Medicine and Health Sciences Commons^™

Bone Marrow Transplantation In A Mouse Model Of Cooley’S Anemia, Jonathan Russell Lockhart

All ETDs from UAB

β-thalassemia is a group of inherited blood disorders that result in defects in β-globin chain production. Cooley’s anemia (CA), or β-thalassemia major, is the most severe form of the disease and occurs when an individual has mutations in both copies of the adult β-globin gene. Patients with CA fail to make adult hemoglobin, have ineffective erythropoiesis, suffer from severe anemia, and are transfusion dependent for life. Currently, allogeneic bone marrow transplantation (BMT) is the only cure; however, few patients have suitable donors for this procedure that carries a significant risk of morbidity and mortality. To develop new and safer alternatives …

Financial Distress – Causes And Consequences: An Examination Of The Nursing Home Industry, Justin Caleb Lord

All ETDs from UAB

Nursing homes operate in a tumultuous and changing environment and are under increasing financial pressure, risk of closure, and financial distress. The issue of financial distress has been explored tangentially within the nursing home industry. This study is the first to validate the Altman Z-Score, a financial distress prediction model, within the nursing home context. The Altman Z-Score model uses multiple discriminate analysis (MDA) to examine multiple financial ratios (liquidity, efficiency, profitability and net worth) simultaneously to predict the likelihood of a firm’s financial distress. After calculating the Z-Score, clustering was used to classify the observations into three groups, distressed, …

Developing Novel And Effective Treatments For Pancreatic Ductal Adenocarcinoma, Aubrey Miller

All ETDs from UAB

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive tumor with a 5-year survival rate of 8%. Over 80% of patients are diagnosed with locally advanced or metastatic disease and undergo systemic chemotherapy with gemcitabine. Virtually all patients develop gemcitabine-resistant disease and median survival for these patients is ~6 months. Thus, identification of novel molecular targets and pre-clinical evaluation of therapeutics is essential to improving patient outcome. The bromodomain and extraterminal domain (BET) proteins are important regulators of transcription and have recently become a potentially effective target to treat PDAC. We have shown that the BET inhibitor JQ1 suppressed PDAC tumor …

Hiv Disclosure, Retention In Hiv Care, And Viral Load Suppression : A Study Among New To Hiv Care Patients, Riddhi Modi

All ETDs from UAB

HIV remains a major ongoing public health problem globally and in the United States (US). Despite the advances in the antiretroviral therapy (ART), new HIV cases continue to occur. Hence, understanding the factors that influence patient’s decision to HIV treatment and prevention is of paramount. HIV disclosure, an important modifiable behavior, is a barrier to linkage and engagement in HIV care. Thus far, studies examining HIV disclosure and its impact on HIV related outcomes, retention in care (RIC) and viral load (VL) suppression among HIV patients newly initiating care are scant. While these studies provide insights on risk factors of …

A Mixed Methods Study Evaluating A Pediatric To Adult Care Transition Program For Sickle Cell Disease, Ardie Vanessa Pack-Mabien

All ETDs from UAB

A MIXED METHODS STUDY EVALUATING A PEDIATRIC TO ADULT CARE TRANSITION PROGRAM FOR SICKLE CELL DISEASE ARDIE VANESSA PACK-MABIEN SCHOOL OF NURSING ABSTRACT Sickle cell disease is a potentially life-threatening hereditary hematological disorder. Transition from pediatric to adult care is a challenging process for many adolescents and young adults with sickle cell disease. These challenges involve the adolescent, young adult, family caregiver, health care provider, and health care system. To address the challenges, a limited number of sickle cell centers have developed transition programs to facilitate the transition process. However, research on transition programs is sparse. To address this gap, …

T Cell Immunity Directed Against Novel Anti-Sense Cryptic Epitopes And Its Impact On Hiv Viral Evolution, Binghao Jason Peng

All ETDs from UAB

After nearly four decades of scientific research, a global solution in eradicating the human immunodeficiency virus - 1 (HIV-1) pandemic has still yet to be discovered. The advent of antiretroviral therapies (ART) has significantly decreased the diseases burden for those infected with the virus; however, the access to ART is often limited to those with the financial abilities to afford it. For this reason, finding a way to vaccinate against HIV-1 successfully remains a sought-after pragmatic solution to this worldwide health issue. HIV immunological studies have taught us that increasing the breadth of response to the virus holds significant potential …

Mucus Adhesion As A Therapeutic Target In Cystic Fibrosis, Courtney Fernandez Petty

All ETDs from UAB

Cystic fibrosis (CF) is a genetic disease resulting from mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. CFTR is an ion channel responsible for proper movement of chloride and bicarbonate ions across the apical cell surface. Defective CFTR results in an absence of bicarbonate transport, which functions in part to chelate Ca2+, a divalent cation found in abundance in mucin granules in normal conditions; this yields a hyperviscous and adhesive mucus on the respiratory and gastrointestinal tracts of patients with CF. Bronchial mucins are glycosylated proteins with neutral and negative sugars modified by negatively charged sialic and neuraminic …

Transcriptional Changes Underpinning Poor Prognosis And Chemoresistance In Pancreatic Cancer, Ryne Ramaker

All ETDs from UAB

With a 5-year survival rate of 7% and only marginal improvements in recent dec-ades, pancreatic adenocarcinoma (PDAC) survival statistics present a disheartening chal-lenge. A majority of the high mortality rate associated with PDAC is due to late-stage diagnosis and limited efficacy of the current chemotherapeutic arsenal. This work is largely focused on the ~20% of tumors detected prior to metastasis for which curative surgical resection can be combined with chemotherapy and radiation therapy, increasing the 5 year survival rate to ~25%. Although a subset of these patients who undergo surgi-cal resection experience sustained remission, a majority of patients still relapse …

The Effect Of Novel Antibiotic Compounds On Endodontic Biofilms, Steven Rhodes

All ETDs from UAB

Purpose: To investigate the effects of three novel experimental antibiotics on monospecies (Enterococcus faecalis) and polymicrobial (mixed) endodontic biofilms. Materials and Methods: Biofilms containing pure Enterococcus faecalis, as well as biofilms derived from mixed bacterial samples aspirated from inside the pulp spaces of necrotic human teeth, were grown onto slices of human dental in vitro. Biofilm formation capability was verified with SEM. The treatment groups consisted of 3 novel experimental antibiotics. 8.25% sodium hypochlorite and sterile saline were used as the controls. The biofilms were investigated with live/dead fluorochrome staining and confocal laser scanning microscopy. Results: The full strength sodium …

The Effects Of Ketamine And Other Rapid Antidepressants On Hippocampal Circuits, Allie J. Widman

All ETDs from UAB

Major Depressive Disorder (MDD) in a common mental disorder that can impair cognitive functioning and negatively impact hippocampus. While several pharmacological treatments are currently available for MDD, most target the monoamine system, providing little variety in approaching treatment. Additionally, a large percentage of people with MDD have an inadequate response to this drug class, leaving them with little optimism of a full functional recovery. Recently, low-dose ketamine, an open-channel N-methyl D-aspartate receptor (NMDAR) antagonist, produced rapid antidepressant effects in humans, including people who do not respond to monoamine-based therapies, that lasted for days. The antidepressant-like behavioral effect of ketamine is …

Assessing The Comparative Effect Of Tocilizumab On Risk Of Cardiovascular Disease Among Rheumatoid Arthritis Patients Using Claims Data: A Direct Comparison Among Biologic Disease-Modifying Antirheumatic Drugs, Fenglong Xie

All ETDs from UAB

ASSESSING THE COMPARATIVE EFFECT OF TOCILIZUMAB ON RISK OF CARDIOVASCULAR DISEASE AMONG RHEUMATOID ARTHRITIS PATIENTS USING CLAIMS DATA: A DIRECT COMPARISON AMONG BIOLOGIC DISEASEMODIFYING ANTIRHEUMATIC DRUGS FENGLONG XIE PhD-EPID ABSTRACT Tocilizumab is a humanized monoclonal anti-body against the interleukin-6 receptor and is effective in the treatment of rheumatoid arthritis (RA) [1]. Multiple studies have observed unfavorable changes in the lipid profile of tocilizumab-treated RA patients. Few studies have compared the cardiovascular disease (CVD) risk associated with tocilizumab to other biologic disease-modifying antirheumatic drugs (bDMARDS). Due to limitations in existing studies, the real-world association of tocilizumab with CVD risk remains uncertain. …

Interorganizational Relationships And Hospital Adoption Of Surgical Robots, Stephen Cullen

All ETDs from UAB

INTERORGANIZATIONAL RELATIONSHIPS AND HOSPITAL ADOPTION OF SURGICAL ROBOTS STEPHEN G. CULLEN EXECUTIVE DOCTORIAL PROGRAM IN HEALTHCARE LEADERSHIP ABSTRACT The study investigates the relationship between interorganizational relationships (IORs) and hospital adoption of robotic surgery in the United States over a ten-year period. As a competitive strategy for hospitals, IORs should matter in a hospital’s decision to adopt a surgical robot given associated costs and risks. While literature exists on IORs and technical innovation, there is a gap in the literature on IORs and hospital adoption of surgical robots. This study explores four types of IORs (i.e., networks, systems, contract management, and …

Effects Of Dietary R,S-1,3 Butanediol Diacetoacetate On Components Of Energy Balance, Rachel A H Davis

All ETDs from UAB

Ketogenic diet (KD) has been used to attenuate the decline in energy expenditure occurring from calorie restriction-induced weight loss, but long-term adherence can be difficult due to the strict nature of the diet. The growing body of evidence supporting KD-treatment of neurologic and metabolic diseases, as well as obesity, has prompted interest in the ability to increase circulating ketones via exogenous delivery. Ketone esters (KE) can raise blood ketone concentrations similarly to fasting and appear to reduce food intake acutely, but studies assessing effects on energy balance are limited and provide a potentially promising direction for weight control. Previous investigations …

Examining The Relationship Between Operational And Clinical Performances Of Federally Qualified Community Health Centers, Ganisher K. Davlyatov

All ETDs from UAB

This dissertation studied the role of Health Information Technology (HIT) adoption on clinical performance; the effects of clinical performance on chief executive officer (CEO) compensation; and the association between CHC’s financial and clinical performances in Community Health Centers (CHC). Data from the Uniform Data System (UDS) and the Internal Revenue System (IRS) 990 Forms were extracted for the period 2011-2016. Generalized estimating equations models with state and year fixed effects were performed. To test the relationship between the age and extent of HIT adoption and clinical performance, Resource-Based View of the Firm constructs were used. The age of HIT adoption …

Cheminformatic Discovery And Characterization Of Copperdependent Bacterial Inhibitors, Alex Dalecki

All ETDs from UAB

Deaths due to antibiotic-resistant bacteria are predicted to exceed 10 million per year by 2050, endangering our ability to conduct fundamental medical procedures such as immunosuppressive therapy or even basic surgery. Unfortunately, we are largely falling behind in the evolutionary arms race against common pathogens. Not only are we in sore need of new antibiotics, we also evidently need altogether new approaches to drug discovery itself, as our familiar avenues are increasingly failing to meet demands. In this dissertation, we describe a promising new source of antibacterials: copper-dependent inhibitors (CDIs), compounds that exert significant antibiotic activity only in the presence …

Elucidating The Role Of Hedgehog Signaling In Modulating Macrophage Function In Breast Cancer, Ann Hanna

All ETDs from UAB

In the tumor microenvironment, breast cancer cells participate in crosstalk with the surrounding stroma. This tumoral-stromal interaction forms a balance that dictates tumor suppressing or tumor promoting response mechanisms. Macrophages in the tumor microenvironment are plastic and can mediate several functions depending on their activation states. Tumor associated macrophages co-exist as two major phenotypes: anti-tumorigenic and immune-eliciting classically activated M1 as well as tumor-promoting and immune-suppressive alternatively activated M2 macrophages. Alternatively activated macrophages are specifically associated with more aggressive stages and poor clinical outcomes in breast cancer patients as they suppress the tumoricidal properties of the immune system, thus facilitating …

Applications Of Next-Generation Sequencing And Functional Genomics In Translational Medicine, Andrew Hardigan

All ETDs from UAB

The development of next-generation sequencing (NGS) technologies has led to unparalleled advances in our understanding of the genetic basis of disease, evolution, and genetic and genomic regulation. Building on the advances made in the Human Genome Project and more recent efforts such as the Encylopedia of DNA Elements (ENCODE) and the Roadmap Epigenomics Project, whole-genome and whole-exome sequencing (WGS/WES) and a wide variety of NGS-enabled functional assays are bridging the gap between scientific discovery and clinical medicine. This trend towards genomically informed “bench-to-bedside” translational medicine is driven in large part by the sharply decreasing costs for NGS in both clinical …

A Qualitative Descriptive Study Exploring The Adaptation Of Families Of Children With Multiple Sclerosis From The Perspective Of Family Caregivers, Yolanda Carol Harris

All ETDs from UAB

Two to 5% of the US population of individuals afflicted with multiple sclerosis (N = 400,000) are diagnosed prior to the age of 18 with pediatric onset multiple sclerosis (POMS). Most children and teens with POMS have a relapsing remitting course of the disease with unpredictable relapse onset causing cognitive and physical disability. This can result in school absences, hospital and outpatient visits, poor academic performance and interruption in normal social activities. In turn, these individuals may develop an inability to provide self-care, which could lead to poor quality of life. POMS can affect the individual diagnosed but may also …

Epigenetic Regulation Of Stem Cell Fate Determination And Tumorigenesis, Kushani Shah

All ETDs from UAB

It is unclear how H3K4 methylation, an epigenetic modification associated with gene activation, regulates stem cell fate determination and tumorigenesis. DPY30 is one of the core subunits of the SET1/MLL complex in mammals responsible for H3K4me. DPY30 enhances the H3K4me activity of the SET1/MLL complex. Here, I sought to define role of DPY30 and H3K4me3 in postnatal neurogenesis and hematopoietic malignancies. Using a conditional knockout model, I found that Dpy30 deficiency halts the development of postnatal hippocampus, the subventricular zone, and cerebellum. Deficiency in cerebellum is most likely the cause of uncoordinated ataxia-like movements in these mice. By deleting Dpy30 …

Regulation Of Effector Cd4 T Cell Pathogenicity During Chronic Inflammation, Boyoung Shin

All ETDs from UAB

Effector CD4 T cells are essential for the balance between pro- and anti-inflammatory immune responses during homeostasis. Dysregulation of effector CD4 T cell responses results in chronic inflammatory disorders such as Inflammatory Bowel Disease (IBD) and Multiple Sclerosis (MS), however therapeutic options for these diseases are limited. Understanding the mechanisms that regulate pathogenicity of effector CD4 T cells is critical to devise new therapeutic interventions. Herein we show two different mechanisms that profoundly impact pathogenic potential of CD4 T cells by regulating heterogeneities of effector functions and differentiation states. Different subsets of effector CD4 T cells utilize distinct metabolic pathways. …

Isolated Ligamentum Flavum Ossification In Primary Hypoparathyroidism, Amir H. Sohail, Muhammad A. A. Maan, Muhammad S. Khan, Qamar Masood

Section of Diabetes, Endocrinology and Metabolism

Basckground: The ligamenta flava can undergo ossification and calcification resulting in myelopathy. Only seven cases of ligamentumflavum ossification in association with hypoparathyroidism have been reported, most of which had concurrent osseous changes in other spinal ligaments. Here, we report a patient with hypoparathyroidism who presented ith ligamentum flavum ossification causing both cervical and thoracic myelopathy.

Case description: A 43-year-old male presented with backache, urinary retention, and lower limb weakness for the last few days. Magnetic resonance imaging scan showed ossification of the ligamentum flavum in the cervical and thoracic regions, with severe spinal stenosis. Following spinal decompressive surgery, the patient …

Atomic Layer Deposition Prepared Nanostructured Materials For Various Catalytic Reactions, Xiaofeng Wang

Doctoral Dissertations

"Atomic layer deposition (ALD) has been widely used for thin film coating and metal nanoparticles (NPs) preparation. In this report, the applications of ALD prepared nanostructured materials in catalysis were examined.

Highly dispersed Pt monometallic catalysts with different substrates and multi-walled carbon nanotubes (MWCNTs) supported Pt-Co bimetallic catalysts were synthesized by ALD for selective hydrogenation of α, β-unsaturated aldehydes to unsaturated alcohols (UA). Pt/MWCNTs showed the highest selectivity of UA in selective hydrogenation of citral, as compared to Pt/SiO₂, Pt/ALD-Al₂O₃, and Pt/γ-Al₂O₃. After adding Co, the highest selectivity was achieved …

The Effect Of Wearing A Lumbar Belt On Biomechanical And Psychological Outcomes Related To Maximal Flexion-Extension Motion And Manual Material Handling, Ali Shahvarpour, Richard Preuss, Michael J.L. Sullivan, Alessia Negrini, Christian Larivière

Études primaires

Workers with low back pain (LBP) may benefit from wearing a lumbar belt (LB), but the biomechanical and psychological mechanisms involved are not fully understood. Two types of flexible LB (extensible and non-extensible) were compared to a control condition (no LB) regarding pain-related (pain, fear of pain and catastrophizing) and biomechanical (range of motion – ROM) outcomes related to two tasks: maximal trunk flexion-extension and manual material handling. Healthy controls and participants with LBP were tested. During both tasks, the two LBs reduced the lumbar ROM in participants with LBP in the same way as healthy controls. This was observed …

Influence Of Psychological Capital And Thinking Perspectives On Construction Safety Climate And Performance, Anne-Perrine Pascale Cades

Walden Dissertations and Doctoral Studies

Understanding safety factors in construction is critical to reducing accident frequency and severity. Grounded in the safety performance model, this study was conducted to examine the impact of psychological capital (PsyCap), which consists of the shared variance of hope, efficacy, resilience and optimism, and Past, Present, and Future thinking perspectives, on safety climate and performance. A nonexperimental quantitative design was used to determine whether PsyCap and thinking perspectives of construction project employees predicted safety performance and/or moderated the relationship between safety climate and performance across construction sites in different countries. 411 construction employees were recruited via a multistage and clustering …

Improving Human Papillomavirus Vaccination Rates Through Evidence-Based Interventions, Deidra Thompson

Walden Dissertations and Doctoral Studies

Cervical cancer is the most common human papilloma virus (HPV) -associated cancer and is the second leading cause of death in the world. Vaccination against HPV is essential to reduce the incidence of HPV and subsequent morbidity and mortality. According to the Centers for Disease Control and Prevention (CDC), approximately 79 million Americans are currently infected with HPV. The site for this DNP project was a 163-bed facility with inpatient and outpatient services in the southern United States. The vaccination rate at the site was 48%. The facility lacked educational interventions to prepare and remind providers to offer HPV vaccine. …

Poverty Rate And Occurrence Of Foodborne Illness Risk Factors In Retail Facilities, Margolite Joseph Cesar

Walden Dissertations and Doctoral Studies

Despite the efforts of food safety regulations and rules, food contamination remains a public health concern and prevalent vehicle of pathogens. This study identifies the predictors of food risk in different types of food establishments in Miami Dade County, Florida during the period November 2014 - November 2016. Guided by the epidemiologic triangle model, this correlational study analyzed the log number of risk factor violations and failure rates controlling for US Census sociodemographic data (2010 to 2014) for the food establishment neighborhoods by using linear and logistic regression. Results indicated that most of food entity types are significant predictors of …

Self-Care Management Of African American Men With Type 2 Diabetes, Kevin Konstantinos

Walden Dissertations and Doctoral Studies

African American men are disproportionately affected by type 2 diabetes and have a 3 times higher rate of 3 serious complications of diabetes, including blindness, amputations, and end-stage renal disease, compared to other groups. The purpose of this project was to address the gap-in-practice disparity that exists in care of African American men with diabetes by providing one-on-one self-care management education in an outpatient clinic setting. The behavior change theories that supported the project intervention were Orem's self-care theory and Bandura's self-efficacy theory. Employing a quasi-experimental design, 33 participants between the ages of 40 and 65 were divided into an …

Physical Activity And Veteran Status In Obesity And Chronic Obstructive Pulmonary Disease, Erin Mcguire Kren

Walden Dissertations and Doctoral Studies

There are few data available regarding the relationship between physical activity and veteran status in those with combined chronic obstructive pulmonary disease (COPD) and obesity. COPD is a common illness and a leading cause of death in the United States. Veterans represent a distinct subpopulation in the United States and are more likely to have COPD, which is a disease with a high rate of comorbidities such as obesity. Physical activity can improve outcomes for those with COPD and obesity. However, recommendations for physical activity for those with COPD and obesity are vague. This study, based on the self-determination theory, …

Applying The Social Change Model Of Leadership To An Entry-Level Occupational Therapy Doctorate Program, Lorry Liotta-Kleinfeld, Debra Gibbs, Yvette Hachtel, Teresa Plummer

Journal of Occupational Therapy Education

Occupational therapy educators are tasked with preparing the future leaders in the profession. This responsibility requires a thoughtful and evidence based approach to reviewing and revising curricula to address changing professional and societal needs while aligning with a university’s mission and vision. While the need for occupational therapy leadership has been a topic of much discussion in the literature, little has been written about evidence-based curricular practices to develop and prepare students for leadership roles. This article demonstrates how one entry-level occupational therapy doctorate program incorporated the underpinnings of the Social Change Model of Leadership Development (Wagner, 2006) into the …

Professional Behaviors And Fieldwork: A Curriculum Based Model In Occupational Therapy, Gabrielle R. Hackenberg, Susan Toth-Cohen

Journal of Occupational Therapy Education

Professional behaviors have been identified as imperative for fieldwork success in occupational therapy, and are held to high expectations by fieldwork educators. This study consisted of three phases. Phase one was a retrospective analysis of past Fieldwork Performance Evaluations (FWPE; n=319). Phase two consisted of the development of a curricular model and Level I Fieldwork Seminar with a focus on low-scoring professional behaviors on the FWPEs, which included verbal/ non-verbal communication, written communication, professional responsibility, work behaviors, and time management. Finally, phase three was a review of the course by the Philadelphia Region Fieldwork Consortium and edits to the seminar …