Medicine and Health Sciences Commons^™

Gender Differences In Clinical Characteristics And Outcome Of Acute Heart Failure In Sub-Saharan Africa: Results Of The Thesus-Hf Study, Okechukwu S. Ogah, Beth A. Davison, Karen Sliwa, Bongani M. Mayosi, Albertino Damasceno, Mahmoud U. Sani, Charles Mondo, Anastase Dzudie, Dike B. Ojji, Charles Kouam, Ahmed Suliman, Neshaad Schrueder, Gerald Yonga, Sergine Abdou Ba, Fikru Maru, Bekele Alemayehu, Christopher Edwards, Gad Cotter

Internal Medicine, East Africa

Background: The impact of gender on the clinical characteristics, risk factors, co-morbidities, etiology, treatment and outcome of acute heart failure in sub-Saharan Africa has not been described before. The aim of this study was to evaluate the sex diffe rences in acute heart failure in sub-Saharan Africa using the data from The sub-Saharan Africa Survey of Heart Failure (THESUS-HF).

Methods and results: 1,006 subjects were recruited into this prospective multicenter, international observational heart failure survey. The mean age of total population was 52.4 years (54.0 years for men and 50.7 years for women). The men were significantly older (p …

Uchunguzi (Journal Watch/Montre De Journal) September 2015, Benjamin Wachira

Internal Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent.

Creating A Foundation For The Causal Relationship Between Libraries And Learning: A Proposed Application Of Nursing And Public Health Research Methods, Marcia A. Mardis, Sylvia K. Norton, Gail K. Dickinson, Shana Pribesh, Allison Cline, Sue Kimmel, Jody Howard

Teaching & Learning Faculty Publications

Thomas Cook, a renowned causal research expert and professor of sociology, psychology, education, and social policy at Northwestern University (USA), called for school library researchers to parallel causality determination efforts in health-related fields. In this paper, we respond to Dr. Cook’s challenge with a proposed research design centered on Mixed Research Synthesis (MRS) as part of process validated by the U.S. Department of Education and National Science Foundation’s Common Guidelines for Education Research and Development. MRS studies, often used in nursing and public health research to develop causal theories, enable researchers to develop evidence summaries; identify and adjudicate rival and …

Stat4 Regulates Multiple Pathogenic Mechanisms Of Cd4 T Cells In Experimental Autoimmune Encephalomyelitis, A Model Of Multiple Sclerosis, Ian Lee Mcwilliams

All ETDs from UAB

Multiple Sclerosis (MS) is an autoimmune disease whereby the host immune system fails to recognize self vs non-self and targets myelin of the central nervous system. Currently there is no permanent cure for MS and the efficacy of immune modulatory treatments often wane over time, therefore we seek to determine novel pathogenic mechanisms to target therapeutically. CD4 T cells have been found within inflammatory CNS lesions of MS patients and are believed to be important mediators of MS pathology. To study CD4 T cells in the context of MS, we use the well-defined MS mouse model experimental autoimmune encephalomyelitis (EAE). …

Non-Compliance In Clinical Trials: The Perils Of Statistical Methods, Peter Drew Merrill

All ETDs from UAB

All clinical trials must deal with protocol deviations that occur during the course of the study. One of the most important deviations is non-compliance to treatment assignment. Intention to treat (ITT) is the most commonly employed method to deal with non-compliance in a clinical trial; however, it provides biased estimates of the effect of receiving the treatment. Other methods such as per protocol (PP) and as treated (AT) provide alternatives to ITT. PP and AT, assume an all-or-nothing compliance situation. However, the possibility of being partially compliant to a treatment is common. We investigate possible approaches to incorporating partial compliance …

Innate Immunity Mechanisms In Parkinson Disease, Mark Moehle

All ETDs from UAB

Parkinson disease (PD) is a late onset, progressive neurodegenerative movement disorder with cardinal symptoms of tremor at rest, bradykinesia, postural instability, and rigidity. These motor symptoms of PD are caused by the progressive loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc). However, despite PDs first modern observation in 1817, little is understood about the causes and molecular mechanisms behind dopaminergic neuron loss. The relatively weak understanding of pathological mechanisms has hindered the development of treatments to slow or halt the progression of PD. However, recently, mounting evidence from post-mortem, imaging, and retrospective studies suggest an important role …

The Interrelationships Among Obesity, Insulin Sensitivity, And Bone Phenotype In Pre-Pubertal Girls, Anna L. Newton

All ETDs from UAB

Impaired insulin sensitivity as a consequence of childhood obesity has been implicated as a contributor to skeletal fragility. There is a need to understand the interrelationships among insulin sensitivity and skeletal parameters (i.e. cortical, trabecular, marrow) in obesity during the pubertal transition. Further, calorie restricted weight loss to stabilize these relationships warrants investigation as well. The goal of this project was to examine the relationships among body composition, skeletal parameters, and insulin sensitivity. The first aim was to evaluate the relationships among total body fat, bone mineral content (BMC) and femoral bone marrow adipose tissue (BMAT) during childhood and underlying …

The Effect Of Breakfast Protein Source On Postprandial Hunger And Glucose Response In Normal Weight And Overweight Young Women, Christina Crowder, Brianna I. Neumann, Jamie I. Baum

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Breakfast consumption has been linked to health benefits such as improved weight regulation and glucose control. Studies have shown higher protein breakfasts lead to a greater reduction in hunger compared to breakfasts higher in carbohydrates. However, few studies have examined the impact of higher protein breakfasts from differing protein sources. The objective of this study was to determine if protein quality (animal (AP) versus plant (PP) protein) influences postprandial appetite, food cravings, food intake and glucose response in participants consuming a high protein breakfast (~30% energy from protein). We hypothesized that AP would be more satiating than PP. Normal weight …

Embedding Into The Nursing Community On An Academic Health Center Campus, Roy E. Brown

VCU Libraries Faculty and Staff Publications

Objectives: To describe and evaluate the process by which a librarian became embedded into the nursing community on an academic health sciences center campus from 2010-2014. These efforts will be evaluated through qualitative and quantitative measures to determine the success of serving the nurses on campus and to address potential improvements.

Methods: In 2010, the library liaison program was enhanced with the goal of embedding into the professional schools. The nursing liaison leveraged relationships with faculty, staff and students to address the educational, research and clinical needs of the school of nursing as well as the nurses in the health …

Protumorigenic Role Of Cathelicidin-Related Antimicrobial Peptide In Chemotaxis And Differentiation Of Myeloid Lineage During Prostate Cancer Progression, Ha-Ram Cha

All ETDs from UAB

A growing body of evidence indicates a positive correlation between the expression of human antimicrobial peptide leucine leucine 37 (LL-37) and the progression of epithelial cancers, including carcinomas of the breast, lung, ovary, and prostate. Although the molecular mechanisms for this correlation have not yet been clearly elucidated, the primary function of LL-37 as a chemotactic molecule for innate immune effector cells suggests its possible association in coordinating protumorigenic mechanisms mediated by tumor-infiltrating immune cells. Using a mouse model of epithelial prostate cancer (PCa), the present study identified a unique role for cathelicidin-related antimicrobial peptide (CRAMP), a murine orthologue of …

Statistical Modeling Of Microrna Expression With Human Cancers, Ke-Sheng Wang, Yue Pan, Chun Xu

Health & Biomedical Sciences Faculty Publications

MicroRNAs (miRNAs) are small non-coding RNAs (containing about 22 nucleotides) that regulate gene expression. MiRNAs are involved in many different biological processes such as cell proliferation, differentiation, apoptosis, fat metabolism, and human cancer genes; while miRNAs may function as candidates for diagnostic and prognostic biomarkers and predictors of drug response. This paper emphasizes the statistical methods in the analysis of the associations of miRNA gene expression with human cancers and related clinical phenotypes: 1) simple statistical methods include chi-square test, correlation analysis, t-test and one-way ANOVA; 2) regression models include linear and logistic regression; 3) survival analysis approaches such as …

El Razonamiento Clínico Desde El Ciclo Básico, Una Opción De Integración En Las Ciencias Médicas, María Teresa Castañeda Licón, Hugo Esteban Rodríguez Uribe, Octelina Castillo Ruiz, Erick D. Lopez, José M. Rodriguez

Health & Biomedical Sciences Faculty Publications

Fundamento: el razonamiento clínico propicia la integración de conocimientos en la formación del profesional de la salud para el desempeño adecuado de su futura labor.

Objetivo: analizar la opinión general de los estudiantes acerca de la inserción de casos clínicos en la asignatura Fisiología, para propiciar el desarrollo del razonamiento clínico desde las ciencias básicas biomédicas.

Métodos: se realizó un estudio descriptivo transversal en la Facultad de Medicina de la Universidad Autónoma de Tamaulipas. El universo estuvo constituido por los estudiantes del tercer semestre de la carrera durante el período de enero a mayo de 2013. Se seleccionó una muestra …

Bayesian Survival Analysis Of Genetic Variants In Ptprn2 Gene For Age At Onset Of Cancer, Ke-Sheng Wang, Yue Pan, Weize Wang, Chun Xu

Health & Biomedical Sciences Faculty Publications

Background: The protein tyrosine phosphatase, receptor type, N polypeptide 2 (PTPRN2) gene may play a role in cancer; however, no study has focused on the associations of genetic variants within the PTPRN2 gene with age at onset (AAO) of cancer.

Methods: This study examined 220 single nucleotide polymorphisms (SNPs) within the PTPRN2 gene in the Marshfield sample with 716 cancer cases (any diagnosed cancer, excluding minor skin cancer) and 2,848 non-cancer controls. Multiple logistic regression model and linear regression model in PLINK software were used to examine the association of each SNP with the risk of cancer and AAO, respectively. …

Genome-Wide Methylome Analyses Reveal Novel Epigenetic Regulation Patterns In Schizophrenia And Bipolar Disorder, Yongsheng Li, Cynthia Camarillo, Juan Xu, Tania Bedard Arana, Yun Xiao, Zheng Zhao, Hong Chen, Mercedes Ramirez, Juan Zavala, Michael A. Escamilla, Chun Xu

Health & Biomedical Sciences Faculty Publications

Schizophrenia (SZ) and bipolar disorder (BP) are complex genetic disorders. Their appearance is also likely informed by as yet only partially described epigenetic contributions. Using a sequencing-based method for genome-wide analysis, we quantitatively compared the blood DNA methylation landscapes in SZ and BP subjects to control, both in an understudied population, Hispanics along the US-Mexico border. Remarkably, we identified thousands of differentially methylated regions for SZ and BP preferentially located in promoters 3'-UTRs and 5'-UTRs of genes. Distinct patterns of aberrant methylation of promoter sequences were located surrounding transcription start sites. In these instances, aberrant methylation occurred in CpG islands …

Tau-Sh3 Interactions: Implications For Alzheimer's Disease, Jesse Nicholas Cochran

All ETDs from UAB

Alzheimer’s disease (AD) is the most common neurodegenerative disease and with Americans’ increasing longevity it is becoming an epidemic. There are currently no effective treatments for this disorder. Abnormalities of tau track more closely with cognitive decline than the most studied therapeutic target in AD, amyloid-beta, but the optimal strategy for targeting tau has not yet been identified. Based on considerable preclinical data from AD models, we hypothesize that interactions between tau and SH3 domain–containing proteins are pathogenic in AD. Genetically reducing either tau or tau interactants has beneficial effects relevant to AD. Here, we describe a drug screen for …

Behavioral And Developmental Abnormalities In Sult4a1 Deficient Zebrafish, Francis Crittenden

All ETDs from UAB

Since its identification in 2000, sulfotransferase (SULT) 4A1 has presented an enigma to the field of cytosolic SULT biology. SULT4A1 is exclusively expressed in neural tissue, is highly conserved, and has been identified in every vertebrate studied to date. Despite this singular level of conservation, no substrate or function for SULT4A1 has been identified. Previous studies demonstrated that SULT4A1 does not bind the obligate sulfate donor, 3’-phosphoadenosine-5’-phosphosulfate (PAPS), yet SULT4A1 is classified as a SULT superfamily member based on sequence and structural similarities to the other SULTs. In this study, RNA-seq was used to search for alterations in gene ex-pression …

Count Models With Multiple Inflations, Arvind Tripathi

All ETDs from UAB

The goal of this research is to develop new statistical models for the analysis of count data even if data exhibit over dispersion or under dispersion and has multiple inflated counts. Although many statistical models are available for the analysis of count data, there is no available statistical model that can address the presence of more than expected multiple counts together with over/under dispersion. In our first paper, we develop a multiple-inflation negative binomial (MINB) model and use the expectation maximization (EM) algorithm along with a numerical optimization to obtain maximum likelihood estimates. We applied the one step smoothly clipped …

Hepatocyte Clock And Alcohol-Dependent Disruption In Glycogen Metabolism, Uduak Sunday Udoh

All ETDs from UAB

Chronic alcohol consumption has been shown to significantly decrease hepatic glycogen, an important storage form of energy for the body and liver. Emerging studies indicate a link between metabolism and the molecular circadian clock. Previously, we have shown that chronic alcohol consumption disrupts the liver molecular clock mechanism. However, it is not known how this alteration impacts hepatic energy (e.g., glycogen) metabolism and contributes to alcohol hepatotoxicity. This dissertation investigates the impact chronic alcohol consumption has on time-of-day-dependent oscillations of various aspects of liver glycogen metabolism, and the importance of the liver circadian clock in these metabolic alterations. Chapter 1: …

Individual, Family, And Social Factors Associated With Adolescent Obesity: A Policy Relevant Focus, Janice Marguerite Utley

All ETDs from UAB

INDIVIDUAL, FAMILY, AND SOCIAL FACTORS ASSOCIATED WITH ADOLESCENT OBESITY: A POLICY RELEVANT FOCUS JANICE M. UTLEY PUBLIC HEALTH ABSTRACT This dissertation is comprised of three papers that examined individual, family, and social factors associated with adolescent overweight and obesity with the aim of generating data that could inform the design of policy interventions to prevent or reverse rising prevalence. The first investigation was a type of literature review called a scoping study that examined the extent, range, and type of research activity on adolescent obesity that used a multilevel or hierarchical design to look at two or more contextual areas …

A Novel Role For Usp14 In Regulating Non-Proteolytic Ubiquitin Signaling, Jada Hallengren Vaden

All ETDs from UAB

Loss of the deubiquitinating enzyme (DUB) USP14 in the ataxia (axJ) mice leads to altered neuromuscular junction (NMJ) structure, reduced synaptic transmission at the NMJ, and decreased mobility. However, the types of processes that USP14 regulates in the nervous system remain unclear. Because association with the proteasome stimulates USP14's ubiquitin hydrolase activity, it is thought to act primarily on proteasomal substrates. Therefore, one way for USP14 to support nervous system function is by modulating protein turnover. While a number of studies done in yeast and immortalized cell lines demonstrate that loss or inhibition of USP14 alters proteasome function, there is …

The Effects Of The Initially Transcribed Sequence On Reiterative Transcription In Escherichia Coli, Jeffery Michael Vahrenkamp

All ETDs from UAB

Transcription, the synthesis of a ribonucleic acid transcript using a nucleic acid template, is the first step in gene expression for all life. In most organisms, high fidelity transcription is achieved through the formation of an RNA:DNA hybrid which allows the RNA polymerase to maintain the correct register. Slippage, which would lead to improper base pairing, is prevented by the heterogeneous sequence of the DNA template. However, when homogenous tracts of bases are present in the template, slippage can occur, allowing a single base in the template to encode multiple bases in the transcript in a process called reiterative transcription. …

A Grounded Theory Model For Faculty Evaluation Of Nursing Student Performance During A Simulation, Penni Isla Watts

All ETDs from UAB

This qualitative grounded theory study explored the process of faculty evaluation of student performance during simulation in the southern United States. In the last decade, simulation experiences have been found to be useful in nursing education as a teaching methodology and as a potential method for evaluation of student performance. While clinical experiences are limited, unpredictable, and difficult to truly evaluate, simulation experiences provide an opportunity for students to manage care through pre-planned patient scenarios without potential harm to real patients. This allows faculty to observe students making decisions and caring for simulated patients in a context designed to elicit …

Characterizing The Nuclear Import And Functions Of Cystin, The Ciliary Protein Disrupted In The Cpk Mouse Model Of Recessive Polycystic Kidney Disease, Jacob Asher Watts

All ETDs from UAB

Autosomal recessive polycystic kidney disease (ARPKD; MIM 263200) is a ma-jor cause of pediatric morbidity and mortality. Typically, orthologous animal models are the mainstay for pathogenic studies of human diseases. However, gene-targeting of Pkhd1, the mouse ortholog of the ARPKD gene, results in mutants with little or no kidney disease. In contrast, disruption of the non-orthologous gene, Cys1, in the cpk mouse model closely phenocopies human ARPKD. We speculate that this phenotypic similarity suggests that the Pkhd1 and Cys1 genes encode proteins (FPC and cystin, respectively) that share, at least in part, common molecular pathways. Our laboratory, as well as …

Effectiveness Of Functional Electrical Stimulation Assisted Rowing To Improve Shoulder Pain And Aerobic Fitness In Manual Wheelchair Users With Spinal Cord Injury, Susan Wilbanks

All ETDs from UAB

Exercise is beneficial to adults with spinal cord injury (SCI) because of its ability to improve function and increase life expectancy. The goal of this dissertation was to determine an effective intervention for increasing aerobic fitness and decreasing shoulder pain in manual wheelchair users with SCI by identifying underlying mechanisms for shoulder pain, optimizing training and utilizing appropriate outcome measures. Three studies were conducted. The first study indicated that exercise interventions for adults with SCI are of low to moderate methodological quality, frequently using outcome measures associated with changes in body structures and functions, and not frequently examining effects on …

Examining Parental And Neighborhood Factors As Moderators In A Youth Violence Prevention Pilot Study, Kendra Piper

All ETDs from UAB

Youth violence is a significant and prevalent public health concern in the United States. Adolescents and young adults have the highest rates of violent crime perpetration and victimization. Youth violence is a complex problem involving multiple levels of influence that interact to diminish or increase risk and protective factors in high risk communities. Family and neighborhood factors have emerged as prominent influences on the risk of violent and delinquent behavior. Approaches to reducing risk behaviors in adolescence have moved beyond traditional risk-factor reduction to emphasize the importance of enhancing protective factors. Positive youth development programs have been found to be …

Trends, Market Correlates, And The Impact Of Health Information Exchange, Saurabh Rahurkar

All ETDs from UAB

The purpose of this dissertation is to examine the effects of Health Information Exchange (HIE) as well to evaluate hospital and market characteristics related to trends in HIE adoption. Widespread HIE is believed to boost efficiency, reduce health care costs, and improve outcomes; as such numerous efforts have aimed to promote and facilitate HIE by providers. Despite this, over a quarter of all hospitals in the U.S. do not participate in HIE and thus it is essential to examine the evidence for the theorized benefits from HIE. As such, the first paper systematically reviews the literature examining the relationship of …

Bioavailability Of Dietary Oxalate, Mary Catherine Robertson

All ETDs from UAB

Urolithiasis, or kidney stone disease, is a costly and painful health problem affecting about 8.8% of Americans with prevalence on the rise. Calcium oxalate stones account for about 80% of all stones. Increased urinary excretion of calcium and oxalate is a risk factor and central feature of such stones; dietary oxalate contributes up to 50% of urinary oxalate. The purpose of our research is to determine if physical manipulation such as chewing or blending prior to ingestion may render some oxalate more accessible for absorption in spinach, a high-oxalate food. In this crossover, controlled trial we enrolled six healthy, non-stone …

The Mechanism Of Small Molecule Viral Fusion Inhibitors, Michael Joseph Rowse

All ETDs from UAB

All negative stranded RNA viruses (NSRV) have genomes encapsidated by oligomerized nucleoprotein (N). The N-RNA complex acts as the template for both transcription and replication. The crystal structure of the N protein from the model NSRV vesicular stomatitis virus (VSV) established the structural basis for the oligomerization of N-protein and the encapsidation of RNA. To determine how the structure of N protein changes in response to specific sequences of RNA, we developed a strategy to digest the random RNA encapsidated in the recombinant N-protein and reencapsidated specific RNA sequences. Poly-rA, poly-rC, poly-rU, and poly-rG sequences were encapsidated and co-crystallized with …

Associations Of Gestational Weight Gain And Breastfeeding With Postpartum Weight Change Among African American Women, Camille Schneider

All ETDs from UAB

Objective: To examine the associations of gestational weight gain (GWG) and breastfeeding (BF) with postpartum (PP) weight change among African American women. Methods: Healthy, low-income African American women (n=32) were enrolled in a prospective observational cohort study of early life origins of obesity. GWG was calculated using data retrieved from medical records. Women were stratified according to the 2009 Institute of Medicine (IOM) GWG guidelines. Investigators measured maternal body weight at 2-weeks and 3-months PP, with the difference reflecting PP weight change. BF status at 2-weeks PP was self-reported. Analysis of covariance with Bonferroni post hoc testing was used to …

The Sialyltransferase St6gal-I Promotes A Cancer Stem Cell Phenotype, Matthew Jonathan Schultz

All ETDs from UAB

Alterations in tumor cell glycosylation have been observed for decades, but the functional consequences of specific glycosyltransferase activity are not well understood. This dissertation focuses on the role of the sialyltransferase ST6Gal-I in driving ovarian and pancreatic cancer development. ST6Gal-I adds a negatively-charged sialic acid sugar in an alpha 2-6 linkage to select receptors, which can alter their function. We show that ST6Gal-I protein is upregulated in ovarian and pancreatic cancers but not expressed in normal epithelial tissue from these organs. ST6Gal-I expression in ovarian cancer correlates with decreased progression-free and overall survival, and we present evidence that ST6Gal-I expression …