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Exploring Structural Factors that Influence Black Maternal Morbidity: A Case Study of Illinois Hospitals
No full textThe United States is the only industrialized country whose maternal mortality rates are increasing at an alarming pace (Ollove, 2018). These deaths are often precipitated by co-morbidities, pregnancy complications, or missed opportunities as it relates to accessing care, quality, and level of care, a missed or delayed diagnosis, or not recognizing warning signs (CDC, 2019). Severe maternal morbidities (SMM) such as preeclampsia, hypertension and hemorrhage represent some of the leading causes of maternal death and significantly disproportionately affect Black women (Howell, 2018). Since evidence suggests that up to half of all maternal deaths may be preventable (CDC, 2019) and 98% of births take place in a hospital, exploring the type of care delivered to patients is a critical element of getting to the root cause of SMM (MacDorman & Declercq, 2019). Research has shown that Black women are significantly more likely to have a severe maternal mortality and morbidity event during delivery (Howell & Zeitlin, 2018). Therefore, it is equally critical to acknowledge and explore this country’s inequitable and fragmented health care system steeped in systemic racism as a root cause of the stark maternal health disparities.The quality of maternal care delivered by hospitals as well as racism, bias, and discrimination experienced along with that care, are significant drivers of high Black maternal morbidity rates (Howell & Zeitlin, 2018). To reduce pregnancy related complications and deaths among Black women, maternal health experts have proposed hospitals transform how they deliver care by ensuring protocols, policies as well as practices that are safe, respectful, and equitable are in place (Howell, et al & Collier and Molina). Furthermore, public health and medical experts have found that organizational factors such as leadership and communication, play a significant role in hospital culture and the delivery of care. Therefore, exploring the intersectionality of these factors with the quality of healthcare, and health disparities and inequities, may provide rich insight into the influence they have on maternal care and pregnancy outcomes, particularly among Black women.This explanatory, multiple methods case study approach focused on Black maternal morbidity occurrences in Illinois and aim to describe: 1) how organizational factors influence the delivery of maternal care within Illinois hospitals, and 2) how hospital labor and delivery practices impact patient safety, and 3) the extent to which Black pregnant and postpartum women receive poor quality hospital-based care and how that care contributes to health disparities in maternal morbidity occurrences. Phase 1 of the study consisted of 8 semi-structured, in-depth individual interviews individuals representing 6 hospitals participating in the Illinois Perinatal Quality Collaborative’s (ILPQC) Birth Equity Initiative. These interviews provided diverse experiences, perspectives, and insights from hospital staff leading the quality improvement (QI) work to improve maternal health outcomes among Black women as well as all patients of color. Phase 2 of the study consisted of facilitated reflective conversations with team leads from ILPQC and national perinatal health experts to validate findings and inform implications for practice and recommendations for future work.Study findings revealed 6 primary themes when exploring structural and organizational factors influencing adverse Black maternal health outcomes and their relationship to these outcomes: adequate and informed staff; communication, collaboration and teamwork; biases and microaggressions; patient voice; SDOH screenings, and leadership buy-in and commitment. The findings from this case study are applicable to other Illinois birthing hospitals participating in the ILPQC Birth Equity Initiative, and possibly applicable to hospitals partnering with the other 49 PQCs across the country working to improve maternal and infant outcomes and aiming to provide high quality, respectful, and equitable care.</p
Microbiological Study of Bacterial Load Reduction in the Root Canal System Utilizing a Novel ErYagLaser
No full textThis study aimed to evaluate the effectiveness of a novel Er:Yag laser-activated irrigation technique in reducing bacterial load in root canals. In this study, mandibular molars are prepared and cultured with Enterococcus faecalis, and experiment was perform to test whether laser-activated irrigation could significantly reduce bacteria in the root canal system. The teeth were divided into four groups: Standard Needle Irrigation (SNI), Photon-Induced Photoacoustic Streaming (PIPS) – single pulse laser mode, Shock Wave Enhanced Emission Photo-acoustic Streaming (SWEEPS) – double pulse laser mode, and a baseline control.
The study found no significant differences in bacterial load reduction between the different preparation sizes (20/.04v and 25/.06v) and irrigation techniques, except when compared to the baseline. However, trends indicated that SWEEPS had the highest efficacy, followed by PIPS and SNI. Confocal Laser Scanning Microscopy (CLSM) showed cleaner canal walls and better irrigant penetration in the SWEEPS group, with visible dead bacterial cells in the peripheral dentin.
The results suggest that larger preparation sizes (25/.06v) are more effective than smaller ones (20/.04v), and that the stronger pulse energy mode (SWEEPS) may enhance irrigation effectiveness compared to the weaker mode (PIPS). Further investigation is needed to validate these findings comprehensively. The study highlights the importance of optimizing instrumentation sizes and laser parameters to improve endodontic treatment outcomes and reduce bacterial loads more effectively
Interdisciplinary Comparative Evaluation of Pediatric Oral Airway Assessment Using Mallampati and Brodsky
No full textPurpose: To evaluate agreement in pediatric airway assessments using Brodsky classification and Mallampati scales among pediatric dental residents, dental faculty, and anesthesiologists.
Methods: This cross-sectional study included 10 first-year and 12 second-year pediatric dental residents, 15 pediatric dental faculty, and 13 anesthesiologists. Participants assessed 17 pediatric airway videos using the Brodsky, Mallampati scales, and binary sedation decisions. A second identical survey followed two weeks later. Inter- and intra-rater agreement were analyzed using Kendall’s W, Intraclass Correlation Coefficient (ICC), and Fleiss’ Kappa. Group differences were assessed with Kruskal-Wallis and Wilcoxon rank-sum tests.
Results: Brodsky classification showed moderate to high inter-rater agreement, with anesthesiologists achieving the highest levels (ICC = 0.627–0.612). Faculty improved between surveys (ICC = 0.587 to 0.654), while residents maintained moderate agreement (ICC = 0.578–0.536). Mallampati scale had lower inter-rater agreement, with anesthesiologists declining from moderate (ICC = 0.365) to lower agreement (ICC = 0.209). Sedation decisions had moderate agreement (Fleiss’ Kappa: anesthesiologists = 0.467, faculty = 0.407). Intra-rater agreement was highest for anesthesiologists (mean = 15.6, SD = 2.07), followed by faculty (mean = 14.62, SD = 1.98) and residents (mean = 13.05, SD = 2.24). Group differences were significant (P = .009). Post hoc analysis showed anesthesiologists were more consistent than residents and marginally better than faculty in Brodsky and sedation assessments.
Conclusions: Variability in agreement was observed across groups. Brodsky classification demonstrated higher agreement, supporting its utility. Mallampati scale showed lower agreement, reflecting subjectivity. Better calibration and education are needed for consistent airway assessments
Affective and Neural Correlates of Nicotine and Cannabis Co-Use in Young Adulthood
No full textCo-use of tobacco and cannabis is increasingly prevalent and is associated with greater risks compared to use of either substance alone. Co-use rates are elevated in young adulthood, but factors that maintain co-use in this age group are less well known. Individual differences in positive affect response to drug use and neural reward reactivity are important predictors of drug use maintenance and potential problematic use patterns, and prior research suggests these affective and neural correlates are related. Research is needed to characterize these two important factors in drug use maintenance in young adults who co-use nicotine and cannabis to further understand vulnerability for problematic use patterns in this population. A subset of young adults enrolled in an observational study utilizing Ecological Momentary Assessment (EMA) to assess the context and subjective experience of cannabis and nicotine co-use were recruited to participate in the current study, where they completed a task to measure neural reward reactivity during electroencephalogram (EEG). Current study aims included: 1) Examine subjective positive affect across cannabis-only, tobacco-only, and co-use times on EMA, 2) Examine relationships between EMA-assessed positive affect and reward reactivity, 3) Determine whether levels of cannabis and nicotine use moderate the relationship between neural reward reactivity and EMA-assessed positive affect. Results suggest that positive affect was elevated at cannabis use and co-use times, relative to non-use times, but not consistently at nicotine-only times. Greater positive affect following co-use was significantly predictive of greater neural reactivity to non-drug rewards. Rates of nicotine and cannabis use were not significant moderators. Overall, current findings suggest that in a young adult co-use population, greater positive reinforcement in the moments following co-use is significantly related to greater neural sensitivity to non-drug rewards when not using drugs. These findings potentially point to why certain individuals are vulnerable to maintaining co-use despite known associated risks
Examining Public Transit Service Integration Strategies with Innovative Private Mobility Providers
No full textOver the past decade, private shared and on-demand mobility options have gained traction and substantially impacted the way people access transportation services. At the same time, transit agencies in the United States have faced significant challenges, including decreasing ridership patterns and the disruptive effects of the pandemic. These trends have pushed public agencies to explore new strategies of service provision, and the integration with private mobility services has become a focal point of interest and concern. This dissertation employs a mixed-methods approach to examine the adoption and outcomes of integration strategies between public and private transportation providers. It includes an in-depth case study of the Chicago Metropolitan Area, drawing on 18 interviews with public and private stakeholders, and a nationwide survey of 180 transit agencies that examines how factors such as agency size, geographic settings, and institutional priorities influence the design and implementation of different integration strategies. By adopting the perspective of public transit agencies, this dissertation contributes to a deeper understanding of the role of public-private partnerships in addressing service gaps and enhancing mobility. It also reflects on the underlying dynamics that influence public sector choices. Ultimately, the study emphasizes the importance of tailoring integration strategies to local needs and contextual characteristics. The findings offer insights for transit agencies and policymakers to navigate the evolving mobility landscape and to design effective, context-sensitive integration strategies
Molar Incisor Hypomineralization and Developmental Dental Anomalies: A Case-Control Study
No full textTitle: Molar Incisor Hypomineralization and Dental Anomalies: A Case-Control Study
Authors : Park J1, Kratunova E1, Alrayyes S1, Alsaleh M1,Galang-Boquiren M2, Ahmed AT 1
Author affiliations :1 Department of Pediatric Dentistry, College of Dentistry, University of Illinois, Chicago, IL, USA
Objectives: To evaluate the association between Molar Incisor Hypomineralization (MIH), early-life adverse environmental and medical events, and co-existing developmental dental anomalies (DDA).
Methods: This case-control study included children aged 6–13 years, with the presence of MIH serving as the inclusion criterion for the case group. Each child with MIH was matched with a child without MIH of similar age and demographic characteristics to form the control group. Trained and calibrated examiners assessed MIH using standardized diagnostic criteria. Biological mothers completed a structured questionnaire addressing pregnancy and early-life adverse events. DDA were identified through clinical and radiographic assessment. Statistical analyses included descriptive statistics, Chi-square and Fisher’s exact tests, and logistic regression.
Results: A total of 56 children were enrolled, including 28 in the MIH group and 28 in the control group. The mean age was 9.32 ± 1.89 years in the MIH group and 8.24 ± 1.46 years in the control group. Among the MIH group, 89.3% were born in the United States compared to 96.3% in the control group, and 70.4% were Hispanic or Latino compared to 78.6% in the control group. Developmental dental anomalies were significantly associated with MIH (χ² = 6.76, P = .0093). No significant differences were found in pregnancy, environmental and early-life adverse events between the MIH and control groups (P > .05).
Conclusions: This preliminary study demonstrates a significant association between MIH and the presence of DDA. Further research with larger sample sizes is needed to confirm these findings
Identifying Diagnostic Biomarkers: Gene Expression Profiling Leptin in Dental Pulp Tissue
No full textRecent studies emphasized the role of leptin/leptin receptor (LEP/LEPR) in normal and inflammatory conditions of dental pulp tissues. LEP/LEPR activity is linked to potential immunomodulation responses during bacterial-induced inflammatory conditions. Additionally, there is substantial association of LEP in dental pulp stem cells (DPSCs), odontoblast differentiation/function and mineralization processes. The objective of this study is to investigate differential leptin gene expression in hypoxic (inflammatory) conditions.
DPSCs were isolated from healthy adult third molars, supplemented with 1% serum containing media or osteogenic media, and cultured in hypoxic (3%) or normoxic (21%) conditions for 21-days. Later, DPSCs collected were extracted for mRNA isolation. The mRNA was sequenced using NextSeq Illumina and was analyzed using the ERGO transcription tool DESeq2 (P<0.05) statistical method to determine differences in transcription and subsequent translation between groups. The count data was imported into R-package for analysis and sequence mapping to the appropriate gene.
The genes and pathways were identified in KEGG pathways overlaying expression values. Over-expressed (p<0.05) genes include ACSL1, LEP, LEPR and PRKAA2 and under-expressed (p<0.05) genes include MAPK8, NFKBIE, RELA.
DPSCs in hypoxic conditions shows down-regulation of AMPK signaling, which is related to cellular energy, transcription factors p65, NF-kappa-B and MAP Kinases associated with transcription regulation and differentiation. Up regulation of LEP/LEPR is associated with fat metabolism and both immune and inflammatory responses. Therefore, LEP signaling is an important regulator of DPSCs function. Furthermore, deciphering LEP/MAPK/Insulin signaling pathways in inflammatory condition of dental pulp could lead to new and more effective treatments for pulpitis and apical periodontitis
“The Girls That Get It, Get It”: An Analysis of Womanhood, Platforms, and Digital Wellness Culture
No full textThis dissertation examines the intersections of womanhood, digital platforms, and wellness culture through a critical feminist lens. The project focuses on short-form video content from TikTok, Instagram, and Facebook and analyzes how online wellness trends commodify femininity and promote narrowly defined ideals of health and womanhood. The project employs critical technocultural discourse analysis to examine the that girl and cycle synching case studies which serves as representations of how wellness and womanhood are presented on social media.
Findings demonstrate that digital wellness culture is not centered around actual health, but rather focused on the performance of an idealized, commodified image of wellbeing. In the that girl trend, wellness is depicted as an aesthetic, characterized by early alarms, green smoothies, matching workout outfits, and other productivity practices. These practices serve to symbolized self-discipline, control, and an idealized image of white femininity. In the cycle syncing trend, the menstrual cycle is reframed as an optimization tool through which ideal womanhood can be achieved. In both trends, self-optimization is framed as an aesthetic practice with neoliberal values embedded that equate health and womanhood with eternal self-improvement and productivity. Furthermore, in both case studies, young, digitally enabled female content creators are framed as the ideal neoliberal citizen because of their eternal labor on themselves and their constant labor of content creation.
Platform dynamics are a central factor in these phenomena. The algorithms that guide short-form video content platforms reward creators who perform wellness in a way that aligns with standards of white beauty and femininity. Through the structuring of these platforms, a feedback loop is created in which creators must produce aesthetically curated, engaging content aimed at sustaining engagement. Non-normative bodies, identities, and experiences are continually written out of digital wellness spaces.
This dissertation argues that digital wellness culture reflects and reinforces racialized, classed, and gendered hierarches. Furthermore, it demonstrates that short-form video content platforms are not neutral but play an active role in cultural production by rewarding performances of ideal womanhood that align with neoliberal standards of femininity and encourage the framing of young women as the eternally producing digitally enabled citizen
System Override: A Critical Virtual Ethnography of Women of Color's Digital Praxis in Horizon Worlds
No full textThis dissertation investigates how women of color navigate, resist, and transform the sociotechnical architectures of social virtual reality platforms, with a primary focus on Meta’s Horizon Worlds. Employing a critical virtual ethnography grounded in Black feminist and decolonized methodologies, the study draws on immersive observation and thirty in-depth interviews with women of color who are active creators, organizers, and participants within these digital spaces. The research interrogates how platform design, monetization models, and moderation practices systematically reproduce racialized and gendered exclusions while simultaneously documenting how marginalized users enact creative resistance and reimagine digital belonging.
Findings reveal that platform defaults—ranging from avatar customization options to visibility algorithms and economic gatekeeping—often reflect Eurocentric and patriarchal biases, constraining the expressive and economic agency of women of color. Yet, the dissertation also uncovers diverse strategies of “system override,” through which participants formulate their own communities of care, repurpose digital tools for cultural affirmation, and develop counterpublics for collective safety and joy. These acts include avatar remixing, private affinity group formation, event hosting, and mentoring, as well as sustained advocacy for platform reform.
The analysis advances a conceptual framework synthesizing feminist standpoint theory, Black cyberfeminism, platformization, and digital racial capitalism, arguing that women of color’s situated knowledge is indispensable for dismantling structural inequities in emerging digital ecosystems. By centering participant voices, the study offers empirical insights and actionable recommendations for inclusive design, transparent moderation, and equitable monetization in the metaverse. The dissertation concludes that the lived digital praxis of women of color does not merely contest technological injustice but generates blueprints for more just, joyful, and participatory virtual futures. This work intervenes in Communication, Science and Technology Studies (STS), and platform studies, advancing critical approaches to virtual world research
Developing Computationally Efficient Optimization Framework for Online Routing of UAV-UGV Systems
No full textUnmanned Aerial Vehicles (UAVs) are increasingly popular for autonomous tasks such as surveillance, package delivery, and disaster relief. However, as these applications expand, so do the challenges of enabling UAVs to perform these tasks over extended durations or on a larger scale. One solution is to pair UAVs with Unmanned Ground Vehicles (UGVs), which can serve as carriers to transport UAVs or as mobile recharging stations to extend their operational range.
To achieve effective performance and coordination between UAVs and UGVs, optimal route planning is essential. The UAV-UGV routing problem, being an NP-Hard combinatorial optimization challenge, is further complicated by the heterogeneity of these vehicles. Traditional optimization approaches, including exact methods like Branch and Bound with MILP formulations, as well as standard heuristics and metaheuristics, are often too time-consuming to be practical due to the dynamic nature of the environment and the autonomous vehicles involved. Thus, a faster, more adaptive planning method is crucial to address these challenges effectively.
This thesis focuses on solving this collaborative UAV-UGV routing problem in a computationally efficient manner such that the solutions are obtained quick enough to be feasibly applied on to the actual UAV-UGV system in a realistic environment. The core concept of solving such a collaborative routing problem is by formulating them as bi-level optimization problem, where the outer-level handles the UGV optimization and for each UGV candidate route, the inner-level handles the UAV optimization. The computational efficiency aspect is made possible by developing a multi-agent optimization framework, where the agents consist of different optimization algorithms integrated into it. Those algorithms are complementary to each other such that the optimization happens to the best of its ability by picking the best performance out of the algorithms used.
Initial studies concentrated on leveraging the existing multi-agent optimization framework known as A-Teams, incorporating Nelder-Mead and Genetic Algorithms with complementary features for outer-level UGV optimization. The framework was tested across various instances to evaluate its performance compared to using only Genetic Algorithm at the outer level. Each of these approaches employs local search heuristics at the inner level for UAV optimization.
Subsequently, the existing A-Teams framework is developed to be more smarter by integrating a newer 'Predictor agent' into the framework, which imparts slightly better computational efficiency compared to the original A-Teams framework. This A-Teams variant is novel in the sense of adding the Predictor agent into the framework.
Finally, an end-to-end autonomous approach is developed to enhance computational efficiency by enabling decision-making during the optimization process. This approach involves creating a learning-based hyper-heuristic method using Reinforcement Learning (RL) within the multi-agent framework to deliver computationally efficient, real-time UAV-UGV routing solutions. This approach increases the autonomy of the framework, requiring minimal user input
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