Medicine and Health Sciences Commons^™

Life-Space And Cognitive Function By Cardiovascular Disease Risk: A Cross-Sectional Analysis From The Regards Study, Emiri Matsuda

All ETDs from UAB

Performance on mobility assessments has been extensively linked to processing speed and executive function among older adults. However, less is known about the relationship between cognitive function and functional mobility as part of day to day life. African American individuals are at higher risk of cardiovascular complications, functional mobility, and cognitive decline compared to Whites. In addition, cardiovas-cular disease risk factors and neuropathology have been linked to impairment in several domains of cognitive function, including processing speed. The current study examined the cross-sectional association between life-space and cognitive function, specifically performance on the Digit Symbol Substitution Test (DSST), a measure …

The Role Of The Β-Catenin Signaling Pathway In Modulating The Nucleolar Proteome Of Triple Negative Breast Cancer, Shannon E. Meier

All ETDs from UAB

Previously, abnormal nucleoli were noted as indicators of cancerous lesions andused as a pathologic readout of neoplasia. Nucleolar hypertrophy and increased nucleolar number have been correlated with increased breast cancer (BC) mortality rates. Although various functions of the nucleolus have been investigated, it remains widely understudied in the context of cancer. The nucleolus was initially thought to be solely the site of ribosome biogenesis. However, over half of the proteins found in the nucleolus are associated with other biological functions. It is evident that the nucleolus plays major roles in stress response, DNA repair, and critical cellular aspects that influence …

Advancing Single Cell And Crispr/Dcas9 Technologies For The Study Of Reward Learning And Addiction, Corey Grant Duke

All ETDs from UAB

Drug addiction is a chronic relapsing condition inflicting tremendous harm to individuals and society with ineffective treatment options available to most people. Drugs of abuse elevate dopamine levels in a brain region known as the nucleus accumbens (NAc), and activate gene programs considered essential for producing lasting synaptic and cell state changes which underlie the generation of addictive behavior. These gene expression changes remain poorly understood due to a complex heterogenous cellular architecture, and the rapidly fluctuating nature of the transcriptional processes themselves which make investigation difficult. Recent technical advances increase access to both profiling and manipulating these transcriptional changes …

Deficiency Of Tumor Suppressor Merlin Induces Metabolic Reprogramming In Breast Cancer, Mateus Mota

All ETDs from UAB

The tumor suppressor Merlin is encoded by Neurofibromin 2 (NF2) gene. Merlin is predominantly located in the cell cortex where regulates cell proliferation by mediating cell contact-dependent growth inhibition. Metastatic breast cancer tissues presented with a remarkable loss of Merlin protein, revealing clinical relevance of Merlin. In order to examine the cellular effect of Merlin deficiency, breast cancer cell lines were silenced for NF2. Additionally, to assess the impact of Merlin loss at the organismal level, a mammary-specific NF2 knockout mouse mammary tumor model was engineered. Merlin deficiency induced a metabolic shift from mitochondrial oxidative phosphorylation to aerobic glycolysis. Furthermore, …

Downstream Pathways Of Glucagon Receptor Agonism In Obesity, Shelly Nason

All ETDs from UAB

Obesity is highly prevalent and strategies to improve weight loss maintenance are critical for healthcare. Behavioral interventions are effective but require major lifestyle changes that are often difficult to maintain long-term. Therefore, modifying energy balance with pharmacotherapy is a strategy to combine with lifestyle modifications for sustained weight loss. Glucagon, a hormone involved in maintaining glucose homeostasis, also regulates energy expenditure, food intake, and lipid metabolism. As such, glucagon-based therapies have gained attention as an attractive clinical target. Glucagon Receptor (GCGR) mono-agonism induces glucose intolerance; therefore, dissecting the mechanisms by which GCGR signaling mediates energy balance are clinically relevant to …

Protective Effects Of Thioredoxin Reductase Inhibition In The Murine Lung: The Regulation And Contribution Of Heme Oxygenase-1, Katelyn Louise Dunigan-Russell

All ETDs from UAB

Endogenous antioxidant responses defend the lung against oxygen toxicity. In premature neonates, oxygen toxicity and impaired antioxidant defenses contribute to the development of bronchopulmonary dysplasia (BPD), the leading cause of long-term morbidity among premature infants. In adults, oxygen toxicity and impaired antioxidant defense contributes to the pathogenesis of acute lung injury (ALI). Acute Respiratory Distress Syndrome (ARDS), a severe form of ALI, can cause permeant lung damage and mortality. Our lab has established that pharmacologic thioredoxin reductase-1 (TXNRD1) inhibition attenuates lung injury in murine BPD and ALI models. The protective effects of TXNRD1 inhibition are mediated by the activation of …

Peace. Love. Youth. (In) Yoga: Development Of A Mental Health Program Among Adolescents Living In The Inner City, Sherilyn Jonnell Garner

All ETDs from UAB

Adolescence is a unique developmental stage during which physical, cognitive, social, and emotional changes occur simultaneously and the traumatic effects of adverse childhood experiences (ACEs) can be particularly salient for the emotional and cognitive development of adolescents as they navigate and adjust to the social environment (Blakemore & Mills, 2014). Seventy-seven percent of Black adolescents have unmet mental health needs, and only 13% of those adolescents receive services compared to 31% of White adolescents. Meeting mental health needs of Black adolescents is imperative as their mental health needs continue to grow and resources become increasingly scarce. Innovative, culturally acceptable, accessible …

Immunopathogenesis In Fungal Asthma, Matthew Stephen Godwin

All ETDs from UAB

Asthma patients are increasingly presenting with asthma that is more difficult to control and treat than in years past. A subset of these patients who are sensitive to fungal species are described as having severe asthma with fungal sensitization (SAFS). Given the severity of disease, there is ever increasing interest in identifying the immune processes underlying SAFS disease pathology and the development of novel therapeutics to improve management. While sensitivity to multiple fungal species has been described in SAFS, none is more common than Aspergillus fumigatus. Here, we describe two previously unrecognized contributors to the amelioration of disease pathology in …

Employer Sponsored Health Insurance And Children With Special Health Care Needs, Kathryn Corvey

All ETDs from UAB

This dissertation is composed of three papers related to children with special health care needs (CSHCN) who are covered by private health insurance, including employer sponsored health insurance. Over the past couple of decades, researchers and advocates have expressed concern about the impact that widespread changes in private insurance coverage may have on families of CSHCN. These researchers point to the rise in high deductible plans and declining generosity in the form of higher premiums and copayments in more traditional plans offered by employers. Despite this expressed concern, little research has been conducted examining how these changes in employer sponsored …

Quality Of Life, Reading And Accommodation In Children With Low Vision, Dawn Kissner Decarlo

All ETDs from UAB

Childhood permanent, uncorrectable vision impairment (VI) is rare, yet it is a public health burden as the impairment lasts a lifetime. Vision impairment describes decreased vision that affects everyday activities. Acuity cut-points commonly used include 20/40, 20/60 or 20/70. Blindness often refers to legal blindness (best corrected visual acuity of 20/200 or worse or a visual field less than 20 degrees). Children with VI often have hereditary conditions such as albinism, optic atrophy and retinal degenerations and are different in many ways than adults with VI. The majority have conditions with onset at or near birth and as a result …

The Relationship Between Accreditation And Performance Among Federally Qualified Health Centers, Henry Thompson

All ETDs from UAB

While past studies have examined the relationship between accreditation and hospital performance, no previous studies have evaluated the relationship between Joint Commission accreditation and Federal Qualified Health Center (FQHC) performance. Multiple regression analyses were used to evaluate the relationship between Joint Commission accreditation and variables of interest. Joint Commission accreditation was utilized as the dependent variable in the evaluation of organizational and environmental market factors, and utilized as the independent variable in the evaluation of clinical and non-clinical performance outcomes. This study applies a novel approach to determine the relationship between Joint Commission accreditation and adoption among FQHCs, and organizational …

Contribution Of Adaptive Immune Responses In Chronic Lung Diseases, Thi Kim Tran-Nguyen

All ETDs from UAB

Immune dysregulation is a hallmark of various chronic lung diseases such as Chronic Obstructive Pulmonary Diseases (COPD) and Idiopathic Pulmonary Fibrosis (IPF). Previous studies in our lab have shown evidences of autoimmunity such as increases in autoantibodies, abnormal T cell profile, immune complex deposition and the presence of ectopic lymphoid structures in the lung of these patients. This thesis consolidates two separate projects about various aberrant immune responses in these diseases. The first project identified Glucose-Regulated-Protein 78 (GRP78) as the common autoantigen in COPD and characterized how GRP78 autoantibodies may increase COPD mortality via its atherogenic effects. I demonstrated that …

Effect Of Cement Selection On Retention Of Zirconia And Lithium Disilicate Crowns, Chan-Te Huang

All ETDs from UAB

Background: Ceramic crowns (lithium disilicate and zirconia) have become the most prescribed material for the restoration of anterior and posterior teeth due to the esthetic concerns of patients and the high cost of noble alloys. Different types of cements are used for luting crowns such as zinc phosphate, glass ionomer, resin modified glass ionomer (RMGI), resin cements and bioactive cements. Selection of different cements and bonding protocols for zirconia or lithium disilicate crowns to increase their bonding strength remains a clinical challenge for dentists. Objectives: To measure the retention strength of lithium disilicate and zirconia crowns cemented with different cements. …

C-Reactive Protein Subverts The Myeloid Lineage: Implications For Renal Injury, Rachel Jimenez

All ETDs from UAB

C-reactive protein (CRP) is an evolutionarily conserved pattern recognition molecule that was first characterized for its participation in the acute phase response to bacterial infection. In the last 90 years, knowledge of CRP biology in innate immunity has expanded significantly. CRP is known to bind and activate the classical pathway of complement, to opsonize bacteria and inflamed tissue, and to modulate myeloid cell functions. CRP is normally present in the blood at low levels with its biosynthesis and serum concentration rapidly rises upon systemic inflammation. For example, high levels of serum CRP are found following acute kidney injury (AKI) in …

An Analysis Of The Impact Of The Long-Term Care Partnership Program On The Number Of Lives Covered By Long-Term Care Insurance And Medicaid Expenditures In Nursing Homes, Cheris Kline

All ETDs from UAB

The growing number of people over the age of 65 in the U.S. will exacerbate already inadequate resources for long-term care, producing increased public health costs. The Long-Term Care Partnership Program (LTCPP) was proposed to save Medicaid expenditures by incentivizing the purchase of long-term care insurance. At this juncture, it is unclear if the partnership program saves the government money. This study draws from the expected utility theory and resource dependency theory to determine whether the LTCPP has increased the purchase of private long-term care insurance and reduced Medicaid expenditures in nursing homes in states that have adopted the partnership …

In Vitro Evaluation Of Candida Albicans Adherence And Disinfection Techniques On Cad/Cam Milled, 3d Printed, And Heat-Cured Pmma, Mohammad Amir Koujan

All ETDs from UAB

INTRODUCTION: Candida albicans has been regarded as the most predominant oral fungal pathogen and the main causative of denture stomatitis. Modern denture are fabricated from various types of polymers commonly: CAD/CAM or heat-cured. C. albicans adherence rate to these polymers and disinfection efficacy of adherent fungal biofilms are multifactorial processes and differ depending on the physical characteristics of the targeted surface. PURPOSE: The purpose of this study was to investigate Candida albicans adherence to specimens from three types of polymers namely: heat-cured PMMA, CAD/CAM milled and 3D printed. The second part compares the efficacy of four common disinfection techniques on …

Exploring Diet Quality In Early Care And Education Centers: Measures, Policies, And Center Characteristics, Elizabeth Kroeger

All ETDs from UAB

Over 65% of children ages 2-5 years attend Early Care and Education (ECE) centers where they consume most of their daily caloric intake; however, children at these centers are not meeting the Dietary Guidelines for Americans (DGA). This could suggest poor diet quality, which is a risk factor for diet-related diseases. Currently, diet quality in ECE centers is measured through the assessment of either the food/beverages listed on the lunch menu (menu), served to the children during lunch (served), or consumed by the children during lunch (consumed). However, the lunch meal may be better viewed as a process, rather than …

Understanding And Targeting Glucose Transporter 3 In Glioblastoma, Catherine Jeanne Libby

All ETDs from UAB

Glioblastoma (GBM) is the most common adult primary malignant brain tumor with a median survival of about 15 months, even after aggressive treatment. Treatment of GBM is difficult for multiple reasons including the location of the tumor, tumor invasiveness, and the high degree of both inter-and intra-tumoral heterogeneity. Contributing to intratumoral heterogeneity are highly tumorigenic, stem-like tumor cells, with the capacity to self-renew and propagate the tumor, termed brain tumor initiating cells (BTICs). BTICs are also commonly therapy resistant, highly invasive, and metabolically plastic with elevated expression of glucose transporter 3 (GLUT3) allowing them to preferentially survive in low nutrient …

Health Systems And Societal Level Community Benefit, Meghan Blueberry Mccarthy

All ETDs from UAB

In America, the amount spent on community benefit as tax exemption justification for not-for-profit health care is approaching 100 billion dollars annually. There are multiple categories for community benefit as defined by the Internal Revenue Service (IRS). The overwhelming majority of these funds are spent on individual financial assistance rather than societal level community health investments to address social determinates of health. Societal level community benefit is defined as the total spending on community health improvement, cash & in-kind donations to community groups and community building as reported on IRS form 990 Schedule H. These three combined itemized areas of …

Translating Public Health Strategies To Examine Hypertensive Disorders Of Pregnancy In Alabama, Matthew Dean Moore

All ETDs from UAB

Hypertensive disorders of pregnancy (HDP) are on the rise in the United States and contribute significantly to maternal and infant morbidity and mortality. The impact of such disorders is especially burdensome for women insured by Medicaid, for those who live in the South, and for those representing racial and ethnic minorities. It is evident across the aims of this dissertation that HDP remains an important public health concern to stakeholders in Alabama, its diagnosis is influenced by various maternal characteristics, and it can result in disparate severe outcomes for some populations. The first aim examines systems level decision-making in the …

Cime Newsletter : January 2020, Cime

Centre for Innovation in Medical Education (CIME) Archives

-Bye 2019, Hi 2020!
-Let’s start 2020 with some reflections on 2019
-News: December 2019 – January 2020
-CIME becomes South Asia’s first to receive SSH accreditation
-RE-ignite the SEARCH 2.0: Research Symposium
-Code Orange Activated @ CIME!
-Management of Common Dermatological Disorders
-Clinical Simulation Educators Programme
-Champions’ Conference 2.0
-AdAsia 2019

Inspire : Vol 3, Issue 1, Department Of Medicine

INSPIRE – Department of Medicine Archives

Content

• Message From the Chair
• Global Fund TB Audit-Reviewing diagnostic algorithms used for clinical diagnosis of TB
• Student Research Forum’s 5th Journal Club
• Medicine at National and International Forums
• Featured Faculty: Ms Safia Awan “Don’t ever give up on your dreams.”
• What are Academics Around the World Reading This Month?
• Publications

An Analysis Of Hospitalist Programs In Critical Access Hospitals, Robert Thomas Peterson

All ETDs from UAB

AN ANALYSIS OF HOSPITALIST PROGRAMS IN CRITICAL ACCESS HOSPITALS ROBERT T. PETERSON HEALTHCARE LEADERSHIP ABSTRACT Hospitalists are physicians specially trained in the care of hospitalized patients. In critical access hospitals (CAHs), the annual cost of a physician-based hospitalist program is approximately $1M. The high cost of hospitalist programs must be offset by the hospitalists’ ability to reduce the cost of inpatient care and/or by their ability to generate additional inpatient volume and revenue. Two well-established metrics are used to measure hospitalist performance: the average inpatient length of stay (ALOS) and the average daily census (ADC). Well-performing hospitalist programs are expected …

The Influence Of Maxillary Sinus Anatomy On Schneiderian Membrane Perforation During Lateral Wall Sinus Augmentation: A 5-Year Retrospective Study, Andrea Pizzini

All ETDs from UAB

Although previous studies have attempted to identify risk factors for membrane perforation, limited information with conflicting data exists regarding the significance of the relationship between buccal wall thickness and membrane perforation. Access to the Schneiderian membrane during the sinus augmentation procedure is obtained through the buccal wall, thus the importance of understanding whether its thickness plays a role in membrane perforations. In addition, the anatomy of the sinus cavity plays an important role in rendering the sinus augmentation procedure straightforward or rather complex. It is theorized that the narrower the sinus cavity, the higher the risk of membrane perforation. Residual …

Ideal Gingival Display Upon Full Smile, A Comparative Evaluation In American Dental Professionals And Laypeople, Anthony Michael Pikos

All ETDs from UAB

IDEAL GINGIVAL DISPLAY UPON FULL SMILE, A COMPARATIVE EVALUATION IN AMERICAN DENTAL PROFESSIONALS AND LAYPEOPLE ANTHONY M. PIKOS UNIVERSITY OF ALABAMA AT BIRMINGHAM, PERIODONTICS DEPARTMENT ABSTRACT The essentials of a smile involve the relationship between three primary components: the teeth, the lip framework, and the gingival scaffold. Excess of the gums while smiling is known as the gingival smile and this has been considered unaesthetic; however, the amount of gingival excess considered appealing differs in the literature. The purpose of this study is to determine if there is a difference in the perceptions of an ideally esthetic smile between dental …

Understanding Financial Hardship In Women With Breast Cancer, Courtney Williams

All ETDs from UAB

Individuals with cancer are at risk of material, psychological, and behavioral financial hardship due to costly new treatments, increasing time on treatment, and longer survival. Breast cancer is an ideal environment to study financial hardship. Treatment options for metastatic breast cancer are heterogeneous due to differences in patient characteristics, disease biology, and because it has the largest number of treatment options of any metastatic cancer. In early stage breast cancer, treatment options include multimodality treatments, including surgery, radiation, and medical therapy (chemotherapy, hormone therapy, targeted therapy), with the choice for each modality being dependent on the other modality decisions. Despite …

Copper Dependent Inhibitors Subvert Common Resistance Mechanisms In Staphylococcus Aureus And Inhibit Crucial Metabolic Pathways, Cameron Crawford

All ETDs from UAB

The effective antibiotic pool is shrinking with antibiotic resistance a constant problem that threatens to make our current therapies obsolete. To combat this, new drug screening methodologies are required since the traditional drug screens are offering limited results or only improvements upon current treatments. This work expands upon the idea that transition metal toxicity can be preferentially targeted towards bacteria. Specifically, the focus is on copper dependent inhibitors that quickly work to eliminate Staphylococcus aureus. S. aureus is a particularly threatening bacteria with high strain variability, a litany of survival and virulence factors, and multiple drug resistance mechanisms that are …

Cd8 T-Cell Responses To A Diverse Virus: Adaptation And Cross-Reactivity In Hiv Vaccination, Sushma Boppana

All ETDs from UAB

In the four decades since human immunodeficiency virus (HIV) was discovered, significant progress has been made in treating HIV infection and in understanding the viral and immune dynamics underlying disease pathogenesis. However, in spite of scientific advances, HIV remains a significant global health issue, and an effective preventative vaccine has yet to be created. Many groups have demonstrated the importance of CD8 T cells in viral control during natural HIV infection and believe that CD8 T cells could contribute to vaccine efficacy by alleviating disease course in individuals who became infected despite vaccination. One major obstacle to inducing potent CD8 …

A Prospective, Rct To Compare Vestibular Incision Supraperiosteal Access And Sulcular Tunnel Access Root Coverage Procedures To Treat Gingival Recession. A Pilot Study, Jamie Hargett Howard

All ETDs from UAB

The objective of this study was to evaluate the clinical and patient centered outcomes obtained following soft tissue grafting utilizing vestibular incision subperiosteal tunneling access (VISTA) or standard tunneling access (STA) procedures with acellular dermal matrix (ADM) and coronal flap advancement to treat Miller class I and II recession defects on single rooted teeth. Nine patients and 29 recession defects were randomly divided into two groups (A: VISTA, B: STA) and were treated and evaluated for six months post-surgically. For all participants included in the study the average recession defects at baseline were 2.48±0.57mm and at the six-month visit the …

Rna Polymerase I Elongation Kinetics: A Biochemical And Global Study Of A Cancer Therapeutic Target, Catherine Elizabeth Scull

All ETDs from UAB

My graduate research has focused on understanding the elongation kinetics of RNA polymerase I (Pol I), the enzyme responsible for synthesizing ribosomal RNA (rRNA), and defining how inhibition of ribosome biogenesis may be used as a cancer therapeutic strategy. Here, I have defined key biophysical features of Pol I and I have expanded the field’s understanding of Pol I elongation by: 1) characterizing the enzymatic properties of Pol I by mutational analysis of the polymerase itself, and by 2) elucidating the role of DNA sequence on Pol I arrest and nucleolytic cleavage activity. In recent years, Pol I has become …