Medicine and Health Sciences Commons^™

Analysis Of Excess Mortality At The County Level In Alabama By Socioeconomic Factors, Abigail Jo Tucker

All ETDs from UAB

Objective: Analyze county level socioeconomic factors and their association with Covid-19 excess mortality in Alabama.Methods: Linear regression analyses were used to evaluate the association between potential risk factors assessed using the American Community survey (n = 40 counties and county clusters) and excess mortality in 2020 per 100,000 population. Excess mortality came from a previously published paper by Ackley et al. Results: Median household income (per 1,000 dollars); an average county median household income that 1,000 dollars higher was associated with 6 per 100,000 lower excess mortality (β= -5.953 p-value

A Gastrointestinal-Specific Antibiotic As An Experimental Treatment For Anxio-Depressive Disorders, Yuang-Tai Huang

All ETDs from UAB

Chronic stress is a predisposing factor for various disease states, including neuropsychiatric disorders, such as depression and anxiety [1]. Stress-related disorders have complicated multifactorial etiologies [2]. Advances in psychotherapeutic and psychotropic treatments have occurred, but anxiety and depressive disorders are still prevalent and remain a burden to our societies [3]. More than 30% of major depressive disorder patients fail to remission despite an FDAapproved medication [4]. Meanwhile, the contribution of microbiota-gut-brain axis signaling in both etiologies and treatment of stress-related disorders is increasingly being recognized [5]. More evidence has shown that the gut microbiota has the potential to alter the …

Adverse Childhood Experiences: Connecting The Dots Between Early Life Stress And Asthma Aming Children And Adolescents With Sickle Cell Disease, Brandi Mcclain Pernell

All ETDs from UAB

Sickle cell disease (SCD) is an inherited red blood cell disorder plagued by increased morbidity and premature mortality. Asthma disproportionally affects individuals with SCD and is strongly associated with an increased incidence of pain, acute lung complications and death among this high-risk population. Psychological stress is a well-established contributor and trigger for asthma development and exacerbations. Adverse Childhood Experiences (ACEs) are defined as traumatic experiences occurring before 18 years of age. ACEs occur at the individual, familial (Original-ACEs) and community level (Expanded-ACEs) and can accumulate with time. Chronic exposure to ACEs leads to toxic stress, widespread inflammation and risk for …

Characterizing Occupational Status History And Assessing Occupational Status As A Social Determinant Of Health In The Deceased Organ Donor Population, Nicole F. Pelletier

All ETDs from UAB

Transplant physicians review clinical data ranging from laboratory values to substance use history and use prediction models combining these factors, along with previous recipient outcomes, to evaluate deceased organ donors for organ suitability. Factors such as social determinants of health (SDOH) are not currently included in prediction models, despite evidence of relationships between SDOH and health outcomes in the general population. Occupational status is a SDOH routinely collected at the time of donation and stored in DonorNet, but not yet characterized in the deceased donor population. Despite well-documented relationships between occupational status and health outcomes in the general population, these …

Development Of A Fit-Matching App: Validation Of 3-D Scanning Applications, Jasna Rosser Williams

All ETDs from UAB

According to the National Institute of Occupational Health and Safety (NIOSH), each day nearly 2,000 workers sustain a job-related eye injury that requires medical treatment. It has been reported that the cause of these eye injuries is frequently due to workers not wearing eye protection because it does not fit properly on their faces. To improve the fit of eye protection, we are aiming to develop a fit matching application (app) which will identify the wearers’ better-fitting safety eyewear using 3D technology. We have successfully tested the feasibility of the use of commercially available 3D scanning apps using a mannequin …

Early Detection Of Acute Kidney Injury In Neonates After Cardiopulmonary Bypass, Tennille N. Webb

All ETDs from UAB

Prophylactic peritoneal dialysis (PD) in neonates undergoing cardiac surgery with cardiopulmonary bypass (CPB) has proven to be safe and improve outcomes. Understanding which neonates would most benefit from prophylactic PD is needed to optimize care. Objective: We sought to validate patient-specific characteristics associated with the need for PD in neonates requiring CPB. We hypothesized serum creatinine (SCr), pre-operative weight, or open chest post-operatively are associated with the need for PD. Methods: We evaluated neonates in the cardiac ICU requiring cardiac surgery with CPB from March 2019 through March 2021 with our new protocol for PD catheter placement. Neonates were classified …

The Effects Of Near Field Magnetic Induction Monitoring Of Health Care Workers' Hand Hygiene Compliance, Thomas H. Ozburn

All ETDs from UAB

Hospital Acquired Infections (HAIs) are among the top five leading causes of death in the United States (Scott, 2009). Estimates of the annual direct medical costs of HAIs to U.S. hospitals have ranged from $28,400,000,000 to $33,800,000,000 (Scott, 2009). Many leading health care organizations have agreed that there is a link between infection prevention and the spread of HAIs (Allegranzi, 2009). This study explored health care workers’ hand hygiene compliance and whether automated compliance reporting improved compliance. A new system powered by technology called Near Field Magnetic Induction (NFMI) found a significant increase in compliance upon introduction of an automated …

An Examination Of The Relationship Between The Role Of The Chief Diversity Officer And Hospital Financial Performance And Patient Experience Measures, Kemberly L. Blackledge

All ETDs from UAB

Healthcare organizations drive to achieve hospital measures has much to do with strategies put in place by the executive leadership team and resources of the firm. Forces such as regulatory changes reducing hospital payments and external forces such as social injustices leave executives turning to innovative ways to improve the bottomline. This study examined the Chief Diversity Officer (CDO) and the relationship with hospitals measures of financial performance and patient experience for hospitals with a CDO and without a CDO. Hospitals with a CDO can deploy organizational strategies such as diversity management and cultural competencies. These strategies are important because …

The Effects Of Charity Hospital Privitization And Medicaid Expansion On Medicaid Patient Emergency Department Utilization In Louisiana, Sean M. Prados

All ETDs from UAB

Two significant events transpired in Louisiana that had sweeping changes for the healthcare system between 2013 and 2016: (1) the privatization of the nation's only stateowned Charity Hospital System via cooperative endeavor agreements with local, private hospitals known as public-private-partnerships (PPP), and (2) the implementation of Medicaid expansion, referred to as implementation of the Affordable Care Act (ACA). Either event independently could have had significant utilization and financial implications for hospitals. This retrospective, quasi-experimental research implemented a generalized estimating equation (GEE) analysis to examine the effects of PPP and ACA on Medicaid patient emergency department utilization by PPP hospital designation, …

Grainyhead-Like 2 (Grhl2) Has Anti-Oncogenic Potential In Glioblastoma, Rachel M. Carnes

All ETDs from UAB

Grainyhead-like 2 (GRHL2) is a complex transcription factor associated with roles in both development and cancer. In development, GRHL2 suppresses a series of genes associated with the mesenchymal phenotype, while actively promoting the expression of genes associated with the epithelial phenotype. Due to this GRHL2 is considered a main gatekeeper of the epithelial to mesenchymal transition (EMT), playing a crucial role in epithelial morphogenesis and neural tube closure. These basic traits for GRHL2 have also been found to be similar in cancer. GRHL2 has multi-faceted functions in cancer, in which it can be considered either an oncogene or a tumor …

The Role Of Dock3 In Normal Skeletal Muscle Function And Metabolism, Adrienne Samani

All ETDs from UAB

DOCK (dedicator of cytokinesis) are proteins of an 11-member family of typical guanine exchange factors (GEFs) expressed almost exclusively in the brain and spinal cord. Human pathogenic DOCK3 variants have been identified to cause debilitating neuromuscular phenotypes such as muscle hypotonia, ataxia, and intellectual disability. Our lab identified DOCK3 as being strongly upregulated in Duchene muscular dystrophy (DMD), specifically in the skeletal muscles of DMD patient and mouse skeletal muscles. Global Dock3 KO mice on the dystrophin-deficient background exacerbated skeletal muscle and cardiac phenotypes. Similarly, DOCK3 KO mice appeared to have poor muscle architecture, locomotive activity, reduced myogenic fusion, impaired …

The Role Between Transactive Memory Systems In The Relationship Between Psychological Safety & Quality In Interprofessional Healthcare Teams, Tera L. Webb

All ETDs from UAB

During uncertainty, the optimum solution for work-related problems or patient care cases require the scopes of practice and competencies beyond a single profession. For this reason, the collaborative efforts of interprofessional teams are a widely used approach to patient care and medical decision making. The interdependency between healthcare professionals with varied expertise and input often lead to desired outcomes. Beyond the structure of the team, there are numerous cognitive processes at play that impact knowledge transfer in highly skilled teams that impact outcomes. Therefore, this dissertation will review relevant literature on two cognitive constructs – psychological safety and transactive memory …

The Requirement Of Transcriptional Lim Complex Co-Regulators For Pancreatic Endocrine Cell Development And Function, Eliana Davi Toren

All ETDs from UAB

The prevalence and tremendous impact of diabetes mellitus has made glucose regulation of the insulin-producing -cell and surrounding pancreatic islet of Langerhans a center of public and research interests alike. A comprehensive understanding of these hormone-producing cells begins with their developmental origins. What are the genetic cues and participants in the tightly orchestrated process of their formation? Investigating the earliest determinants of islet-cell fate not only allows us to deeply understand mature - and islet-cell function, but also produces a data-driven template for how these cells can be reproduced in future stem-cell based diabetes therapies. LIM transcriptional complexes are indispensable …

Evaluating The Association Among Demographic, Disease, And Symptom Profiles And Quality Of Life In Connective Tissue Disease-Related Interstitial Disease, Lanier O'Hare

All ETDs from UAB

m

Connective tissue disease-related interstitial lung disease (CTD-ILD) results in an unrelenting symptom burden and may progress to death. The morbidity and mortality associated with CTD-ILD likely has a profound impact on individuals’ quality of life (QOL). Quality of life is a phenomenon that has yet to be sufficiently described in the literature on CTD-ILD. The factors associated with QOL in other chronic lung diseases have been described, but because of the different clinical and demographic characteristics of CTD-ILD, it is unknown if these same factors are associated with QOL in CTD-ILD. The purpose of this study was to examine …

The Role Of Alternative Payment Models In Pharmaceutical Services And Outcomes, Matthew G. Parker

All ETDs from UAB

A persistent challenge within the healthcare sector is balancing cost containment for health services and the quality of care associated with these services. This challenge has reinvigorated interest in alternative payment models (i.e., risk-sharing, shared savings, capitation), arrangements between payers and healthcare providers that structure reimbursement for services based on health outcomes. Although much research has assessed the association between these payment models and financial outcomes for medical services, there is a paucity of research that has likewise assessed pharmaceutical outcomes (i.e., electronic prescribing, evidence-based prescribing, medication adherence). The papers comprising this dissertation contribute to this limited body of research …

In Vitro And In Vivo Antidiabetic Potential Of Monoterpenoids: An Update, Lina T. Al Kury, Aya Abdoh, Kamel Ikbariah, Bassem Sadek, Mohamed Mahgoub

All Works

Diabetes mellitus (DM) is a chronic metabolic condition characterized by persistent hyper-glycemia due to insufficient insulin levels or insulin resistance. Despite the availability of several oral and injectable hypoglycemic agents, their use is associated with a wide range of side effects. Monoterpenes are compounds extracted from different plants including herbs, vegetables, and fruits and they contribute to their aroma and flavor. Based on their chemical structure, monoterpenes are classified into acyclic, monocyclic, and bicyclic monoterpenes. They have been found to exhibit numerous biological and medicinal effects such as antipruritic, antioxidant, anti-inflammatory, and analgesic activities. Therefore, monoterpenes emerged as promising molecules …

Barriers And Facilitators Of Availability Of Hydroxyurea For Sickle Cell Disease In Tanzania; A Qualitative Study Of Pharmaceutical Manufacturers, Importers, And Regulators, Hamu J. Mlyuka, Manase Kilonzi, Ritah F. Mutagonda, Lulu Chirande, Wigilya P. Mikomangwa, David T. Myemba, Godfrey Sambayi, Dorkasi L. Mwakawanga, Joyce Ndunguru, Paschal Ruggajo

Internal Medicine, East Africa

Despite three decades of proven safety and effectiveness of hydroxyurea in modifying sickle cell disease (SCD), its accessibility is limited in Sub-Saharan Africa, which shares 75% of the world’s SCD burden. Therefore, it is time to explore the barriers and facilitators for manufacturing and importation of hydroxyurea for SCD in Tanzania. This was qualitative research that employed a case study approach. Purposive sampling followed by an in-depth interview (IDI) using a semi-structured questionnaire aspired by data saturation enabled us to gather data from 10 participants. The study participants were people with more than three years of experience in pharmaceuticals importation, …

Ccit Report 2022, Critical Creative Innovative Thinking

Critical Creative Innovative Thinking (CCIT) Archives

Content

• About us
• Incubation
• National Health Incubation Program (2021-2022)
• what we do
• System Innovation
• Research & Communication
• Our path in Education
• 2023: onwards & upwards

Synergy Between Stenotrophomonas Maltophilia And Pseudomonas Aeruginosa During Polymicrobial Airway Infections, Melissa Skye Mcdaniel

All ETDs from UAB

Stenotrophomonas maltophilia is a Gram-negative bacillus that can act as an opportunistic pathogen in patients with respiratory diseases, including cystic fibrosis (CF) and ventilator-associated pneumonia. Infection with S. maltophilia is associated with worse lung function, but it remains unclear if this organism contributes directly to lung function decline. Lung infections are often polymicrobial, and S. maltophilia can be isolated from the lung with the key pulmonary pathogen Pseudomonas aeruginosa. In the first half of this work, we investigated the pathogenicity of S. maltophilia alone and during polymicrobial infection with P. aeruginosa. We used respiratory infections in mice to assess persistence …

Nutrition Practices And Body Composition In Infants Born Preterm, Maggie Jerome

All ETDs from UAB

Adequate nutrition and optimal growth are critical goals of clinical care for premature infants in the NICU due to rapid brain growth and development that occur during this time. Emerging evidence suggests that body composition in preterm infants is predictive of neurodevelopmental and metabolic outcomes later in childhood. The objective of this dissertation is to investigate factors affecting premature infant growth and body composition, including high enteral protein supplementation, nutrition during the first two weeks of life, and race of infants born at 22-32 weeks gestational age admitted to the UAB NICU. In a pilot study, 56 preterm infants were …

Evaluation Of A Living Shoreline Technique On A Southeastern United States Reservoir, Eric V. Muth

All ETDs from UAB

The impoundment of rivers in the southeastern United States has led to the creation of reservoirs that have seen the riparian zone become heavily developed with residential real estate. As the hybrid river/lake systems started forming new shorelines, property owners reacted by attempting to reduce their losses. This has been done in a variety of ways, with the majority falling into the bulkhead category. The use of vertical hard armament has resulted in a loss of ecological function and an increase in erosion of the lakebed at the toe or escarpment. In response to this, the idea was proposed by …

Molecular Imaging Of Cancer For Detection And Monitoring Of Response To Combination Therapy, Tiara S. Napier

All ETDs from UAB

Imaging is a primary component of cancer care and aids in diagnosing, response assessment, and monitoring. Molecular imaging techniques provide visualization of unique tumor biology that can be used to personalize treatment. Key features of an effective biomarker are sensitivity, specificity, and ability to provide clinical value beyond that of other types of information already available at the time of diagnosis. For particularly heterogeneous cancer subtypes, such as glioblastoma (GBM) and triple negative breast cancer (TNBC), reliable biomarkers can be challenging to identify and there are few tar-getable receptors for therapy. Our findings demonstrate that quantifying tumor EGFR (panitumumab-IRDye800CW), granzyme …

Restoring The Sphingolipid Balance In Glioblastoma, Cyntanna C. Hawkins

All ETDs from UAB

Glioblastoma (GBM) is a highly aggressive brain tumor with a median survival of 15 months even with standard of care—surgical resection, radiotherapy, and chemotherapy. Two of the key characteristics contributing to this malignancy are its highly invasive phenotype and resistance to the chemotherapy, temozolomide (TMZ). We, and others, have identified the sphingolipid balance as a driver of these phenotypes with dysregulated sphingolipid metabolism seen in GBM patient samples. The ceramidases, specifically acid ceramidase (ASAH1), mediate the balance between ceramides and sphingosine-1-phosphate (S1P). ASAH1 breaks down ceramides ultimately forming S1P. While ceramides induce cell death, S1P promotes migration and cell survival. …

Cell Type-Specific Diurnal Variation In Hippocampus Physiology, Lacy Kathryn Goode

All ETDs from UAB

Circadian rhythms are biological processes that cycle across 24 hours. Driven endogenously by widely expressed and highly conserved clock genes that compose the circadian molecular clock, circadian rhythms are exhibited in numerous facets of physiology across nearly every tissue throughout the body. Diurnal rhythms in cognition, long-term potentiation (LTP), and the expression of clock genes in hippocampus subfields support a role for circadian regulation of hippocampus physiology. However, little is known regarding the circadian molecular clock and diurnal rhythms in neurophysiology at the cellular level. Here, we characterized diurnal differences in spatial memory, LTP, excitability of and synaptic transmission onto …

The Use Of Vesgen For Analysis Of Retinal Vasculature In Pulmonary Arterial Hypertension, Mariana Desiree Dupont

All ETDs from UAB

Pulmonary artery hypertension is a chronic and progressive disease leading to right heart failure and, ultimately, death if untreated. The goal of the studies in this dissertation was to determine if fluorescein angiography (FA), and color fundus angiography (CF) imaging could be used to garner critical information about retinal changes in individuals with pulmonary artery hypertension (PAH). VESsel GENerational Analysis (VESGEN) is a noninvasive computer program that assigns branching generation to large and small vessels. VESGEN was utilized to investigate vascular alterations in FA, and CF imaging investigating disease progression in PAH. This dissertation demonstrated that PAH patients had aberrant …

Exploring The Influence Of Psychosocial Stress And Inflammatory Properties Of The Diet On Cardiometabolic Risk And Gut Microbiome Health Among Young Adult Women Of Birmingham, Alabama, Rachel Olivia Knight

All ETDs from UAB

Concerning trends for obesity, diabetes, heart attacks, and obesity-related cancers, or cardiometabolic disease (CMD), are developing within the emerging and young adult/adulthood (EYA) population. Evidence supports the concept that chronic stress leads to physiologic dysregulation, reduced mental health, chronic diseases, and reduced longevity; however, these are not inevitable outcomes, and resilience or vulnerability is determined by interacting environmental and biobehavioral factors. Although CMD manifests clinically in older adulthood, disease pathophysiology begins earlier, and thus, EYA is a critical time for observation and intervention. Growing evidence indicates inflammation is a major risk factor in CMD development and may be exacerbated by …

Predicting Change In Quality Of Life In Patients With Advanced Cancer And Family Caregivers Using Gps Data, Kyungmi Lee

All ETDs from UAB

Patients with advanced cancer and their family caregivers often experience poor quality of life. Measuring patient and caregiver physical and mental quality of life is typically performed using participant reported outcome measures, especially validated questionnaires. However, this self-report approach has several limitations, including recall bias, respondent burden, and social desirability bias. One potential solution to these limitations may be to use passive data collected by personally owned smartphones (e.g., GPS data) to model and assess the quality of life in family caregivers and patients with advanced cancer. Yet, there is no evidence to date that passively collected smartphone data is …

Palliative Care Experiences And Educational Needs Of Healthcare Interprofessionals In Jamaica: A Mixed Methods Study, Rebecca L. Edwards

All ETDs from UAB

Universal access to palliative care (PC) is a human right that much of the world has not accomplished and educating a PC workforce is critical to PC advancement. Higher PC disparities exist in low-and-middle income countries, such as Jamaica. The World Health Organization Public Health Model and the International PC Initiative’s PC roadmap emphasize the importance of PC education. The purpose of this mixed methods dissertation study was to investigate the PC experiences and educational needs of healthcare interprofessionals who provide care for patients with late-stage serious illnesses in Jamaica. Three specific aims incorporated quantitative investigation of physicians’, nurses’, and …

Intrinsically-Photosensitive Retinal Ganglion Cells And Their Functional Roles, Kevin Q. Chang

All ETDs from UAB

This project was conducted in Old World monkeys and focused on characterization of the intrinsically photosensitive retinal ganglion cells (ipRGCs) as they pertain to the pupillary light reflex, as well as on the neuroanatomical and electrophysiological characterization of the suprachiasmatic nucleus (SCN) of the hypothalamus as it pertains to circadian rhythms. A custom antibody was developed against the human melanopsin gene. We validated the antibody using western blot and immunohistochemistry. The functional role of ipRGCs in driving pupillary responses was investigated through immunotoxin-induced ablation in Rhesus macaques with the antibody conjugated to saporin. As hypothesized, the pupillary light reflex and …

Health Disparities In Cardiometabolic Risk Among African American And European American Adults, Catharine A. Couch

All ETDs from UAB

African American (AA) individuals are disproportionately burdened by cardiometabolic disease, including type 2 diabetes (T2D) and cardiovascular disease (CVD), and associated risk factors. The objective of this dissertation research was to investigate pathophysiological and lifestyle contributors to racial disparities in cardiometabolic disease including beta-cell dysfunction, ectopic fat, the natriuretic peptide system, and diet. These first three risk factors, beta-cell dysfunction, ectopic fat, and the natriuretic peptide system, were explored in a cross-sectional study of young AA and European American (EA) adults. The fourth risk factor, diet, was explored in a large, national cohort of black and white adults. First, we …