Medicine and Health Sciences Commons^™

Study Of Microrna-23a Cluster In Bone Formation, Revati Suryawanshi

All ETDs from UAB

The differentiation of mesenchymal stem cells to pre-osteoblasts, lies upon various transcription factors and physiological signaling, but is also governed by the micro-RNA-23a cluster. The miR-23a cluster has miR-23a, miR-27a and miR-24-2 transcribed from a single promoter as a sole RNA primary transcript. Its effects have been observed in embryonic stem cells, mesenchymal stem cells (MSCs), and in cancer (1-2). It regulates the lineage commitment of MSCs. (3). With respect to bone formation, miR-23a cluster is involved MSCs commitment to and osteoblast maturation (4). Here, through in vivo and in vitro experiments, we report that knock down of microRNA-23a cluster …

Evaluation Of Ventilation Performance And Respirable Particles In Food Trucks, Dong Lee Yang

All ETDs from UAB

Background: The food truck industry in the U.S. has rapidly expanded, with an average growth of 7.9 % from 2017 to 2022. Food truck workers are potentially exposed to harmful airborne contaminants such as particulate matter (PM) and aldehydes produced during cooking process. Kitchen exhaust hoods are designed to capture the cooking emissions, but it is not well understood whether the commercial kitchen exhaust hoods in food trucks are properly, efficiently operated to reduce the workers' exposure to such harmful contaminants. The purpose of the study was to evaluate food truck workers' exposure to respirable particulates generated from cooking process …

Predictors Of Us Hospital Responsiveness To International Patient Inquiries, Suzanne M. Garber

All ETDs from UAB

Medical travel has been growing at a steady rate as global travel has also increased. However, with the advent of COVID-19, all global travel came to a screeching halt, including travel intended for medical purposes across borders. Now that travel is resuming worldwide, American hospital administrators are anxious to fill their beds with more profitable, international patients to make up for revenue losses incurred during the pandemic. Existing literature on the topic of medical tourism focuses on the role of patient initiative, choice, and risk-taking behaviors with little mention of hospital leadership’s ability or desire to construct a management strategy, …

The Effect Of Federally Qualified Health Centers (Fqhcs) Prevalence On Uncompensated Care In Us Hospitals, Kena R. Norris

All ETDs from UAB

Over the past two decades, uncompensated care in U.S. hospitals has grown at a staggering rate and reached $46.4 billion in 2013. It began to decline in 2014, due to the passage of the Patient Protection and Affordable Care Act (ACA), but is now on the rise again. Uncompensated care is typically affected by policy and market factors such as legislative changes and an increase in the number of uninsured. While hospitals continue to serve as critical safety net providers, they are often not the only or most appropriate facility to serve the indigent in U.S. communities. Instead, federally qualified …

The Effect Of Integrative Medicine Interventions On Patient Activation Measure, Rochelle F. Richards

All ETDs from UAB

Activated patients believe they have essential roles in achieving and maintaining their health. Patient activation is strongly related to improved clinical outcomes (Hibbard, 2017; Greene, 2013). The study’s primary purpose is to evaluate the use of Integrative Medicine Interventions (IMIs) and their relationship to patient activation levels; and to investigate the association between IMI protocols and patient activation levels on patient reported outcomes (PROs) for those with chronic diseases, specifically chronic fatigue and mental health-related conditions of anxiety and depression, using the principles of Integrative Medicine’s (IM) whole-person approach as the model of care in independent IM practices across the …

Alterations In Synaptic Structure And Tau Phosphorylation In Alheimer's Disease, Courtney K. Walker

All ETDs from UAB

Alzheimer’s disease (AD) is the most common cause of dementia in individuals over the age of 65. Of the two hallmark pathologies of AD, tau neurofibrillary tangles (NFTs) correlate more strongly with cognitive decline than do Aβ plaques. NFTs form in the entorhinal cortex (EC) and appear in anatomically connected regions over time as disease progresses. This tau spreading may occur via synaptic connections. Most excitatory synapses occur on dendritic spines, which house the postsynaptic machinery. Spines are actin-rich, plastic structures that change their size and shape in response to synaptic activity in a process that is dependent on actin …

Care-Resistant Behavior Trajectories Of Individuals Living With Dementia In Nursing Homes And Distal Outcomes In Oral Health: A Secondary Analysis, Chunhong Xiao

All ETDs from UAB

Persons living with dementia who exhibit care-resistant behaviors (CRB) are likely to resist mouth care and have poor oral health. Knowing the “balance” between providing optimal mouth care while managing CRB is critical for developing tailored interventions. No evidence has demonstrated a balance between CRB level, mouth care completion, and oral health status. The overarching goal of this study was to identify a balance or “sweet spot” between enough mouth care to maintain oral health and a manageable level of CRB intensity. The purpose of this study was to examine and describe the characteristics of CRB trajectories as they relate …

The Effect Of Training On Eye Movement While Learning To Use A Non-Foveal Retinal Locus, Jason Eugene Vice

All ETDs from UAB

Vision is our most far-reaching sense. It allows us to quickly detect information about the environment and enhances our ability to interact with the world around us. Accordingly, many neural areas are devoted to obtaining, processing, and interpreting visual information. When vision is impaired through normal aging or disease processes, the functional implications for a person can be quite significant. This is particularly true when a person is deprived of high acuity, central vision. Many people with bilateral central visual impairments learn to compensate for vision loss by adopting a viewing strategy that involves the use of the peripheral retina. …

The Adoption Of New Cancer Drugs In Non-Academic Cancer Centers, Warren M. Smedley

All ETDs from UAB

Advancements in medical knowledge are producing significant improvements in medical technology, developing breakthrough drug therapies, advancing the practice of medicine, and improving outcomes for cancer patients. However, there are delays in getting new and improved therapies incorporated into routine clinical use, depriving cancer patients of valuable and potentially lifesaving treatments. The purpose of this study was to examine the rate of adoption of new cancer drug discoveries into routine clinical practice in non-academic cancer centers. The process of adoption takes a period of time to embrace new therapies, due in part to a prescriber’s need to gain greater comfort with …

Guided Exploration Of Military Servicewomen's Healthcare Experiences And Related Outcomes (Gems Hero), Princess Victoria Jane Nash

All ETDs from UAB

Purpose: This study focuses on factors related to healthcare seeking behaviors and utilization of Veterans Affairs primary care services by female African American Veterans. The purpose of this mixed methods study is to assess what factors influence seeking care at VA healthcare facilities. Research Design: This study used a modified explanatory sequential mixed methods design to assess health services utilization and healthcare experiences of African American female Veterans. This research utilized items from the Health Belief model as a guiding framework to highlight factors that could impact VA healthcare utilization. Methodology: Health services utilization analysis used national data from the …

Effects Of Exercise On Cerebral Oxygen Extraction Fraction, Hippocampal Subfields, And Cognition In Older Women, Amani M. Norling

All ETDs from UAB

Cardiorespiratory fitness (CRF) is associated with enhanced cognitive functions in aging. The relationship between fitness and brain function is supported by evidence of improvements or maintenance of gray matter volume, and cerebral blood flow (CBF). Research focused on interactions between CRF and changes in cerebral structure and function have not identified the underlying mechanisms of exercise-induced improvements, and none included the effects of CRF on cerebral oxygen extraction fraction (OEF), which is a measure of the ratio of oxygen that a tissue extracts from the blood to maintain morphological and functional integrity. Here, we present evidence from existing studies that …

Study Of The Effects Of Contusion Spinal Cord Injury And Optogenetic Stimulation On Lower Urinary Tract Function, Salvador A. Lopez

All ETDs from UAB

Lower urinary tract (LUT) dysfunction is a detrimental ailment that negatively affects a person’s independence, health, and overall quality of life. More specifically, LUT dysfunction as a result of spinal cord injury (SCI) is seen in more than 17,000 cases per year and of those cases, <20% are discharged from care with normal micturition1. Initially, after SCI, there is an acute period of spinal shock when the urinary bladder is flaccid and underactive, while the external urethral sphincter (EUS) that constricts the bladder outlet quickly becomes tonically active. In days to weeks after injury, spinallymediated, reflex bladder contractions re-emerge2-4. Numerous studies have examined aspects of LUT function using various models of SCI, primarily utilizing complete transection injuries. This set of studies first examined the effect of moderate to severe midthoracic contusion SCI on LUT function by examining cystometrogram (CMG) and EUS recordings, bladder/spinal cord morphology, sensory innervation of bladder tissue, and spinal neuronal activation in female mice. This model of SCI produced significant changes in normal bladder function as well as altered bladder morphology, including a robust loss of bladder afferent nerve fibers necessary for micturition. Inhibition of histone deacetylase 6 (HDAC6) has been shown to prevent the loss of sensory nerve fibers in mouse hind paw tissue5, thus HDAC6 inhibition was examined as a possible strategy to prevent the observed loss of sensory nerve fibers in bladder tissue post-SCI. iv Mice were treated using intraperitoneal injections of inhibiting compounds ACY-1083 (10 mg/kg) or Tubacin (5 mg/kg). Treatment resulted in significant improvements in CMG measures and sensory innervation of the bladder wall. Finally, optogenetic stimulation was examined using an adenoassociated virus containing cre-recombinase for cre-dependent expression of channelrhodopsin (ChR2) in both spinal intact and SCI mice. The ability to spare afferent axons in bladder tissue post-SCI through HDAC6 inhibition allowed ChR2 expression in sensory nerve fibers. Direct photostimulation of the bladder using various parameters of duration (1, 2, 5, 10 sec continuous stimulation) and power (0.1mW/mm2, 0.95mW/mm2, 6.50mW/mm2) resulted in the ability to control bladder contractions in both spinal intact (SI) and SCI animals, allowing for on-demand voiding post-injury.

Relationship Between Neighborhood Deprivation And Epigenetic Age Acceleration With Pain In Adults With Musculoskeletal Pain, Pamela Jackson

All ETDs from UAB

Residents of high-deprivation neighborhoods shoulder a greater burden of age-related health conditions, including experiencing worse chronic musculoskeletal pain outcomes, compared to residents of more affluent neighborhoods. Advancing age is a risk factor for chronic health conditions, which epigenetic modifications may explain. Epigenetic age acceleration occurs when an individual’s epigenetic age is older than their chronological age, and that discordance has been identified as a strong predictor of age-related conditions. Epigenetic age acceleration has also been correlated with neighborhood deprivation. However, the mechanisms for neighborhood disparities in chronic musculoskeletal pain remain unclear. The purpose of this dissertation study was to examine …

Impact Of Nontypeable Haemophilus Influenzae And Pseudo Aeruginosa Polymicrobial Infections On The Cystic Fibrosis Lung, Natalie R. Lindgren

All ETDs from UAB

Nontypeable Haemophilus influenzae (NTHi) is a Gram-negative commensal of the healthy nasopharynx; however, this organism can function as an opportunistic pathogen as a result of disruptions to the microbiome, as is the case in cystic fibrosis (CF) disease. People with CF experience changes in microbial residents of the respiratory tract over the course of their lifespan, seen in shifts from early-life pathogens, such as NTHi, to late-stage pathogens, such as Pseudomonas aeruginosa, that accompany a decrease in organismal diversity of the microbiome. In this work, we characterized the pathogenicity of NTHi alone and in polymicrobial respiratory infections. Using CF specific …

Three Heads Are Better Than One: A Structural Look At Staphylococcal Bacteriophage Capsids, N'Toia Chivon Hawkins

All ETDs from UAB

Staphylococcal species such as S. aureus and S. epidermidis are opportunistic pathogens that are the leading causes of nosocomial infections. They have become of growing concern due to the virulence factors that they have acquired as well as their inability to be treated due to resistance to antibiotics. Bacteriophages have increasingly become a popular contender for eliminating these pathogens, however not every phage is suitable for the job. Size of the genome, life cycle, the ability to mobilize genomic material, and host range all factor into how well-suited a phage is to be used as a therapeutic. In this dissertation …

Hedgehog Signaling Rewires M2 Macrophage And Regulatory T Cell Metabolism Within The Tumor Microenvironment Of Breast Cancer, Dominique C. Hinshaw

All ETDs from UAB

Current treatments for breast cancer offer little relief to patients with metastatic disease. A contributory factor to tumor growth and metastasis is aberrant up-regulation of developmental signaling pathways such as the Hedgehog (Hh) signaling pathway. This pathway is aberrantly activated in breast cancer and contributes to tumor progression and metastasis. The success of these events is highly influenced by the surrounding immune microenvironment. Macrophages exist along a spectrum of M1 (tumor-eradicating) to M2 (tumor-promoting), while regulatory T cells (Tregs) are an immunosuppressive cell type. The predominant functions of M2 macrophages and Tregs include dampening the immune response and promoting wound …

Comprehensive Characterization Of Structural Variations Using Long-Read Sequencing Data, Yu Chen

All ETDs from UAB

Structural variants (SVs) contribute to genomic diversity and play pathogenic roles in a wide range of genetic disorders. Accurate characterization of SVs is critical for genomic research and studies of disease mechanisms. The rapid development of Third-Generation Sequencing (TGS) technologies has largely increased sequencing read length compared to Next-Generation Sequencing (NGS), bringing both great potentials and challenges in SV discovery through alignment-based and assembly-based approaches. In order to take full advantage of TGS data, I have developed a suite of bioinformatics tools focusing on comprehensive characterization of SVs. For the alignment-based SV discovery, I have developed DeBreak to identify SVs …

Multilevel Influences On Physical Activity Participation In Rural And Cancer Populations With Obesity, Nashira Inika Brown

All ETDs from UAB

espite the strong evidence of physical activity benefits, the prevalence of physical inactivity and associated obesity continues to increase. Rural and cancer survivor populations with obesity, in particular, remain highly inactive and are at increased risk of comorbidities. Thus, physical activity interventions are needed to promote active lifestyles. However, before developing or adapting existing multi-level physical activity interventions, more research is needed to understand the necessary components to meet the needs and preferences of these unique populations. Therefore, this project involved identifying the gaps in literature followed by three studies to investigate the multilevel influences on physical activity in rural …

Decreasing Indwelling Catheter Utilization Days In An Inpatient Rehab, Lisa Morgan Msn, Rn, Cnrn, Agcns-Bc

Nursing Publications, Posters, & Presentations

Purpose of Poster: The aim of this initiative was to decrease the indwelling catheter utilization in inpatient rehab.

Presented at the SUNA national conference 2022.

The Roles And Contributions Of Certified Transport Registered Nurses In Critical Care Ground Transport Today., Jennifer Esslinger Bsn, Rn, Cfrn, Ctrn, Sue L Parrigin, Amy Grand, Kimberly D Bronow, Jacqueline C Stocking

Nursing Publications, Posters, & Presentations

Registered nurses are core members of critical care ground transport teams because of their education, experience, and scope of practice. Advances in medicine, technology, and equipment, combined with regionalization of specialized care and, most recently, the coronavirus disease 2019 pandemic, necessitate that transport nurses possess specialized knowledge, skills, and abilities. National specialty certification in ground transport nursing via the Certified Transport Registered Nurse (CTRN) offers registered nurses a process to validate their expertise. The most recent transport nursing role delineation study, which was conducted by the Board of Certification for Emergency Nursingin 2019, provided the foundation for the revised CTRN …

Primary Cilia Regulate Inflammation And Macrophage Accumulation During Injury And Cyst Formation In Mouse Pkd Models, Zhang Li

All ETDs from UAB

Polycystic kidney disease (PKD) is one of the most common inherited renal disorders. The most common form, autosomal dominant polycystic kidney disease (ADPKD), affects more than 13 million people around the world, and over 50% of them will develop end-stage renal disease (ESRD). Although ADPKD genetically is caused by mutations of PKD1 or PKD2 genes, there is increasing evidence showing that non-genetic factors such as renal injury and inflammation play important roles in cyst severity and progression in PKD. Macrophages are cells of the innate immune system known to be involved in kidney injury and repair. Data from our lab …

The Role Of Protein Translation And Degradation In Aging And Alzheimer Disease Pathogenesis, Harper S. Kim

All ETDs from UAB

Protein translation (PT) is an essential cellular process playing crucial roles in growth and development. PT precipitously declines with age in multiple animal species, including humans. It has been implicitly assumed that elevated PT at young ages is beneficial to health while PT ends up dropping as a passive byproduct of aging. However, whether this holds true and how dynamic fluctuations in PT over time impact aging remain unknown. In Drosophila, we show that a transient PT spike in early-adulthood drives aging by triggering dysfunction in protein homeostasis (proteostasis) at old ages. We propose the early-adulthood spike in PT to …

Determining The Impact Of Immune Dysregulation On Cd4 T Cell Responses To Hiv-1 And Sars-Cov-2, Jacob K. Files

All ETDs from UAB

CD4+ T cells, often referred to as helper T cells, play a crucial role in the formation of antiviral immune responses following infection and vaccination. However, this can be disrupted by various forms of immune dysregulation. Many groups have described how HIV-1 adaptation and immune escape can lead to dysregulated HIV-specific immune responses. Our lab has previously shown that predicted HLA-II associated HIV-1 adaptation leads to dysregulated, poorly immunogenic CD4+ T cell responses in HIV-1 infection. Here, we focus on the impact of this HLA-II associated viral adaptation in the setting of HIV-1 vaccination. We show that HLA-II associated, vaccine-matched …

Driving Anger And Aggression In Persons With And Without Adhd, Maria T. Lechtreck

All ETDs from UAB

Driving a motor vehicle is both a privilege and one of the primary activities of daily living for most persons in the U.S. and many persons abroad; however, motor vehicle collisions (MVCs) bring great costs both to individuals and society. Driver behavior is the critical factor in an estimated 94% of MVCs and aggressive driving is the cause of two-thirds of U.S. traffic fatalities. Certain populations are at an increased risk for MVCs including persons who are young (ages 15-24), persons who have developmental disabilities such as Attention-Deficit/Hyperactivity Disorder (ADHD), and persons who have a high propensity for driving-related anger. …

Exploring The Influence Of Family History Before And After Type 2 Diabetes Development Through Statistical Analysis Of Biomarkers And An Educational Intervention, Jessica Johnson Denton

All ETDs from UAB

The prevalence of type 2 diabetes is increasing at an alarming rate in both children and adults worldwide. Timely identification of those at risk for type 2 diabetes is essential to reduce morbidity and mortality and to mitigate the toll on families and the healthcare system. Family history is an effective, universal tool that can be used to identify individuals at risk for type 2 diabetes before they acquire additional risk factors. Understanding how family history contributes to biomarkers associated with diabetes in healthy individuals could facilitate the creation of early screening and prevention strategies designed for this specific at-risk …

Comparison Of The Condyle-Fossa Relationship And Resorption Between Patients With And Without Juvenile Idiopathic Arthritis (Jia): A Retrospective Three-Dimensional Cone-Beam Computed Tomography Study, Ahmet Arif Celebi

All ETDs from UAB

Introduction: The most common disease in pediatric rheumatology is juvenile idiopathic arthritis (JIA). JIA is considered to be an autoimmune disease with an onset before the age of 16. The temporal mandibular joint (TMJ) has been reported to be involved in up to 87% of patients with JIA. Even though much research has been conducted on JIA, limited research has studied to understand its effect on the condyle-fossa relationship and to evaluate resorption amount on condyle by using a scoring system. Aim: The purpose of this study was (1) to evaluate the anatomical features of the glenoid fossa, (2) to …

An Evaluation Of The In Vitro Antibacterial, Biocompatibility, And Mineralization Properties Of Six Calcium Silicate-Based Pulp Capping Materials, Taimy Cruz Hondares

All ETDs from UAB

Purpose: The purpose of this study was to evaluate the antibacterial activity, biocompatibility, and mineralization-inducing potential of calcium silicate-based pulp capping materials. Methods: Six contemporary calcium silicate-based pulp capping materials were compared in this study, including ProRoot MTA, MTA Angelus, Biodentine, EndoSequence, NeoMTA 2 and NeoPutty. The antibacterial effects of these materials against Streptococcus mutans UA159 and Enterococcus faecalis ATCC 29212 were determined by the agar-diffusion assay and the direct culture test. The biocompatibility and mineralization-inducing potential of these materials in preodontoblastic 17IIA11 cells were compared by the MTT assay and by evaluating alkaline phosphatase activity and calcium deposits, respectively. …

Socioeconomic Status, Hbb, And Ttr Variants, And Cardiorenal Outcomes: The Regards Study, Onika E. Abrams

All ETDs from UAB

Blacks are disproportionately affected by heart failure (HF) and end-stage renal disease (ESRD). While poorer health outcomes in Blacks have been associated with social determinants of health, there are some biological differences worth noting, namely genetic risk variants for both TTR and HBB. These genetic risk variants are known to confer additional risk in the development of heart failure and end-stage renal disease, respectively. While we understand these genetic variants aren’t fully penetrant, and genetics and are not deterministic, we aimed to examine additional factors and mechanisms responsible for the increased risk in HF and ESRD in Blacks. Neighborhood socioeconomic …

Optimal Antero-Posterior Position Of The Maxillary Central Incisors And Its Relationship To The Forehead In Adult Hispanic Females, Balraj Bains

All ETDs from UAB

Objective: The objective of this study is to investigate the relationship of forehead inclination to anteroposterior position (AP) of the maxillary central incisors in adult Hispanic females. Materials and Methods: 70 participants were recruited for this study and smiling profile photographs were taken. All images were deidentified and placed in standardized dimension of 7.5” by 6.5”, which were then added to a PowerPoint to be evaluated by a judging panel. 24 Adult Hispanic Females (AHF) made up the control group and were seen to have an optimal incisor AP position. 46 AHF were in the study group and were judged …

Association Between Regional Covid-19 Vaccine Hesitancy And Reported Positive Covid-19 Cases In The Southern United States, Orielle Caudle

All ETDs from UAB

The use of vaccinations has been shown to be beneficial in pandemics in the past, and in some cases, it has led to elimination of a particular disease (i.e. polio). The COVID-19 vaccination can also serve the same purpose, however, vaccine hesitancy within specific regions of the country may prevent and/or dilute the effectiveness of the vaccine. Vaccine hesitancy can be defined as a delay in acceptance, or refusal despite the availability of vaccine services. Southern regions have consistently had the lower vaccination rates compared to its other regional counterparts, even as the pandemic progressed and death rates increased over …