Medicine and Health Sciences Commons^™

Conjunctival Gene Expression And Tear Biomarkers In Atopic And Non-Atopic Keratoconus Patients Relative To Matching Controls, Erika Marie Morrow

All ETDs from UAB

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The Relationship Between Hospital Interdepartmental Transfers And Patient Experience, Betty O. Mortensen

All ETDs from UAB

This study examined the potential relationship between interdepartmental transfers and perceptions of adult patients who were admitted and discharged from a 300-bed, not-for-profit community tertiary hospital in the Midwest. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a publically reported comparative data tool measuring hospital patient experiences. As consumers, patients are more informed about their own health and are challenging the quality and service of care provided by hospitals. The value-based purchasing reimbursement model has become a new challenge for hospitals. Historically, hospitals were reimbursed through a volume driven model. Comparatively, the value-based model focuses on …

Transcriptional Regulation Of Interleukin 10 In Cd4+ T Cells, Carson Edward Moseley

All ETDs from UAB

Autoimmune and autoinflammatory diseases are a collection of disorders that are mediated by reaction of the adaptive immune system against self or commensal antigens. Altered transcription of genes involved in T cell activation and function is a key mediator of predisposition to numerous autoimmune disorders, including Inflammatory Bowel Disease (IBD) and Multiple Sclerosis (MS). However, we have an inadequate understanding of how the transcriptional circuits controlling these genes are dysregulated in disease. Interleukin-10 (IL-10) is cytokine with potent anti-inflammatory activity that is critical for restraining immune-mediated pathology to self-tissues. Notably, patients with nullifying mutations in IL10 develop a severe IBD …

Examining The Impact Of Emergency Department (Ed) Registered Nurse (Rn) Staffing On Ed Patient Experience, Deana L. Nelson

All ETDs from UAB

EXAMINING THE IMPACT OF EMERGENCY DEPARTMENT (ED) REGISTERED NURSE (RN) STAFFING ON ED PATIENT EXPERIENCE DEANA NELSON DOCTOR OF SCIENCE IN HEALTH SERVICES ADMINISTRATION ABSTRACT Patient experience ratings are important to healthcare organizations from both a clinical and financial perspective. Studies examining the relationship between patient experience and nurse staffing are prevalent in the inpatient setting, but not as much is known about how staffing affects these ratings in the Emergency Department (ED). This study examined the relationships between ED RN staffing, patient expectations and patient experience ratings, using a conceptual framework adapted from Donabedian’s structure/process/outcome model, and expectancy disconfirmation …

The Regulation Of Alternative Pre-Mrna Splicing In Photoreceptor Cells., Daniel P. Murphy

Graduate Theses, Dissertations, and Problem Reports (ETD)

Alternative pre-mRNA splicing provides an important mechanism for generating the diverse array of proteins required to generate complex tissue and cell types from a limited genome. Therefore, the proper regulation of alternative splicing is vital to shape cellular identity and function. As consequence, defects in alternative splicing are associated with disease phenotypes that can range from systemic syndromes to the dysfunction of single cell types. For example, heterozygous mutations in ubiquitously expressed components of the spliceosome lead to photoreceptor specific cell death. This suggests that the topography of alternative splicing in photoreceptors cells may be unique, a notion which is …

The Effect Of Common Wrist Orthoses On The Stiffness Of Wrist Rotations, Daniel B. Seegmiller, Dennis L. Eggett, Steven K. Charles

Faculty Publications

Wrist orthoses (also known as splints, braces, or supports) are commonly used to support or restrict the motion of a weak or injured wrist. These orthoses generally function by stiffening the wrist joint. Therefore, choosing the proper orthosis (or improving orthoses) requires that we understand their stiffness properties. In this study, we present a method for measuring the stiffness of wrist orthoses, and we apply this method to 12 of the most common wrist orthoses. We found similarities and differences between these orthoses, indicating that different orthoses have different effects on the wrist joint and, presumably, on wrist behavior. In …

La Diabetes Y La Alimentación Determinantes En La Progresión De Aterosclerosis, Adriana Leticia Perales-Torres, Octelina Castillo-Ruíz, María Teresa Castañeda Licón, Sanjuana E. Alemán-Castillo, Juan Miguel Jiménez Andrade

Health & Biomedical Sciences Faculty Publications

El propósito de esta revisión es analizar la progresión bioquímica de la placa aterosclerótica y la relación que presenta con la diabetes y la alimentación. Se exponen las evidencias científicas de pacientes con diabetes, que a diferencia de pacientes no diabéticos presentan niveles más elevados de algunos ácidos grasos en la placa de ateroma (como el palmítico, linoleico y oleico), elevada incidencia de trombosis coronaria relacionada con el incremento en el tama˜no de la base necrótica y la disminución del tama˜no de la capa fibrosa de los ateromas. Entre ambos grupos de pacientes se expone la diferencia en el perfil …

Hospital-Physician Vertical Integration: The Effect Of Integration On Cardiology Compensation And Clinical Productivity, Vance Mcleod Chunn

All ETDs from UAB

HC2.

Cultural Competence Practices Implemented In Hospitals And Health Systems By Minority Executives On The Top Management Team, John H. Cunningham

All ETDs from UAB

The study examined whether hospital implementation of cultural competence practices was influenced by the racial/ethnic composition of top management. With one-third of the U.S. population identifying with a racial or ethnic group other than non-Hispanic White, and that population continuing to grow increasingly diverse, racial and ethnic minorities are increasingly accessing health care services. Yet they represent less than 1% of the top management teams (TMT) of health care organizations. The study sought to determine the extent to which health care organizations with TMTs that are representative of the racial and ethnic compositions of the communities in which they serve …

Three-Dimensional Facial Morphological Changes From Adolescence To Adulthood In Caucasian And African American Populations, Matthew Davis

All ETDs from UAB

The purpose of this cross sectional retrospective study was to use three dimensional surface imaging to determine gender dimorphism and facial morphological changes from adolescence to adulthood in African American and Caucasian populations. Materials and Methods: Three-dimensional images were captured using a laser scanner (Minolta Vivid VI900) and a stereophotogrammatic camera system (3dMDfaceTM). The total sample size included 371 subjects, including the following: 107 African-American adolescents 10–13 years of age, 100 African-American adults 19–30 years of age, 64 Caucasian adolescents 10–13 years of age, and 100 Caucasian adults 18–30 years of age. All subjects had normal body mass index, no …

Human Cytosolic Sulfotransferase (Sult) 1b1 Half-Site Reactivity And The Identification And Characterization Of A Novel Variant Sult1b1 Isoform (L145v), Zachary Evan Tibbs

All ETDs from UAB

The human cytosolic sulfotransferases (hSULTs) are a fourteen-member family of phase II drug-metabolizing enzymes that catalyze the transfer of a sulfonate moiety from 3’-phosphoadenosine 5’-phosphosulfate (PAPS) to a recipient substrate. SULT-mediated sulfation serves to deactivate physiological hormones and detoxify xenobiotics. SULT1B1 is primarily resident to the gastrointestinal tract, liver, and possibly peripheral white blood cells (WBCs), whereby it performs its supposed physiological role. The iso-form has the capacity to sulfate thyroid hormones, small phenols, and polyaromatic hy-drocarbons resulting in their inactivation, detoxification, and bioactivation/detoxification, respectively. Immunohistochemistry was used to show hSULT1B1 protein is present in periph-eral lymphocytes and neutrophils. Further, …

Microglia Orchestrate The Inflammatory Response To Alpha-Synuclein In Parkinson Disease Models, Aaron Thome

All ETDs from UAB

Parkinson disease (PD) is the most common neurodegenerative movement disorder characterized by a progressive loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc) and widespread aggregates of the protein alpha-synuclein (α-syn). Increasing evidence points to inflammation as a chief mediator of PD with many of the inflammatory manifestations of human PD cases recapitulated in animal models of PD. We began by examining the inflammatory potential of α-syn fibrils, a newly characterized α-syn conformation that is neurotoxic and prion-like in its endogenous α-syn recruitment and cellular transmission. Our studies provide evidence that the α-syn fibrils evoke a pro-inflammatory response …

Polycomb Repressive Complex 2 And Heterochromatin Protein 1 Beta Regulate Neural And Neural Crest Development, Chih-Liang Tien

All ETDs from UAB

Epigenetic factors control gene expression via modulating chromatin conformation. Current studies on epigenetics mainly focus on biochemical mechanisms or functions of epigenetic factors in cancer or neurobiology. The underlying mechanism for epigenetic regulation in early embryonic development, particularly neural and neural crest development, is not well understood. In this thesis, the model organism, Xenopus laevis, is used to study epigenetic factors – polycomb repressive complex 2 (PRC2) and heterochromatin protein 1 beta (HP1β) in neural and neural crest development. In chapter one, the processes of neural and neural crest development are described, and the concepts of epigenetic mechanisms, such as …

The Experience Of The Expectant Mother Follwing A Diagnosis Of A Fetal Anomaly, Janet Adams Tucker

All ETDs from UAB

statistical analysis to estimate the parameters of a general linear model. Yet, when the

Methods For Analysis Of Genetic Differences In Sex And Ethnicity For Complex Human Traits, Yogasudha Veturi Veturi

All ETDs from UAB

In the last two decades, thousands of genome-wide association (GWA) analyses have been published. These studies have been primarily conducted using data from Caucasians and many of the reported findings have not been replicated in other populations, perhaps reflecting that the underlying architecture of effects may vary across ethnically diverse groups. Similarly, the possibility that the genetic architecture of traits may vary between males and females has also been overlooked. We propose a methodology for estimation and testing of effect heterogeneity between groups such as sex or ethnicity that involves modeling genotype-by-group random interactions. Using simulations, we show that the …

Pay For Performance In Dentistry: Is It Worth It?, Andreea Voinea-Griffin

All ETDs from UAB

Introduction: The variability of dental care and the slow implementation of evidence-based dentistry point to the need for change. Pay for performance (P4P) programs may foster quality improvement if appropriately designed. This work demonstrates the use of modeling and simulation to evaluate such programs prior to deployment. An example is provided in the form of a P4P program for the treatment of occlusal early caries (EC) in permanent teeth. Research Design: The proposed P4P program evaluation consists of two steps. First step is to determine the optimal treatment. In this example, three non-invasive treatments (NTs), watchful-waiting (WW), sealants, and fluoride …

Effect Of Margin Design On Fracture Strength Of Zirconia Crown, Eleni Voltidi

All ETDs from UAB

Purpose: To compare the fracture load of monolithic Zirconia crowns and E-max crowns with different margin designs and to create a guideline for margin design for monolithic Zirconia crowns. Methods: Digital design of prep maxillary molar tooth was performed with TOC 20 degrees and occlusal reduction 1 mm and axial reduction 1 mm and two different margin designs (group 1: Shoulder 0.8mm group 2: Light Chamfer 0.3mm). Dies were milled using Ultra Crystal material. Monolithic Zirconia crowns were milled (n=9 in group 1 and n=8 in group 2). Crowns were cemented with Rely X luting Plus. The specimens were stored …

Germline Restriction Of B Cell Receptor Repertoire Influences Antigenic Epitope Recognition And Primary Antibody Deficiency Pathogenesis, Yuge Wang

All ETDs from UAB

Part I. Mouse Studies Complementarity determining region 3 of the immunoglobulin (Ig) H chain (CDR-H3) lies at the center of the antigen binding site where it often plays a decisive role in antigen recognition and binding. Amino acids encoded by the diversity (DH) gene segment are the main component of CDR-H3. Each DH has the potential to rearrange into one of six DH reading frames (RFs), each of which exhibits a characteristic amino acid hydrophobicity signature that has been conserved among jawed vertebrates by natural selection. A preference for use of RF1 promotes the incorporation of tyrosine into CDR-H3 while …

Cell Signaling Pathways As Targets For Precision Medicine In Head And Neck Squamous Cell Carcinoma, Alice Weaver

All ETDs from UAB

Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous disease with high rates of recurrence and mortality. Unlike other cancer types, genome sequencing studies have failed to produce clinically actionable targets to improve HNSCC management. Therefore, alternative methods are needed to study the molecular mechanisms responsible for disease progression and response to therapy. The focus of this research was to determine how dysregulation of cell signaling pathways affects outcomes in HNSCC. In HPV-positive HNSCCs, we hypothesized that HPV induces dysregulation of the DNA damage response which mediates differences in therapeutic sensitivity and survival. We identified a defect in DNA …

The Effect Of Data-Entry Template Design And Anesthesia Provider Workload On Documentation Quality, Documentation Efficiency, And User-Satisfaction, Bryan Anthony Wilbanks

All ETDs from UAB

The purpose of this study was to evaluate the relationships between method of data entry into electronic health records and anesthesia provider workload on: (a) documentation efficiency, (b) intraoperative anesthesia documentation accuracy, and (c) user satisfaction. The study was separated into three papers. The first paper is an integrative literature review on how accuracy was defined in anesthesia information management systems. The second paper was a state-of-the-science literature review that presents evidence-based guidelines for interface design for data entry into electronic health records. The third paper was an empirical study to detect relationships among all of the concepts of interest …

Influence Of Maternal Age On The Effects Of Organic Selenium In The Animal Model Daphnia Pulex, Jordan E. Roberts

All ETDs from UAB

As a necessary micronutrient, seleno-L-methionine (SeMet) exhibits a U-shaped dose-response with deficiency and toxicity leading to adverse health outcomes. Some studies suggest dietary selenium may offer protection against toxicity from other metals, but excessive dietary levels can also lead to toxicity. In addition, increased maternal age has been shown to increase the risk of adverse developmental outcomes. We hypothesize that older maternal age will increase susceptibility in offspring exposed to toxic concentrations of SeMet. The goal of this project was to evaluate the effects of SeMet treatment on lifespan and determine if the effects are altered by maternal age using …

Cd4 Regulatory T Cells Augment Hiv-1 Expression Of Polarized M1 And M2 Monocyte Derived Macrophages, Tanya Robinson

All ETDs from UAB

Polarization of macrophages is critical for an effective host immune response against invading pathogens. However, the HIV-1 virus can alter the cytokine/chemokine profile of polarized macrophages which may ultimately lead to their increased susceptibility to viral infection. M1 monocyte-derived macrophages (MDM) have been shown to suppress CCR5-tropic HIV-1 replication, while M2 MDM promote it. We generated M1 (GM-CSF + IFN-γ + LPS) and M2 (M-CSF + IL-4) MDM with predicted phenotypes and exposed them to a CCR5 (R5) “highly macrophage-tropic” viral strain, HIV-1BaL. M2 MDM had notably higher levels of HIV-1 infection than M1 MDM. We also investigated R5 HIV-1 …

Altering Metabolism In The Tumor Microenvironment To Enhance Anti-Tumor Immunity For Lung Cancer, Cara Schafer

All ETDs from UAB

Overcoming cancer cell immune escape represents a fundamental obstacle in the treatment of cancer. Indoleamine 2,3-dioxygenase (IDO)-expressing myeloid-derived suppressor cells (MDSCs) are known to induce oxidative stress and alter amino acid metabolism within the tumor microenvironment (TME). The tryptophan (Trp)-catabolizing action of IDO not only promotes T cell tolerance and evasion but is also associated with impaired quality of life in cancer patients. We have previously demonstrated that a novel combination therapy, consisting of MDSC-depleting gemcitabine and a superoxide dismutase mimetic, prolonged survival of tumor-bearing mice by enhancing CD8+ memory T cell metabolism. We identify that combination therapy inhibits IDO …

16s Rrna Gene Sequencing To Evaluate The Effects Of Six Commonly Prescribed Antibiotics, Kendall Slaton

All ETDs from UAB

16s rrna gene sequencing to evaluate the effects of six commonly prescribed antibiotics kendall slaton, dmd dentistry abstract introduction: the rapid antibiotic sensitivity test (rast) is a novel in-office culture and sensitivity system for endodontic infections. the purpose of this research was to validate the rast system as a viable, in-office alternative to antibiotic sensitivity testing using turbidity, to determine antibiotic sensitivities of endodontic infections. methods: aspirates were taken from the root canals of nine necrotic human teeth at the initiation of root canal therapy. these samples were cultured in the rast medium and antibiotic sensitivity to six antibiotics was …

Learning By Doing: Students From Three Disciplines Work Together To Help People With Dementia With Their Communication And Physical Challenges., Tyson G. Harmon, Brenda Everett Mitchell, Anna Weinberg

Faculty Publications

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Exploring The Clinical Utility Of Relative Fundamental Frequency As An Objective Measure Of Vocal Hyperfunction, Christopher Dromey, Nelson Roy, Rebecca A. Fetrow, Ray M. Merrill

Faculty Publications

Purpose: Vocal hyperfunction, related to abnormal laryngeal muscle activity, is considered the proximal cause of primary muscle tension dysphonia (pMTD). Relative fundamental frequency (RFF) has been proposed as an objective acoustic marker of vocal hyperfunction. This study examined (a) the ability of RFF to track changes in vocal hyperfunction after treatment for pMTD and (b) the influence of dysphonia severity, among other factors, on the feasibility of RFF computation. Method: RFF calculations and dysphonia severity ratings were derived from pre- and posttreatment recordings from 111 women with pMTD and 20 healthy controls. Three vowel–voiceless consonant–vowel stimuli were analyzed. Results: RFF …

Laryngeal Desiccation Challenge And Nebulized Isotonic Saline In Healthy Male Singers And Nonsingers: Effects On Acoustic, Aerodynamic, And Self-Perceived Effort And Dryness Measures, Christopher Dromey, Kristine Tanner, Robert B. Fujiki, Ray M. Merrill, Whitney Robb, Katherine A. Kendall, J Arden Hopkin, Ron W. Channell, M Preeti Sivasankar

Faculty Publications

Summary: Objectives. This study examined the effects of a laryngeal desiccation challenge and nebulized isotonic saline on voice production in young, healthy male singers and nonsingers. Study design. This is a prospective, double-blind, within-subjects experimental design. Methods. Participants included 10 male university-trained singers and 10 age-matched nonsingers (mean age, 21.8 years; range, 18–26 years) who underwent a 30-minute oral breathing laryngeal desiccation challenge using medical grade dry air (<1% relative humidity) on two occasions in consecutive weeks. After the challenge, participants received either 3 mL or 9 mL of nebulized isotonic saline (0.9% Na+ Cl); order of administration was counterbalanced. Phonation threshold pressure (PTP), the cepstral spectral index of dysphonia (CSID) for sustained vowels and connected speech, and self-perceived vocal effort, mouth dryness, and throat dryness were measured at each recording (baseline, after challenge, and at 5, 35, and 65 minutes after treatment). Results. Self-perceived effort and dryness measures increased (worsened) after desiccation challenge and decreased (improved) after nebulized treatment (P < 0.05). No consistent changes were observed for PTP or CSID over time. Overall, singers demonstrated significantly lower vocal effort and CSID as compared with nonsingers. Conclusions. Young, vocally healthy men may not experience physiologic changes in voice production associated with laryngeal desiccation and nebulized saline treatments; however, self-reported increases in vocal effort which are associated with dryness symptoms might improve with nebulized treatments. Future hydration research should consider age and sex variables

The Effect Of Ignoring Statistical Interactions In Regression Analyses Conducted In Epidemiologic Studies: An Example With Survival Analysis Using Cox Proportional Hazards Regression Model, Kristina Vatcheva, Joseph B. Mccormick, Mohammad H. Rahbar

School of Mathematical & Statistical Sciences Faculty Publications

Objective: To demonstrate the adverse impact of ignoring statistical interactions in regression models used in epidemiologic studies.

Study design and setting: Based on different scenarios that involved known values for coefficient of the interaction term in Cox regression models we generated 1000 samples of size 600 each. The simulated samples and a real life data set from the Cameron County Hispanic Cohort were used to evaluate the effect of ignoring statistical interactions in these models.

Results: Compared to correctly specified Cox regression models with interaction terms, misspecified models without interaction terms resulted in up to 8.95 fold bias in estimated …

Density Functional Theory Calculations On The Doping Sequence Of Mnxfen(1-X)Ge, Jordan C. Ball

Honors Capstones

No abstract provided.

The Role Of Hydrogen Peroxide In The Modulation Of Capsule Biosynthesis In Streptococcus Pneumoniae Serotype 2, Jocelyn Renee Hauser

All ETDs from UAB

Streptococcus pneumoniae is a gram-positive bacterial pathogen that causes diseases such as pneumonia, meningitis, bacteremia and middle ear infections. The major virulence factor of S. pneumoniae is its polysaccharide capsule. The capsule enables the organism to evade host defenses by providing protection against complement-mediated opsonophagocytosis in systemic sites and by allowing the organism to successfully colonize the nasopharynx. The nasopharynx is the natural reservoir of S. pneumoniae. In the nasopharynx, S. pneumoniae is in a high oxygen (O2) environment, however when it has the opportunity to bypass host defenses and invade systemic sites, it reaches environments with low O2. Capsule …