Medicine and Health Sciences Commons^™

Quality Of Life And Sexual Function Of Women With Endometriosis At The Aga Khan University Hospital Nairobi, Edna Mohere Chacha

Master of Medicine in Obstetrics and Gynecology

Introduction: Endometriosis is a benign, chronic condition that affects up to ten percent of women of childbearing age. It’s marked by the presence of endometrial tissue outside the uterine cavity (Giudice, 2010). It is a health condition with wide-ranging and pervasive sequelae making it a significant health concern requiring appropriate action (Rush & Misajon, 2018). We observed that there was a paucity of data relating to how endometriosis impacted on female sexual function and quality of life in sub-Saharan Africa, Kenya included. Objectives: The primary goal of this empirical investigation was to determine the quality of life of women who …

Machine Learning Framework For Real-World Electronic Health Records Regarding Missingness, Interpretability, And Fairness, Jing Lucas Liu

Theses and Dissertations--Computer Science

Machine learning (ML) and deep learning (DL) techniques have shown promising results in healthcare applications using Electronic Health Records (EHRs) data. However, their adoption in real-world healthcare settings is hindered by three major challenges. Firstly, real-world EHR data typically contains numerous missing values. Secondly, traditional ML/DL models are typically considered black-boxes, whereas interpretability is required for real-world healthcare applications. Finally, differences in data distributions may lead to unfairness and performance disparities, particularly in subpopulations.

This dissertation proposes methods to address missing data, interpretability, and fairness issues. The first work proposes an ensemble prediction framework for EHR data with large missing …

Biomolecules From Macroalgae-Nutritional Profile And Bioactives For Novel Food Product Development, Laura E. Healy, Xianglu Zhu, Milica Pojić, Carl Sullivan, Uma Tiwari, James Curtin, Brijesh K Tiwari

Articles

Seaweed is in the spotlight as a promising source of nutrition for humans as the search for sustainable food production systems continues. Seaweed has a well-documented rich nutritional profile containing compounds such as polyphenols, carotenoids and polysaccharides as well as proteins, fatty acids and minerals. Seaweed processing for the extraction of functional ingredients such as alginate, agar, and carrageenan is well-established. Novel pretreatments such as ultrasound assisted extraction or high-pressure processing can be incorporated to more efficiently extract these targeted ingredients. The scope of products that can be created using seaweed are wide ranging: from bread and noodles to yoghurt …

Quality Improvement Project To Assist In Implementation Of Prediabetes Screen Protocol, Kyai Forney

Doctoral Projects

Prediabetes is a reversible condition that causes blood glucose levels to be higher than normal, but not high enough to be diagnosed as type 2 diabetes. When one has prediabetes, the cells in the body do not respond normally to insulin, and insulin acts like a key to letting blood sugar into cells to use energy. The pancreas produces insulin to try to get the cells to respond, but eventually, the pancreas has a challenging time keeping up, and the blood sugar level rises causing prediabetes (Lehrman, 2021). A person can have prediabetes for years with no obvious symptoms, so …

Portable Hepa Filtration Successfully Augments Natural-Ventilation-Mediated Airborne Particle Clearance In A Legacy Design Hospital Ward, Mehael Fennelly, S. Hellebust, J. Wenger, D. O'Connor, G.W. Griffith, B.J. Plant, A.P.C. Microbiome Institute

Articles

As the severe acute respiratory syndrome coronavirus-2 pandemic has proceeded, ventilation has been recognized increasingly as an important tool in infection control. Many hospitals in Ireland and the UK do not have mechanical ventilation and depend on natural ventilation. The effectiveness of natural ventilation varies with atmospheric conditions and building design. In a challenge test of a legacy design ward, this study showed that portable air filtration significantly increased the clearance of pollutant aerosols of respirable size compared with natural ventilation, and reduced spatial variation in particle persistence. A combination of natural ventilation and portable air filtration is significantly more …

Modulation Of Tlr4/Nf-Κb, Nrf2/Ho-1 And Pi3k/Akt Signaling By Cilostazol Mitigates Lipopolysaccharide-Induced Septic Acute Kidney Injury, Ahmed F. Mohamed Dr., Helmy Said Dr, Hala F. Zaki, Marwa M. Safar Prof. Dr.

Pharmacy

Aim: Cilostazol was investigated as a protective agent against lipopolysaccharide (LPS)-associated acute kidney damage in mice. Methods: Cilostazol (50 mg/kg/day; p.o.) administered for 7 consecutive days before a single LPS dose (2 mg/kg; i.p.). Results: Cilostazol hampered serum creatinine, cystatin C, and renal kidney injury molecule-1 and neutrophil gelatinase associated lipocalin; repressed toll-like receptor 4 and MyD88 transcription, as well as nuclear factor-kappa B p65, interleukin-1b, and malondialdehyde content; and boosted Nrf2 mRNA expression, hemeoxygenase-1 activity, and reduced glutathione content. This was synchronous with an upregulation of p-phosphoinositide 3-kinase and p-Akt expressions. Conclusion: Collectively, cilostazol prevented LPS renal injury, which …

Elafibranor Modulates Ileal Macrophage Polarization To Restore Intestinal Integrity In Nash: Potential Crosstalk Between Ileal Il-10/Stat3 And Hepatic Tlr4/Nf-Κb Axes, Andrew Hakeem, Mohamed M. Kamal, Rasha A. Radwan, Basma A. Abdelrahman, Olfat A. Hammam, Mohey M. Elmazar, Aiman S. El-Khatib, Yasmeen M. Attia

Pharmacy

Experimental and clinical evidence implicate disrupted gut barrier integrity in provoking innate immune responses, specifically macrophages, towards the progression of non-alcoholic steatohepatitis (NASH). Peroxisome proliferator-activated receptors (PPARs), a subset of the nuclear receptor superfamily, act to fine-tune several metabolic and inflammatory processes implicated in NASH. As such, the current study was carried out to decipher the potential role of dual PPAR α/δ activation using elafibranor (ELA) on ileal macrophage polarization (MP) and its likely impact on the liver in a NASH setting. To achieve this aim, an in vitro NASH model using fat-laden HepG2 cells was first used to validate …

Marine-Based Candidates As Potential Rsk1 Inhibitors: A Computational Study, Amgad Albohy, Mousa Altarabeen, Peter Proksch, Qosay Al-Balas, Werner Ernst Georg Müller

Pharmacy

Manzamines are chemically related compounds extracted from the methanolic extract of Acanthostrongylophora ingens species. Seven compounds were identified by our research group and are being characterized. As their biological target is unknown, this work is based on previous screening work performed by Mayer et al., who revealed that manzamine A could be an inhibitor of RSK1 kinase. Within this work, the RSK1 N-terminal kinase domain is exploited as a target for our work and the seven compounds are docked using Autodock Vina software. The results show that one of the most active compounds, Manzamine A N-oxide (5), with an IC50 …

Africa Guidelines For Hepatocellular Carcinoma Buildup Process, Ghassan Abou-Alfa, Mary Afihene, Marinela Capanu, Joanne Chou, Akwi Asombang, Olusegun Alatise, Adda Bounedjar, Lina Cunha, Hailemichael Mekonnen, Papa Diop, Reda Elwakil, Mahamat Ali, Ntokozo Ndlovu, Jerry Ndumbalo, Precious Makondi, Christian Tzeuton, Tiago Castria, Adwoa Afrakoma Agyei-Nkansah, Fiyinfolu Balogun, Alain Bougouma, Blaise Ibara, Eduard Jonas, Stephen Kimani, Peter Kingham, Reshad Kurrimbukus, Nazik Hammad, Mona Fouad, Noha S. El Baghdady, Eloumou Fiacre, Vikash Sewram, C. Wendy Spearman, Ju Yang, Lewis Roberts, Ashraf Abdelaziz

Pharmacy

Abstract

Purpose

Hepatocellular carcinoma (HCC), the fourth most common cancer in Africa, has a dismal overall survival of only 3 months like in sub-Saharan Africa. This is affected by the low gross domestic product and human development index, absence of coherent guidelines, and other factors.

Methods

An open forum for HCC-experienced health care workers from Africa and the rest of the world was held in October 2021. Participants completed a survey to help assess the real-life access to screening, diagnoses, and treatment in the North and Southern Africa (NS), East and West Africa (EW), Central Africa (C), and the rest …

Proposal Of A Selection Protocol For Replication Of Studies In Sports And Exercise Science, Jennifer Murphy, Christian Mesquida, Aaron R. Caldwell, Brian D. Earp, Joe P. Warne

Articles

To improve the rigor of science, experimental evidence for scientific claims ideally needs to be replicated repeatedly with comparable analyses and new data to increase the collective confidence in the veracity of those claims. Large replication projects in psychology and cancer biology have evaluated the replicability of their fields but no collaborative effort has been undertaken in sports and exercise science. We propose to undertake such an effort here. As this is the first large replication project in this field, there is no agreed-upon protocol for selecting studies to replicate. Criticism of previous selection protocols include claims they were non-randomised …

Caring For Individuals Who Have Used Methamphetamine: A Study Exploring The Experiences Of West Australian Nurses Working In An Authorised Mental Health Institute, John Kriticos

Theses

Background: Methamphetamine (MA) use in Australia has stabilized over the last 22 years, however changing routes of administration and increased purity of the drug has led to greater rates of physical dependency and higher rates of cardiovascular, neurological, and mental health complications. Challenges managing MA related presentations have been reported in Australian Emergency Departments (ED’s), with limited research considering nurses’ experience treating individual(s) who use MA (IWUM) and require prolonged mental health care. Purpose: The aim of this study was to understand nurses’ experiences who care for IWUM in a West Australian hospital’s inpatient mental health service. Methods: Interpretive phenomenological …

Novel Electrocardiogram Biomarkers In Long Qt Syndrome, Daniel Theodore Tardo

Theses

Prolongation of the corrected QT interval (QTc) is key in diagnosing long QT syndrome (LQTS), however 25-50% of individuals with congenital LQTS (cLQTS) demonstrate a normal resting QTc. T wave morphology (TWM) can distinguish cLQTS subtypes but its role in acquired LQTS (aLQTS) requires further elucidation. Beyond the challenge of concealed LQTS, utilising the QTc is complicated by limitations related to overcorrection at fast and slow heart rates, due to assumptions based on non-physiological QT rate dependence. QT-RR dynamics enable improved heart rate correction and have been shown to distinguish cLQTS from controls, however RR dynamics have not yet been …

An Examination Of The Trends In Activities Of Daily Living In The 12 Months After Total Knee Arthroplasty: A Descriptive Study, Irene Van Staden

Theses

Background

The current trend to reduce the length of stay for patients undergoing total knee arthroplasty, together with the steadily increasing number of procedures being performed, has impacted on the functional independence goals expected by patients and the ability of nurses to deliver adequate education prior to discharge. Over the past 10 years length of stay has reduced from 7-10 days to 3-4 days and patients are expected to largely self-manage their post-operative rehabilitation and optimise their functional outcomes.

Patient feedback confirmed that patients do not feel ready for discharge and lack the ability to self-manage some activities of daily …

'Crying Wolf': Generating New Understandings Of Alarm Fatigue Using A Convergent Mixed Methods Approach, Meagan Rae Vidyaeva

Theses

Introduction: Alarm fatigue is a consequence of sensory overload due to frequent nuisance alarms from physiologic monitoring devices. This ‘cry wolf’ phenomenon occurs frequently in the context of continuous cardiac monitoring and ST segment monitoring.

Research significance: The effect of these alarm types on nurses’ perceived alarm fatigue in Australian settings is yet to be examined. Accordingly, this thesis explores registered nurses (RN’s) perception of alarm fatigue. The effect of ST segment monitoring on perceived alarm fatigue, as well as the necessary resources for RNs to reduce alarm fatigue is also a focus of this thesis.

Methodology: The research was …

Inspire : Vol 6, Issue 1, Department Of Medicine

INSPIRE – Department of Medicine Archives

• Message from the Chair
• Medicine at National and International Forums
• Medicine at National and International Forums
• Annual Appreciation Event 2022
• Dr Bloomfield’s AKU visit
• Neurology | 22nd Annual Update Conference
• PADCON | 41st Conference
• Neurology Annual Appreciation Evening
• Nephrology | Mock TOACS Exam
• Featured Faculty: Dr. Zarmeen Nasim | Senior Instructor | Data Science Team “...Be honest with your work. Whatever you are doing in life, be loyal and committed…”
• Publications

Standard Deviations Of Mr Signal Intensities Show A Consistent Trend During Imaging Follow-Ups For Glioblastoma Patients When Corrected For Non-Biological Heterogeneity Due To Hardware And Software Variation, Subhendra N. Sarkar, Rafael Rojas, Evans Lespinasse, Xiangfu Zhang, Ruth Zeron

Publications and Research

Introduction

Glioblastoma multiforme (GBM) has a poor prognosis in spite of advanced MRI guided treatments today. Routine MRI using conventional T₁ or advanced permeability based MRI of GBM often does not adequately represent changing tumor phases or overall survival. In this work, region of interest (ROI) based tissue MR standard deviation (SD) is demonstrated as an important MRI variable that could be a potential biomarker of GBM heterogeneity and radioresistance.

Materials and methods

MRI characterization is often qualitative and lacks reproducibility. Using standardized MRI phantoms we have normalized retrospective records of 12 radioresistant GBM patients that underwent radiation therapy …

Dact1, The “Super-Crosslinker”: Regulation Of Non-Canonical Wnt Signaling During Vertebrate Convergent Extension By Modulating Dishevelled Oligomerization, Allyson Angermeier

All ETDs from UAB

A broad spectrum of human birth defects arise from the disruption of morphogenesis, the critical process through which tissues and organs acquire their proper shape. Convergent extension (CE) is a universal morphogenetic engine that promotes polarized extension of diverse tissues and organs by regulating directional cell behavior, such as oriented cell intercalation. In vertebrates, CE is regulated by non-canonical Wnt/Planar Cell Polarity (PCP) pathway, an ancient signaling pathway that was originally discovered to coordinate the cellular polarity in the plane of the epithelium. Non-canonical Wnt/PCP signaling shares the Frizzled (Fz) receptor and cytoplasmic signal transducer Dishevelled (Dvl) with the canonical …

Modifiable Risk Factors And Subsequent All-Cause And Cause-Specific Late Mortality After Blood Or Marrow Transplanta-Tion (Bmt), Nora Balas

All ETDs from UAB

The objective of this dissertation was to examine the association between modifiable risk factors and subsequent all-cause and cause-specific late mortality among blood or marrow transplantation (BMT) recipients. I analyzed data for participants who were ≥18 years (y) at study participation from the BMT Survivor Study (BMTSS). BMTSS (U01 CA213140, PI: Bhatia) is a cohort study designed to examine the long-term outcome of individuals who survived ≥2y after undergoing BMT between 1974 and 2014, at the University of Alabama at Birmingham, City of Hope, or University of Minnesota. BMTSS also examines outcomes in an unaffected comparison group drawn from the …

Regulatory Elements Of Polyphosphate Biosynthesis, Marvin Qortez Bowlin

All ETDs from UAB

Polyphosphate (polyP) is an ancient, conserved, inorganic biomolecule. Biological systems have adapted many functions for this high-energy molecule, ranging from immune regulation in mammals to gene regulation in prokaryotes. Of particular interest is its use in bacterial stress responses. Bacteria use polyP to resist hazardous environmental elements like toxic molecules or nutrient starvation. In many bacterial species, polyP is synthesized by polyphosphate kinases (PPKs). PPK – discovered in Escherica coli (E. coli) – hydrolyzes adenosine-5’-triphosphate (ATP) to synthesize polyP. Species that use PPK develop multiple pathogenic defects when PPK activity is impaired, including, among others, antibiotic susceptibility. There is no …

The Influence Of Proximity On Patient Outcomes For Differently Structured Ambulatory Surgery Centers, Wendy Michelle Smith

All ETDs from UAB

THE INFLUENCE OF PROXIMITY ON PATIENT OUTCOMES FOR DIFFERENTLY STRUCTURED AMBULATORY SURGERY CENTERSWENDY SMITH HEALTH SERVICES ADMINISTRATION ABSTRACT This study examines the complication rates and patient-reported outcome measures (PROMs) for total hip and knee replacement surgeries conducted in one of two differently structured ambulatory surgical centers (ASCs) with varying interprofessional surgical teams. There is an ongoing shift from in-hospital total joint replacement surgeries to ASCs. Additionally, there is specialization occurring within ASCs. In this study, we compare single specialty ASCs designed to perform solely TJR surgeries with one orthopedic group and interprofessional team, with multi-specialty ASCs that perform an array …

Evaluation Of A Hospital Pdmp Ehr-Integration Implementation: A Mixed, Heather D. Martin

All ETDs from UAB

Background: Many providers continue to over prescribe opioids for pain, and Prescription Drug Monitoring Programs (PDMP) can be used as a tool to assist with appropriate opioid prescribing decisions. Despite mandates requiring opioid prescribers to review patients’ prescribing history in their state’s PDMP, barriers to PDMP success still exist such as a difficult PDMP logon process and having to log on to a separate PDMP system, which can cause access, workflow, time commitment, and ease of use issues and deter providers from using the PDMP. Some health care organizations have implemented PDMP electronic health record (EHR) integration (PDMP EHR-integration) to …

Manipulation And Dependence On Host Cell Cycle By Human Rna And Dna Viruses: Human Coronavirus Oc43 And Bk Polyomavirus, Jason M. Needham

All ETDs from UAB

Cell cycle is a universal necessity of cellular life and impacts nearly every process within the cell. However, despite over one hundred years of research, there still remain questions concerning the mechanisms and regulation of eukaryotic cell cycle. From the beginning, viruses have informed our knowledge of cell cycle. Many key regulators such as the E2F transcription factors, Src kinase, and p53 were originally discovered while studying the interactions between viruses and the cell. Herein, we continue the investigation of viral interactions with cell cycle machinery by researching an RNA virus and a DNA virus. These viruses, human coronavirus OC43 …

A Tale Of Two Waves: The Role Of Genomic Enhancers In Regulating Transcriptional And Epigenetic Responses To Neuronal Activitiy, Robert A. Phillips

All ETDs from UAB

The mesolimbic dopamine (DA) pathway, which consists of dopaminergic neurons that project from the ventral tegmental area (VTA) to the nucleus accumbens (NAc), is heavily implicated in drug addiction. Exposure to drugs of abuse results in increases in extracellular concentrations of DA in the NAc, which in turn activates an immediate early gene (IEG) expression program that primarily consists of activity-dependent transcription factors, such as the AP1 subunits Fos and JunB. IEGs engage a set of temporally and functionally distinct genes, termed the late response gene (LRG) expression program. While gene expression changes are critical for drug-dependent adaptations, two major …

Randomized Control Trial Of A Novel Dental Gel As An Adjunct To Scaling And Root Planing In Subjects With Stage Ii & Iii Periodontitis, Sarah Pham

All ETDs from UAB

The current standard of care for treating chronic periodontitis is scaling and root planing (ScRP) followed by supportive periodontal therapy (SPT) (Cobb et al., 2021; Ramfjord et al., 1987). The goal of ScRP is to eliminate supra- and subgingival bacterial deposits and to reduce periodontal pathogens, inflammation, and pocket depths (Greenstein, 2000). Although ScRP has been shown to significantly improve baseline clinical parameters, moderate to advanced cases may require additional surgical therapy which many patients resist (Stambaugh, 1981; Becker et al., 2001). Currently, no dentifrice used adjunctively has been proven to increase the therapeutic effects of scaling and root planing. …

Physical Activity And Related Social Cognitive Theory Constructs By Major Depression Status In Persons With Multiple Sclerosis, Catherine Danielle Jones

All ETDs from UAB

Major depressive disorder (MDD) is highly prevalent among the 1 million per-sons living with multiple sclerosis (MS) in the United States. The prevalence of MDD is nearly 1.7 times higher in persons with MS than in the general population. MDD is associated with negative outcomes in MS, including worse neuropsychological functioning, lower quality of life (QOL), and worse disability. Higher levels of physical activity (PA) are associated with lower depressive symptoms in MS and participation in moderate to vigorous physical activity (MVPA) has been recommended for managing depression se-verity in the general population. However, the rates, patterns, and behavioral correlates …

Increasing Patient Safety By Reducing Falls Among In-Hospital Community-Dwelling Patients 65 Years Old Or Older By Using A Shift Change Fall Safety Checklist, Janice Isaac Brooks

All ETDs from UAB

This manuscript is designed to promote and improve healthcare safety, quality, efficiency, and lower medical costs for hospitals and patients. Falls, fall injuries, and their devastating consequences are rising, yet falls are preventable even among senior patients. Search Engines and Key Terms SciWheel was used to save the literature and eliminate duplications. Key terms were used in the Boolean strings: elderly fall prevention, senior fall safety, in-hospital fall prevention, falls in the aging, and fall prevention tools. The CINAHL Plus yielded 58. PubMed search yielded 121. And Google Scholar yielded 32. The total of all three searches was 211. Thirteen …

New Records Of Distribution And Natural History Of Vertebrates In Arkansas: 2020-2023, R. Tumlison, H.W. Robison, M.B. Connior, D.B. Sasse, T.S. Risch, K. Edmonds, J.D. Wilhide, C.R. Allen

Journal of the Arkansas Academy of Science

Small details of natural history often go undocumented to science if those details are not parts of larger studies. However, knowledge of small details can provide insights that lead to interesting questions about ecological relationships or environmental change. We have compiled recent important observations of natural history of vertebrates, including several distributional and size records of fishes, atypical carapace shape in a common snapping turtle, an unusual support structure for a bird nest, healed damage to a broken jaw of a young deer, and numerous distributional records of bats.

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

Maternal, Infant, And Early Childhood Home Visiting And School Readiness In Alabama, Heather H. Johnson

All ETDs from UAB

This study examined the relationship between home visiting and school readiness in Alabama. Topics included a scoping review of the home visiting literature, statistical analyses of Alabama’s Teaching Strategies GOLD® (GOLD) data to determine if there were differences in performance among children who received home visiting compared to those who did not, and the development of a Key Driver Diagram (KDD) to inform improvement in home visiting practices that support school readiness. The scoping review of the literature indicated an absence of consistent definitions and measurement of the concept of school readiness. Through thematic analysis of the articles, contextual factors …

Differential Mechanisms Of Intestinal Inflammation Drive Pathogenesis Of Diabetic Retinopathy In Type 1 And Type 2 Diabetes, Jason Levi Floyd

All ETDs from UAB

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and, along with diabetic macular edema (DME), accounts for the greatest source of vision-threatening eye disease in the working-age community. DR is caused by weakening of the retinal vasculature, the blood-retinal barrier (BRB), by high levels of blood glucose (hyperglycemia), exacerbations of oxidative stress, and systemic inflammatory factors. Many of these inflammatory factors are metabolic by-products and cell membrane constituents of the gut microbiota, the resident community of microbial species which inhabit the lumen of the gastrointestinal tract. These factors are collectively termed gut microbial antigens (GMAs). In diabetes, …