Medicine and Health Sciences Commons^™

Reducing The Burden Of Diabetes Mellitus: Is It Achievable?, Rafay Iqbal, Raheel Ahmad, Aisha Ambreen

Department of Family Medicine

Diabetes mellitus is rapidly on the rise globally, particularly in low- and middle-income countries. Pakistan has emerged with the highest prevalence of diabetes by percentage according to recent estimates. Evidence is available for different strategies to reduce this burden. Screening high-risk individuals can reduce burden of undiagnosed diabetes and improve outcomes. Although prediabetes can progress to type 2 diabetes, it has the potential to regress to normoglycaemia as well. Interventions like lifestyle modifications and metformin in high-risk individuals can reduce the risk of progression to diabetes. Furthermore, there is a potential to reverse diabetes in some individuals in the early …

Data Normalization For Addressing The Challenges In The Analysis Of Single-Cell Transcriptomic Datasets, Raquel Cuevas-Diaz Duran, Haichao Wei, Jiaqian Wu

Faculty, Staff and Student Publications

BACKGROUND: Normalization is a critical step in the analysis of single-cell RNA-sequencing (scRNA-seq) datasets. Its main goal is to make gene counts comparable within and between cells. To do so, normalization methods must account for technical and biological variability. Numerous normalization methods have been developed addressing different sources of dispersion and making specific assumptions about the count data.

MAIN BODY: The selection of a normalization method has a direct impact on downstream analysis, for example differential gene expression and cluster identification. Thus, the objective of this review is to guide the reader in making an informed decision on the most …

Hormonal Basis Of Brain Fog In Cancer Treatment, Yuan Pan, Jian Hu

Faculty, Staff and Student Publications

The cognitive side effects of cancer treatment are common, but no targeted therapy exists yet to treat or prevent such neurological sequelae. We explore the role of hormones as mediators between cancer therapy and cognitive impairment, discussing potential future directions.

The Case For Curanderismo: A Path To Culturally Competent Healthcare For Hispanic Populations In The U.S., Chloe Cutshall

The Agora

Curanderismo, a traditional healing practice in the Hispanic community, presents a possible opportunity to improve healthcare access and outcomes for Hispanic patients in the United States. However, careful planning and attention to safety and efficacy would be necessary when integrating these practices into the healthcare system. Despite the challenges, this paper argues that the potential benefits warrant consideration. Primary reasons for integration include the presence of significant Hispanic populations that may benefit, more culturally competent and therapeutic care, and improved communication between healthcare providers and Hispanic patients. Research articles and journalistic pieces were analyzed for this paper. The evidence showed …

Physical And Optical Properties Of Material Used For Injection Molding, Nadia Christine Farias Machado

All ETDs from UAB

Background: This project investigates the materials used in injection molding dental resin composites which involves injecting flowable composite into a clear mold. Understanding the physical and optical properties of both the resin composite and the clear mold material is crucial for successful clinical outcomes. For the clear mold material, its translucency, curing light transmission, and rigidity are vital factors. Correlations may be present between trans-lucency and curing light transmission. For the resin composite, comparing wear, hardness, translucency, radiopacity, shrinkage stress, flexural strength, and modulus will affect mate-rial performance. Finally, the depth of cure of the material will be dependent on …

Psychometric Evaluation Of A Perceived Barriers To Medication Adherence Instrument And Association Between Perceived Barriers And Patient Characteristics, Lynn Andreae

All ETDs from UAB

Medication adherence is an important component of diabetes management, yet nonadherence is common and has substantial patient and economic costs. In order to achieve meaningful improvements in medication adherence, clinicians and researchers need good ways of both identifying those at risk of nonadherence and ascertaining the specific reasons driving nonadherence in those patients. Current options for self-reported medication adherence are limited in their vulnerability to response bias, which may lead to overestimation of adherence. A measure that assesses perceived barriers to medication adherence may be a useful alternative, as it may identify patients at risk of nonadherence while reducing socially …

Provider Perceptions Of Pediatric Obesity Management In The Primary Care Setting, Rina Edelson

Conference Presentation Abstracts

Background: Childhood obesity is a critical public health issue. The primary care setting provides an accessible avenue for management. However, primary care physicians report significant barriers to success in treating this condition.

Objective: The purpose of this study was to compare clinician perception of pediatric overweight and obesity management before and after implementation of a standardized treatment protocol based on the clinical practice guidelines released by the American Academy of Pediatrics in January 2023.

Design/Methods: This study was deemed exempt by the Institutional Review Board. A survey was created by the study team to assess 5 domains: disease knowledge, current …

Parents And Health Care Teams Perceptions Of Communication In Neonatal Intensive Care Unit, Marjan Mardani, Haydeh Heidari

The Qualitative Report

Parents experience a lot of stress in the neonatal intensive care unit (NICU). Then effective communication between parents and members of the care team is an essential component of improving the quality of care. The present study was conducted by qualitative exploratory research method for explaining parents and health care teams' perceptions of communication in NICU. We selected 39 participants by purposive sampling. We collected data through in-depth semi-structured, face-to-face interviews. The transcripts were analysed using the conventional content analysis approach. Three themes were obtained by analyzing the data included, the nature of communication, the theme of factors affecting successful …

Ras G-Domains Allosterically Contribute To The Recognition Of Lipid Headgroups And Acyl Chains, Neha Arora, Huanwen Mu, Hong Liang, Wenting Zhao, Yong Zhou

Faculty, Staff and Student Publications

Mutant RAS are major contributors to cancer and signal primarily from nanoclusters on the plasma membrane (PM). Their C-terminal membrane anchors are main features of membrane association. However, the same RAS isoform bound to different guanine nucleotides spatially segregate. Different RAS nanoclusters all enrich a phospholipid, phosphatidylserine (PS). These findings suggest more complex membrane interactions. Our electron microscopy-spatial analysis shows that wild-types, G12V mutants, and membrane anchors of isoforms HRAS, KRAS4A, and KRAS4B prefer distinct PS species. Mechanistically, reorientation of KRAS4B G-domain exposes distinct residues, such as Arg 135 in orientation state 1 (OS1) and Arg 73/Arg 102 in OS2, …

The Relationships Among Economic Support And Hypertension And Diabetes Among The Adult Jamaican Population, Andrea Wolfe

Walden Dissertations and Doctoral Studies

A significant number of adult Jamaicans have been diagnosed with diabetes and hypertension, and individual socioeconomic status (SES) has been linked to these health outcomes. SES included income, education and employment. Income may directly influence health; however, some individual’s income may not be sufficient to cover all financial obligations and income support may be necessary. Local or overseas family members may significantly augment an individual’s income and financial situation that could affect health outcomes. This quantitative cross-sectional study was used to examine whether there were relationships between health outcomes (hypertension and diabetes) and economic support (governmental and familial). The Jamaica …

Contraception And Menstrual Management In Transmasculine And Gender-Diverse Individuals, Adrian Chiem, Maria Cristina Marcos, Beth I. Schwartz

Department of Obstetrics and Gynecology Faculty Papers

Purpose of Review This review outlines the current evidence on the contraceptive and menstrual management methods that are used for transmasculine or gender-diverse (TGD) individuals, as well as the gaps in the literature for this population.

Recent Findings Contraception and menstrual management continue to be an understudied area in the care of TGD individuals, with much of existing research extrapolated from cisgender populations. Emerging studies have looked at contraceptive and menstrual management choices and outcomes in adolescents and highlight the 52 mg LNG-IUD as an option that is efficacious for both indications, as well as high-dose progestin-only pills for menstrual …

Serine Deamination By Human Serine Racemase Synergizes With Antibiotics To Curtail The Replication Of Chlamydia Trachomatis, Patricia D. Mott, Arnold H. Zea, Jamiya Lewis, Oygul Mirzalieva, Ashok A. Aiyar

School of Medicine Faculty Publications

The obligate intracellular bacterium, Chlamydia trachomatis, has evolved to depend on its human host for many metabolites, including most amino acids and three of the four nucleotides. Given this, it is not surprising that depletion of a single amino acid in the host cell growth medium blocks chlamydial replication. Paradoxically, supra-normal levels of some amino acids also block productive replication of Chlamydia. Here, we have determined how elevated serine levels, generated by exogenous supplementation, impede chlamydial inclusion development and reduce the generation of infectious progeny. Our findings reveal that human serine racemase, which is broadly expressed in multiple tissues, potentiates …

Association Between Retinal Microvascular Abnormalities And Late-Life Brain Amyloid-Β Deposition: The Aric-Pet Study, Marco Egle, Jennifer A Deal, Keenan A Walker, Dean F Wong, A Richey Sharrett, Rebecca F Gottesman

2020-Current year OA Pubs

BACKGROUND: Retinal microvascular signs are accessible measures of early alterations in microvascular dysregulation and have been associated with dementia; it is unclear if they are associated with AD (Alzheimer's disease) pathogenesis as a potential mechanistic link. This study aimed to test the association of retinal microvascular abnormalities in mid and late life and late life cerebral amyloid.

METHODS: Participants from the ARIC-PET (Atherosclerosis Risk in Communities-Positron Emission Tomography) study with a valid retinal measure (N = 285) were included. The associations of mid- and late-life retinal signs with late-life amyloid-β (Aβ) by florbetapir PET were tested. Two different measures of …

Metaplastic Regeneration In The Mouse Stomach Requires A Reactive Oxygen Species Pathway, Zhi-Feng Miao, Jing-Xu Sun, Xuan-Zhang Huang, Shi Bai, Min-Jiao Pang, Jia-Yi Li, Han-Yu Chen, Qi-Yue Tong, Shi-Yu Ye, Xin-Yu Wang, Xiao-Hai Hu, Jing-Ying Li, Jin-Wei Zou, Wen Xu, Jun-Hao Yang, Xi Lu, Jason C Mills, Zhen-Ning Wang

Faculty, Staff and Students Publications

In pyloric metaplasia, mature gastric chief cells reprogram via an evolutionarily conserved process termed paligenosis to re-enter the cell cycle and become spasmolytic polypeptide-expressing metaplasia (SPEM) cells. Here, we use single-cell RNA sequencing (scRNA-seq) following injury to the murine stomach to analyze mechanisms governing paligenosis at high resolution. Injury causes induced reactive oxygen species (ROS) with coordinated changes in mitochondrial activity and cellular metabolism, requiring the transcriptional mitochondrial regulator Ppargc1a (Pgc1α) and ROS regulator Nf2el2 (Nrf2). Loss of the ROS and mitochondrial control in Ppargc1a-/- mice causes the death of paligenotic cells through ferroptosis. Blocking the cystine transporter SLC7A11(xCT), which …

Interprofessional Curriculum Delivery: Experience Of A Primary Care Education Program, Jessica A Davila, Nancy D Harada, Kathryn Wirtz Rugen, Stuart C Gilman, Shubhada Sansgiry

Faculty, Staff and Students Publications

Few post-graduate training programs offer a comprehensive curriculum that includes structured clinical experiences to teach interprofessional care. To address this need, the United States Department of Veterans Affairs, Office of Academic Affiliations funded the Centers of Excellence in Primary Care Education (CoEPCE) from 2011-2019 to provide interprofessional curricula for health profession trainees (HPTs), including physician residents, nurse practitioner residents, pharmacy residents, and psychology residents. We examined changes over time in curricular domains, system impacts, and program practices based on HPT survey data and the qualitative evaluation of narrative feedback. An annual survey was administered to participants. Indirect standardized ratios were …

Does Point-Of-Care Ultrasound Affect Fluid Resuscitation Volume In Patients With Septic Shock: A Retrospective Review, Enyo A Ablordeppey, Amy Zhao, Jeffery Ruggeri, Ahmad Hassan, Laura Wallace, Mansi Agarwal, Sean P Stickles, Christopher Holthaus, Daniel Theodoro

2020-Current year OA Pubs

BACKGROUND: Fixed, large volume resuscitation with intravenous fluids (IVFs) in septic shock can cause inadvertent hypervolemia, increased medical interventions, and death when unguided by point-of-care ultrasound (POCUS). The primary study objective was to evaluate whether total IVF volume differs for emergency department (ED) septic shock patients receiving POCUS versus no POCUS.

METHODS: We conducted a retrospective observational cohort study from 7/1/2018 to 8/31/2021 of atraumatic adult ED patients with septic shock. We agreed upon

RESULTS: 304 patients met criteria and 26% (78/304) underwent POCUS. Cardiac POCUS demonstrated reduced ejection fraction in 15.4% of patients. Lung ultrasound showed normal findings in …

Attention Lstm U-Net Model For Drosophila Melanogaster Heart Tube Segmentation In Optical Coherence Microscopy Images, Xiangping Ouyang, Abigail Matt, Fei Wang, Elena Gracheva, Ekaterina Migunova, Saathvika Rajamani, Edward B Dubrovsky, Chao Zhou

2020-Current year OA Pubs

Optical coherence microscopy (OCM) imaging of the

Off-Pump Coronary Surgery Combined With Aortic Valve Replacement Under Hypothermic Circulatory Arrest Within An Unexpected Porcelain Aorta, Abdelkader Boukhmis, Khaled Khacha, Djouaher Yacine

Journal of the Saudi Heart Association

Unexpected porcelain aorta is a real challenge to safely completing aortic valve replacement combined with coronary artery surgery. This condition often leads to an aborted sternotomy in the hope of performing transcatheter procedures, the feasibility of which may be hampered by anatomical considerations. We report the case of a 71- year old man with history of hypertension, type 2 diabetes mellitus and chronic kidney disease, which was referred for severe aortic valve stenosis and severe coronary artery disease. He benefited from an anaortic off-pump coronary surgery and clampless aortic valve replacement under hypothermic circulatory arrest to overcome an unexpected porcelain …

A Multi-Modal Intervention To Decrease Hpv Vaccine Hesitancy And Increase Uptake In Young Adult Women, Rylee Cartales

Evidence-Based Practice Project Reports

Human Papillomavirus (HPV) is the leading cause of cervical cancer worldwide and the most common sexually transmitted disease, yet hesitancy towards the HPV vaccine remains high and uptake of the HPV vaccine remains remarkably low (CDC, 2021b). The purpose of this evidence-based practice (EBP) project was to determine if the implementation of a multimodal intervention including a motivational interview, strong provider recommendation, and educational materials will decrease HPV vaccine hesitancy and consequentially increase uptake of the vaccine. Eleven young adult women ages 18-26 from a rural outpatient Obstetrics and Gynecology (OBGYN) clinic in Indiana participated in this project. After agreeing …

A Multi-State Look Into Early Intervention Speech-Language Pathologists’ Confidence Identifying And Diagnosing Autism, Adelaide Parr

Honors Capstones

Although autism can be reliably diagnosed by 18 months of age, long wait times and limited access to qualified providers prevent families from obtaining diagnostic services. Trained speech-language pathologists (SLPs) are qualified to diagnose autism, ideally as part of a multidisciplinary team. SLPs working on early intervention (EI) teams are well-situated to help close this diagnostic wait time gap. The purpose of this survey study was to explore EI SLPs’ experiences serving autistic children on their caseloads, confidence in identifying and diagnosing autism, and potential barriers/facilitators to increasing diagnostic confidence and decreasing wait times. 287 EI SLPs from 23 states …

Addressing Stroke Care Disparities Through Patient Education, Christina Annerino

Honors Capstones

It has been found across current studies and evaluations of stroke care and patient outcomes that there is a disparity in disability and mortality between male and female patients who have experienced stroke. The aforementioned studies did not identify the cause of this disparity, although a number of hypotheses for this phenomenon were provided. This study then conducted a preliminary survey of 130 participants, both men and women, aged 18-80 years old, to evaluate potential barriers to accessing stroke care and receiving treatment effectively. Preliminary survey data demonstrated consistent gaps in knowledge related to stroke risks, stroke symptoms, and when …

Efficacy Of Intravesical Nadofaragene Firadenovec For Patients With Bacillus Calmette-Guérin-Unresponsive Nonmuscle-Invasive Bladder Cancer: 5-Year Follow-Up From A Phase 3 Trial, Vikram M. Narayan, Stephen A. Boorjian, Mehrdad Alemozaffar, Badrinath R. Konety, Neal D. Shore, Leonard G. Gomella, Ashish M. Kamat, Trinity J. Bivalacqua, Jeffrey S. Montgomery, Seth P. Lerner, Joseph E. Busby, Michael Poch, Paul L. Crispen, Gary D. Steinberg, Anne K. Schuckman, Tracy M. Downs, Joseph Mashni, Brian R. Lane, Thomas J. Guzzo, Gennady Bratslavsky, Lawrence I. Karsh, Michael E. Woods, Gordon Brown, Daniel Canter, Adam Luchey, Yair Lotan, Brant A. Inman, Michael B. Williams, Michael S. Cookson, Sam S. Chang, Alexander I. Sankin, Michael A. O'Donnell, David Sawutz, Richard Philipson, Nigel R. Parker, Seppo Yla-Herttuala, Dorte Rehm, Jørn S. Jakobsen, Kristian Juul, Colin P.N. Dinney

Department of Urology Faculty Papers

Purpose: Nadofaragene firadenovec-vncg is a nonreplicating adenoviral vector–based gene therapy for bacillus Calmette-Guérin (BCG)–unresponsive carcinoma in situ (CIS) with/without high-grade Ta/T1. We report outcomes following 5 years of planned follow-up.

Materials and Methods: This open-label phase 3 trial (NCT02773849) enrolled patients with BCG-unresponsive nonmuscle-invasive bladder cancer in 2 cohorts: CIS ± Ta/T1 (CIS; n = 107) and Ta/T1 without CIS (Ta/T1 cohort; n = 50). Patients received 75 mL (3 × 1011 vp/mL) nadofaragene firadenovec intravesically once every 3 months with cystoscopy and cytology assessments, with continued treatment offered to those remaining high grade recurrence–free (HGRF).

Results: One hundred fifty-seven …

Expressive Therapies And Resiliency – Resistance In Mental Health: A Literature Review, Gabrielle Lopez

Expressive Therapies Capstone Theses

This review evaluates the current literature on psychological resistance amongst human service professionals experiencing burnout and the effect of Expressive Arts interventions on resiliency. Concepts include identifying the main symptoms, risk factors, causes, and treatments for burnout in education faculty, medical staff, and clinicians. Qualitative, quantitative, and meta-analysis studies are included to identify the most prevalent intervention frameworks for reducing stress including Arts-Based and Mindfulness-compassion based techniques. The effectiveness of Arts-based tools on strengthening identity, self-esteem, emotional regulation, and meaning-making in combating burnout is presented. Based on analysis of the literature, the author proposes a three-step intervention framework for utilizing …

A Scoping Review Of Drama-Based Interventions With Migrant Populations For Health Outcomes, Cassandra Doria

Expressive Therapies Capstone Theses

This scoping review investigates the breadth and nature of literature that currently exists on the topic of utilizing drama-based interventions with migrant populations for therapeutic goals. This author searched for empirical studies on the topic and charted data to understand the quality, number, and type of studies that have been done, and risk factors for epistemic injustice or misrepresentation of marginalized participants. A brief overview of methods, results, and discussions of articles revealed the most prevalent outcomes, limitations, and forms of data collection. Social connection and belonging, education, communication skills, empathy, identity reconstruction, meaning making, and adaptive adjustment to the …

Neuroqueering Art Therapy: Bringing Neurodivergent Gender Diversity Into The Creative Arts Therapy Room: A Literature Review, Avital Eisen

Expressive Therapies Capstone Theses

Recent research across disciplines has established the significance of the overlap between neurodivergence and gender diversity, a truth long espoused by the community. Acting on this research, some mental health disciplines have begun addressing neurodivergent transgender and gender diverse people as a unified population in their research, but the field of art therapy has not yet followed suit. Theoretical frameworks of intersectionality, queer theory, and disability justice highlight the importance of centering the unique experiences and needs of neurodivergent gender diversity. Using these frameworks, this literature review synthesizes community knowledge with art therapy research on both neurodivergence and gender diversity, …

The Hero’S Journey Through Therapy: A Literature Review, Rylee Blake

Expressive Therapies Capstone Theses

The Hero’s Journey (Campbell, 1949) is a common narrative structure throughout ancient mythology and modern storytelling which describes the transformation of a hero through a journey of trials and represents the experience of psychological healing throughout various cultures. Because of the ancient and common nature of this structure and the psychological importance of personal narrative and storying even from an early age (Boyd, 2018; Klees, 2016), this thesis hypothesizes that a client’s experience throughout psychotherapy will follow the stages of the Hero’s Journey and that invoking this structure within the therapy room, particularly for drama therapists, will empower clients toward …

Method Acting As A Therapeutic Intervention For Trauma Recovery, Remi Moses

Expressive Therapies Capstone Theses

While considered controversial by some, Method acting as popularized by Lee Strasberg is a technique that elicits powerful and authentic results on stage and screen. The foundational Method acting techniques, the Relaxation Exercise (RE) and the Sense Memory Exercise (SME), share similarities to bottom-up therapeutic processes like Somatic Experiencing and Eye Movement Desensitization and Reprocessing. By implementing a trauma-informed drama therapy framework with these two exercises, the RE and SME were restructured as a therapeutic intervention for people in trauma recovery. The author implemented a study of three consecutive group therapy sessions for people healing from trauma where clients participated …

A Community Re-Integration Mental Health Occupational Therapy Program For Veterans At The Sioux Falls Veterans Affairs Hospital, Holly M. Forrester

Occupational Therapy Capstone Presentations

The Veteran population continues to be disproportionately impacted by mental health disorders despite growing efforts to address this epidemic. Despite an increase in Veterans Affairs (VA) sponsored programs to mitigate the disparity, the interdisciplinary team tasked with implementing the novel programs remains undiversified. My capstone project aimed to provide a comprehensive community reintegration program to the Veterans in the inpatient behavioral health setting and advocate for the role of occupational therapy on the mental health interdisciplinary team. The literature and needs assessment indicated a need for the implementation of occupational therapy specific groups that aimed to increase functional independence and …

Examining The Rate Of Failed Hearing Tests In Children >15 Months Of Age Who Are Referred To Speech Therapy: A Retrospective Analysis, Malika Goel, Kerry Mychaliska

Conference Presentation Abstracts

No abstract provided.

Exploring Early Language Acquisition Through English And French, Rebecca C. Aguilar

Honors Capstones

Knowing that there is no singular event that leads to learning a language, and factoring in the extent an individual’s culture can affect language learning, this study emphasizes the importance of a cross-linguistic approach to continue to broaden the scope of language acquisition research. The primary objective is to identify and analyze the critical commonalities in the initial stages of learning English and French as first languages through two major categories: speech/language and culture. This project carried out an analytical review of 24 pieces of relevant literature, in both languages, in an effort to highlight key findings. Those findings include: …