in Alabama. First, we described the cohort’s sociodemographic characteristics and behavioral risk profile for HIV and other sexually transmitted infections, and assessed the factors associated with HIV-1 viral …

Understanding The Relationship Between The Emotional Competence Inventory - University Edition And The Myers-Briggs Type Indicator In The Admission Of College Students To An Orthopaedics-Based Honors Program, Carrie A. Yocum

Dissertations

Problem

The Orthopaedic Scholar Institute (OSI) Team realized its need for a more objective selection and admission process that, as much as possible, quantified the characteristics desired in OSI students rather than relying solely on referral perception, intuition, and an interview, but it did not have a clear method or approach to do so. Administering standardized inventories that highlighted these desired characteristics and aided in the selection and admission process seemed to be an objective approach to obtain more quantifiable data. The problem for my study was, therefore, whether the Myers- Briggs Type Indicator (MBTI) alone could measure a student’s …

The Health Of Patient Privacy: The Patient's Perspective On The Hipaa Protected Health Information, Deborah Lange-Kuitse

Dissertations

Problem

As healthcare entities continue to focus on HIPAA compliance, they must enforce policies that require patients to sign and express understanding of the organization’s privacy policies. It appears the patient’s perspective on healthcare privacy has not been considered within the HIPAA privacy ruling. Patients are healthcare consumers, yet little research has been done on assessing the individual consumer’s perspective on what Protected Health Information (PHI) is actually important to protect and from whom it is important to protect it.

Method

A quantitative survey was developed and distributed to the participants of the Carnegie group, an independent insurance firm in …

Supporting Personhood In Dementia: Examining The Impact Of Volition On Function In Everyday Occupations, Christine L. Raber

Theses and Dissertations

Understanding volition and preferences for occupation is a critical underpinning of effective occupational therapy services that promote and preserve identity for persons with moderate dementia. Although it has been posited that this population has significant difficulty expressing volition for daily occupations, little research has examined the role of volition in guiding engagement in occupations. This phenomenological study provides an in-depth description and analysis of volition in eight persons with moderate dementia. Guiding questions related to understanding patterns of past life interests, outward demonstration of volition, volitional continuity. and the relationship of the social environment to volition and engagement in daily …

Transition From Health Maintenance Organizations To Consumer Driven Health Plans: Measurement Of Initial Impacts For Members With Chronic Conditions, Carl F. Goff

Theses and Dissertations

New consumer driven health insurance products are designed to contain health care costs by making consumers more accountable for the care they receive through being responsible for more cost sharing, making decisions regarding health care providers they will use, and increasing exposure to and use of health information for services and providers. Potential benefits of consumer driven products include increased information regarding personal health and a more knowledgeable patient base. Potential drawbacks of consumer driven products include negative impacts on consumers with chronic and complex health conditions.

The purpose of this study was to ascertain differences in health services utilization …

On The Binding Of N1-Substituted Tryptamines At H5-Ht6 Receptors, Abner Nyamwaro Nyandege

Theses and Dissertations

Serotonin was first discovered in the late 1940s as a vasotonic factor and is now considered a principal neurotransmitter in the nervous system. 5-HT6 receptors are one of the most recently identified members of the serotonin receptor family which consists of seven classes (5-HT1-5-HT7). 5-HT6 receptors are G-protein coupled, positively coupled to an adenylate cyclase second messenger system and are primarily found in the central nervous system (CNS). The exact functional role of 5-HT6 receptors has not been determined, but is implicated to have possible involvement in certain neuropsychiatric disorders and cognition. To investigate the functional role of these receptors, …

Adverse Anesthesia Outcomes: A Retrospective Study Of An Ambulatory Surgical Center Versus A Dental Office Setting, Gaurav Agarwal

Theses and Dissertations

Purpose: The purpose of this study was to compare the adverse events that occur with general anesthesia for dental rehabilitation between a hospital setting and dental clinic setting. Methods: A retrospective chart review was performed examining patients who had received dental rehabilitation with general anesthesia at the Virginia Commonwealth University Department of Pediatric Dentistry. Subjects were either treated in the Pediatric Dental Clinic or the Hospital Ambulatory Surgery Center (ASC) from July 2005 to December 2006. Anesthesia records of induction, intubation, maintenance, emergence and recovery were compared between the two settings.Results: There were a total of 422 charts reviewed with …

Analgesic Use In U.S. Emergency Departments For Patients Reporting Moderate To Severe Pain: Diagnosis And Select Patient Characteristics Influencing Narcotic Analgesic Prescribing Practices, Hassan Zakaria

Theses and Dissertations

Objective: This study aims to examine the relationship between emergency department patient encounter characteristics and narcotic analgesic prescribing practices in order to determine what patient characteristics, if any, influence the decision to prescribe narcotics.Methods: Cross sectional data on patients presenting to U.S. emergency departments from the 2003 and 2004 National Hospital Ambulatory Medical Care Survey were analyzed. Patients reporting moderate to severe pain were included in the sample and analysis. Chi square tests of significance were used to assess the association between individual demographic and encounter characteristics to narcotic prescription or administration. Separate multiple logistic regressions were then performed on …

Characterization Of The Factors Associated With Sccmec Mobility In Staphylococcus Aureus, Michael James Noto

Theses and Dissertations

The gene encoding resistance to β-lactam antibiotics in the staphylococci is found on the chromosome in a genomic island designated Staphylococcal Chromosome Cassette mec or SCCmec. In addition to the resistance gene, mecA, SCCmec also contains site specific recombinase genes, ccrAB, that are capable of catalyzing the chromosomal excision and integration of SCCmec. The increasing prevalence of methicillin-resistant Staphylococcus aureus infections may be due, in part, to the transfer of SCCmec into successful methicillin-sensitive S. aureus lineages. In this work we attempt to better characterize the factors associated with SCCmec transfer, beginning with CcrAB-mediated SCCmec excision in a collection of …

Improving Life Satisfaction Of Elders Through Oral History: The Narrator's Perspective, Mary B. Ligon

Theses and Dissertations

Oral history is a method of preserving historical information through in-depth interviews. Because the process requires narrators to use remote recall while sharing their life experiences, it can also be considered a reminiscence-related activity. Before this study, the positive effects on narrators of providing an oral history were noted in the research literature but had not been evaluated through quantitative methods. Based on theoretical constructs of Erikson and Butler, it was hypothesized that participation in oral history interviews would improve the life satisfaction of narrators. Life satisfaction was operationalized and measured using the Life Satisfaction Index Version A (LSIA). The …

Sodium Hypochlorite's Effect On Nickel-Titanium Rotary Instruments And Its Effect On Resistance To Fracture, Michael Shane Smith

Theses and Dissertations

The purpose of this study was to examine the effect of partial and total immersion in sodium hypochlorite on nickel-titanium rotary files and to determine whether resistance to fracture was influenced by the immersion time. One hundred K3™ and 100 ProFile® rotary files were either partially or totally immersed in 5.25% sodium hypochlorite for zero, one, five, thirty, or sixty minutes. After immersion, files were subjected to cyclic fatigue testing. Time to fracture was recorded and analyzed by a two-way ANOVA. Tukey's honest significant difference was used to identify any differences in immersion times. Within all ProFile groups and partial …

Impact Of Combat Stress On Mental Health Outcomes: Brfss Survey Data 2006, Emily Pedneau

Theses and Dissertations

Objectives: This study sought to determine the relationship between combat experience and mental health outcomes. The study sought to determine whether age was a significant factor in poor mental health outcomes. Methods: Multiple logistic regression (n = 195,048) and multiple linear regression (n = 264,154) were performed on the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. Veteran status and a host of demographic and health status questions were analyzed in relation to diagnosis of anxiety or depressive disorder (multiple logistic regression) and to number of days poor mental health (multiple linear regression). Results: Diagnosis of anxiety or depression was …

Trend Analysis Of Automobile Collision Amongst 15-19 Year Olds In Virginia, 2000-2004, Imo F. Ndem

Theses and Dissertations

Purpose. This research study on automobile collision in Virginia amongst fifteen to nineteen (15-19) year olds looked into the trend analysis over a five (5) year period of 2000 to 2004. Trend analysis is usually done for aggregates of all injuries—either intentional or unintentional injuries, or both. The primary objective of this research study was to examine the trend in hospitalization rates and mortality rates for males and females independently. It further looked into the trend, if any, in hospitalization rates, mortality rates, and case-fatality rates, for both males and females combined. The different Tables illustrate the extent and the …

Immunohistochemical Study Of Phenotypes Of Dendritic Cells In Dental Pulps From Non-Carious And Carious Teeth, Melissa A. Harmon

Theses and Dissertations

Mature dendritic cells (DCs) in inflamed tissues may promote inflammation but the status of DCs in pulpitis is not known. We hypothesized that DC maturation would correlate with carious lesion depth and that CD4+ cells would be found in association with mature DCs. Pulps were collected from teeth exhibiting: (I) no caries (n=9), (II) shallow dentinal caries (n=5), and (III) deep caries (n=9). Pulpal tissues were cryo-sectioned and positive cells were examined with immunohistochemistry, Mature DCs (CD83+) were almost exclusively restricted to pulps from deep caries. Furthermore, CD209+ DCs in deep caries were elevated over other groups and CD209+ cells …

Examination Of Birth Outcomes With Mode Of Delivery For Breech Presentation, Kelly Marie Arey

Theses and Dissertations

Introduction: Approximately 3% to 4% of all pregnancies at term will have a fetus with a breech presentation. Studies have shown that the US has almost completely abandoned vaginal delivery for breech presentation through the influence of the "Term Breech Trial" (TBT) which concluded that a policy of planned caesarian section would reduce perinatal mortality, late neonatal mortality, and serious neonatal morbidity by approximately two-thirds for term fetuses. However, the recommendations are still being challenged by others.Objectives: The purpose of the study was to describe who in Virginia is having a vaginal delivery for a breech presentation and to determine …

An Invitro Leakage And Viscosity Analysis Of Root End Filling Materials, Paul D. Clark

Theses and Dissertations

The purpose of this study was to determine if the viscosity of MTA Angelus Fluid is lower than that of Pro Root MTA and MTA Angelus; and to compare the viscosity, leakage and particle size of these materials to determine whether a relationship exists between these properties. The viscosity of each material was measured and compared with the Student's t test. MTA Angelus Fluid's viscosity was significantly lower than the other two materials tested. Microleakage of root end fillings was assessed in a passive diffusion model. Leakage groups were compared with a one-way ANOVA (p < 0.05). No significant difference was found. Particle size and shape were evaluated with the SEM. MTA Angelus Fluid has a lower viscosity than the other materials tested. There was no significant difference in the sealing ability of the three materials tested and there was no apparent variation in each material's particle size or shape.

Children With Special Needs Oral Health Quality Of Life Survey, Kristin Elizabeth Nelson

Theses and Dissertations

Purpose: The purpose of this study was to asses the oral health quality of life of children with special health care needs. This study examined the effects of oral health conditions on general well-being and family life of these children. A secondary aim of the study was to investigate correlations between specific health care conditions, gender, and age of these children and their global ratings of oral health and well-being.Methods: This study was a cross-sectional design with subjects who are members of the Virginia Care Connection for Children program, based at Virginia Commonwealth University. The oral health quality of life …