University of Illinois at Chicago
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Long-term Geospatial Access to Food Environment and Breast Cancer Risk in Metropolitan Chicago
No full textNeighborhood food environments are recognized as important structural determinants of health, yet their long-term impact on cancer outcomes remains poorly understood. Previous studies have cross-sectionally measured exposure at diagnosis, providing only a snapshot of exposure. This dissertation addressed this gap by examining how long-term cumulative access to healthy and less healthy food outlets influences breast cancer incidence and survival in Metropolitan Chicago from 1990 to 2019. Using data from a large case–control cohort (~32,900 participants; 7,682 cases with frequency matched controls), thirty years of residential histories were linked to the annual National Establishment Time Series (NETS) database of food outlets. Food access was quantified using nearest-distance and inverse-distance-weighted (IDW) measures for walking (1.5 miles) and driving (5 miles), capturing realistic neighborhood access over time using Esri’s Network Analysis. IDW captured both density and proximity, whereas nearest distance reflected proximity to the nearest outlet. Multivariable logistic regression, causal mediation, and Cox proportional hazards models were used to estimate associations, adjusting for individual and neighborhood characteristics. Greater access to healthy outlets was associated with lower breast cancer incidence, and vice versa for less healthy outlets. These relationships were strongest for nearest-distance measures. Obesity did not meaningfully mediate these associations, suggesting that food environments may influence breast cancer risk through mechanisms beyond adiposity, such as diet quality or inflammation. In survival analyses, greater pre-diagnostic access to healthy food outlets was modestly associated with lower breast cancer mortality, whereas greater access to less healthy outlets predicted poorer survival. This work is innovative in integrating three decades of geospatial and residential data to measure cumulative, dynamic food environments across the cancer continuum. Findings demonstrate that nearest-distance measures more effectively capture meaningful exposure than aggregated IDW metrics. Together, results highlight that obesity may not be the pathway linking food access to breast cancer and underscore the importance of addressing neighborhood food environments through structural, place-based strategies to reduce breast cancer risk, improve survival, and promote health equity
Essays on Women's Education, Health Knowledge, and Fertility: Evidence from Vietnam
No full textIn 1991, Vietnam introduced a compulsory primary education reform requiring all children aged six and above to complete five years of primary schooling before age 15. This dissertation examines the reform’s implications for educational attainment, health knowledge, and early life outcomes. Chapter 1 exploits variation in reform exposure by age in 1991 to estimate its impact on educational attainment. I find that exposure to the reform increased primary school completion and improved transitions to secondary education among ethnic minorities. However, effects on higher schooling levels likely reflect concurrent educational and economic developments, so the reform does not provide a clean source of exogenous variation in schooling.
Chapters 2 and 3 instead focus on reduced-form effects of reform exposure, capturing both schooling-related and contemporaneous influences. Chapter 2 shows that exposure improved HIV/AIDS knowledge but did not reduce stigma, suggesting that discrimination in Vietnam is rooted more in cultural norms than in information deficits. Chapter 3 finds that exposure delayed early childbearing among ethnic minority women, likely through longer schooling and expectations of improved job opportunities arising from economic growth
Pragmatic Nationalism and Rural Groupness in Volhynia and the Chełm Lands, c. 1914-1945
No full textPragmatic Nationalism and Rural Groupness in Volhynia and the Chełm Lands examines how rural populations in Volhynia and the Chełm lands, regions straddling the Polish-Ukrainian borderlands, understood and performed national belonging from the late imperial era through the ethnic violence of the Second World War. Focusing on Polish- and Ukrainian-speaking villagers, the study challenges linear narratives that depict the countryside as a site of steady nationalization or inevitable radicalization. Instead, it argues that rural attachments to national groupness were socially contingent, situational, and pragmatic.
Drawing on Polish and Ukrainian archival materials alongside memoirs, ethnographic studies, and oral history, the dissertation traces how local communities navigated a series of political and social ruptures: imperial Russification campaigns, First World War and subsequent Polish-Ukrainian War, the consolidation of the interwar Polish nation-state, the 1937 Polonization and Revindication Action, and the overlapping Nazi and Soviet occupations. These shifting regimes and events transformed the meanings and practical consequences of belonging to a given nation. National groupness emerged most forcefully at historical flashpoints, when affiliating with a particular nation offered tangible advantages, protection, or access to scarce resources. In this way, this dissertation seeks to contextualize localized Polish-Ukrainian violence during the Second World War in this region.
In these contexts, pragmatic concerns such as safety, land acquisition, and the preservation of religious practice often outweighed abstract ideological commitments. National identification thus operated as one of several nested identities that coexisted with local loyalties, familial ties, and confessional affiliations. The study also highlights periods of coexistence and the persistence of alternative frameworks of belonging that challenged the hegemony of the national paradigm in organizing everyday life.
By foregrounding the interplay between pragmatic nationalism, local solidarities, and alternative moral economies, this project reframes the history of interwar and wartime Volhynia and Chełm not as a linear progression toward ethnic conflict, but as a complex and historically contingent social terrain. It contributes to broader debates on nationalism, everyday groupness formation, and the dynamics of violence and coexistence in East Central Europe’s borderlands
Deformability and Dynamics in Linear and Looped/Supercoiled DNA with Implications for Damage Sensing
No full textDamage-sensing proteins must scan billions of base pairs (bp) of genomic DNA to identify damaged sites and initiate repair. These proteins diffuse rapidly along DNA, with 10 ms). This discrepancy in “interrogation” and recognition timescales raises a key question: how do proteins slow down to recognize damage? Additionally, most studies use short, torsionally-relaxed DNA, but in cells, DNA is often looped and/or supercoiled, introducing bending and torsional strain. These topological changes are expected to impact DNA deformability and damage recognition. We employed advanced fluorescence approaches to study protein-DNA dynamics on biologically relevant timescales, identified DNA features enabling damage recognition, and unveiled how looping/supercoiling alters DNA mechanics and protein binding.
We studied two repair proteins: 1) Rad4 (yeast ortholog of human XPC), which recognizes DNA lesions from UV-light and other environmental genotoxins and initiates nucleotide excision repair; 2) MutS, which recognizes single mismatches or unpaired nucleotides introduced during replication and initiates mismatch repair. Using linear DNA with 3-bp mismatches as mock lesions for Rad4, we found that Rad4-specific substrates were more dynamic on sub-millisecond timescales, similar to Rad4 dwell times, suggesting that these fluctuations help “stall” Rad4 to allow recognition. These substrates also showed slower (>50 ms) fluctuations, potentially reflecting spontaneous sampling of Rad4-preferred conformations, supporting a “conformational capture” mechanism.
To study the effects of DNA topology, we used torsionally-relaxed and supercoiled DNA minicircles (126 bp and 336 bp, comparable in size to ~150 bp DNA persistence length). In 126-bp relaxed minicircles, Rad4 affinity increased ~50-fold and MutS affinity ~10-fold, to their respective specific sites. Interestingly, DNA appeared more rigid in these minicircles compared to linear DNA. 336-bp minicircles also impacted DNA conformations, but only when supercoiled. This study is the first to show how bending strain enhances damage recognition and how looping/supercoiling influences DNA conformations at mismatched sites. It emphasizes that short, linear DNA fragments are poor models for in vivo damage sensing and highlights the need for further studies exploring the role of DNA topology in repair mechanisms
Politics of Nation Building & Belonging: Democratization, Revolution, Civil War, & the Modern Salvadoran
No full textThe biggest challenge that contemporary liberals face globally today is counterbalancing the wider social and economic role of the state while guaranteeing civil liberties and a more robust social system of checks and balances. Trust in our governments is at an all-time low while social polarization continues to rise due to dogmatic individualism which has led to the abandonment of political cooperation. My study of the Salvadoran nation building process is essential for understanding both distrust of the state and social polarization because democracy without constitutional constraint infringes on freedom, prosperity, peace and in a broader context contributes to the erosion of a national sense of belonging.
This project explores how although El Salvador was founded on constitutional republican principles, its social and governing practices in the latter half of the nineteenth century remained fastened to colonial structures of power. Thus, the nation building processes continued advancing through processes of deculturization, Ladinoization, the rapid disappearance of Campesino livelihood, which concomitantly augmented by the processes of centralizing power gave rise to capitalist nationalism and the hardening of the already existing class differences that severed the majority of Salvadorans from the national project. Notably, although the Salvadoran constitution was rooted in republicanism and democratic ideals it was subsequently misconstrued to subvert the tenuously established democratic system to emplace a decades long military dictatorship, demonstrating that democracy and democratic ideals are fragile because they are dependent on their interpretation of those in power. Nonetheless, it was amid the curtailment of freedoms, repression, and oppression in the twentieth century that Salvadorans committed to changing the narrative of belonging and what it means to be Salvadoran.
Central to this project is the study of the history of ideologies and individual actions that constitute value for the purpose of historical change in relation to nation building and belonging, with a keen focus on global democratization in the immediate aftermath of World War II, the Salvadoran Revolution and Civil war, and the fruitless democratic enterprise in times of peace within El Salvador. Inherently, this project looks back at the history of nation building in the latter half of the nineteenth century to encapsulate how the discourse of nation building and belonging was contested and how the illegitimate political, economic, and social order that authenticated the concept of capitalist nationalism was put in place. Categorically, this project explores the complex narratives of modernity in El Salvador to accentuate the permanent changes accomplished through temporary revolutionary moments and their importance for democratization, peace, posterity, and engendering an ardent and alienating sense of belonging.
This project examines a few of the complex narratives of modernity in El Salvador throughout the twentieth century in El Salvador to accentuate the permanent changes accomplished through temporary revolutionary episodes because it recognizes that generational social culture is produced through common experiences and through discourse about it. Via the examination of the common experience and the discourse about that experience this project finds important details about watershed moments of contention that begin decoding important fragments of this past rooted in the process of advocating for change and orienting the masses. Several of the foundational questions this project addresses are: How do we learn to draw distinctions between legitimacy and illegitimacy and how do these distinctions organize forms of social practice and memory? How was the concept of democracy understood by the stakeholders and used to incentivize socio-political modernity and distinction in El Salvador? How did the stakeholders perceive themselves as part of socio-political modernity in El Salvador? And what can we learn from the Salvadoran experience, its political overreaches, and the misinterpretation of their own constitution, to help us perceive the fallacies that can endanger the democratic systems that have endured in the post WWII world?
More importantly, this project identifies transformational moments in the social and political history of nation building in El Salvador, exploring discourses of agency, power, legitimacy, nostalgia, and other transformational moments in the creation of memory. The ethnographic portion of this project focuses on testimonies of individual actors, adding the emotional register to the historical narrative. Comprehensively, my work contributes to the dynamic field of nation building history in Latin America and to the growing field of literature across disciplines engaging with the history of agency and memory through a social and political lens
Quarkonium Suppression in pPb Collisions at CMS and Timing Detectors for Future Collider Experiment
No full textDescribing the strong interaction at low momentum transfers remains a central challenge in Quantum Chromodynamics, where perturbative methods fail and precise measurements are required. The study of heavy-ion collisions at the Large Hadron Collider has firmly established the existence of the quark–gluon plasma (QGP), yet recent experimental results suggest that QGP-like phenomena may also emerge in smaller systems such as pp and pPb collisions. Quarkonium, bound states of heavy quark–antiquark pairs, provide sensitive probes in this context because their survival strongly depends on binding energy and the surrounding medium. The excited-to-ground state charmonium cross-section ratio, (2S)/J/, measured in pPb collisions at 8.16 TeV with the CMS detector, shows a statistically significant suppression of the prompt ratio with increasing multiplicity, representing the first such observation in proton–ion collisions. In addition, bottomonium production has been studied through (nS)/(1S) yield ratios, which exhibit suppression patterns consistent with those of the charmonium results, indicating that a similar final-state effect may be at play. These results indicate final-state effects preferentially dissociate weakly bound states, consistent with co-mover interactions or, potentially, the formation of QGP. Together, these measurements provide additional constraints on hadronization models of heavy quarks in nuclear collisions. In parallel, recent detector R&D has explored AC–LGAD prototypes to address the demands of next-generation collider experiments, where dense environments require simultaneous spatial and temporal precision. Beam tests demonstrate timing resolutions of 20–35 ps and spatial resolutions of 12–20 µm, establishing AC–LGADs as promising candidates for 4D tracking layers in future experiments, including the future Electron–Ion Collider
Teaching Informed Consent: A Scoping Review
No full textInformed consent discussions are a critical and routine task for surgeons and surgical trainees. Surgical trainees have reported they lack competence and confidence in obtaining consent. Despite its importance, there is no standardized training for medical students or surgery residents to learn skills for conducting informed consent discussions. Given the critical gap regarding informed consent education, this scoping review aims to characterize and describe the currently available educational curricula designed to teach informed consent communication to surgical trainees including medical students on surgery clerkships and surgery residents.
On 1/16/2025 the authors searched MEDLINE, Embase, ERIC, Education Source, Web of Science Core Collection, and MedEdPortal without date limitations for studies addressing informed consent education. Studies describing educational interventions to teach U.S. trainees were included. Studies reporting attitude, opinions, or beliefs without an educational intervention were excluded. The Arksey and O’Malley framework was applied to inform study stages and PRISMA-ScR reporting guidelines followed.
We identified 6,126 publications from databases, of which sixteen studies met criteria for data extraction. Graduate Medical Education learners were the focus of most studies. A wide range of teaching methods implemented by a variety of instructors including attending surgeons, risk management personnel, and peers were utilized. Defined elements of informed consent taught to learners was variable in the nine studies reporting definitions. There was no overlap of assessment tools used by any studies.
Future efforts should address the fundamental problem of what defines informed consent elements and subsequently what and how to teach these elements to surgical learners
Non‐Pharmacological Sleep Interventions after Cardiac Surgery: A Systematic Review and Meta‐Analysis of Randomised Controlled Trials
No full textAIM: To synthesise up-to-date research evidence for non-pharmacological interventions to improve various sleep outcomes (e.g., sleep quality, duration) in postsurgical cardiac patients.
BACKGROUND: Sleep disturbances are common amongst postsurgical cardiac patients, yet the effectiveness of non-pharmacological interventions in improving various sleep outcomes has not been comprehensively reviewed.
DESIGN: A systematic review and meta-analysis guided by the PRISMA protocol.
METHODS: CINAHL, PubMed, PsycINFO, Embase, Web of Science, and Cochrane Library were searched for relevant research in May 2023. Included studies used a randomised controlled trial design that applied a non-pharmacological intervention for postsurgical cardiac patients and reported sleep as an outcome. For the meta-analysis, mean effect sizes were separately calculated for studies with regular and reverse-scored scales.
RESULTS: Of 37 studies included, the most common cardiac surgery was coronary artery bypass graft. Most interventions were performed within the first postoperative week and assessed sleep quality outcomes using the Pittsburgh Sleep Quality Index. The interventions are categorised into five types. Human resource-based strategies emerged as the most effective. The meta-analysis of 27 eligible studies showed a mean effect size of 0.76 for studies with regular scoring scales and - 1.04 for those with reverse-scored scales, indicating medium to large effect sizes.
CONCLUSION: Our findings provide strong evidence that non-pharmacological interventions, particularly human resource-based strategies, significantly improve sleep quality in postsurgical cardiac patients. The medium to large effect sizes underscore the clinical significance of these findings.
IMPLICATIONS: Healthcare professionals should consider incorporating non-pharmacological interventions, especially human resource-based strategies, in care plans for postsurgical cardiac patients to improve sleep outcomes and promote recovery. These interventions should be tailored to individual physical and cultural differences for maximum effectiveness. Future research should evaluate the long-term effects of these interventions on various sleep outcomes, using both objective and subjective measures to provide a comprehensive assessment of their efficacy.
REPORTING METHOD: This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol.
NO PATIENT OR PUBLIC CONTRIBUTION: Patient and public contributions were not required for this review.</p
Factors associated with self-reported diagnosis of depression in Kenya: insights from 2022 Demographic and Health Survey
No full textBackgroundMental health issues, particularly depression, have seen a significant increase worldwide in recent years, raising global concern. Depression is projected by the World Health Organization to become the leading cause of mental illness by 2030. This condition severely impacts the quality of life and psychosocial functioning of those affected, underscoring the need for effective interventions and awareness. The 2022 Kenya Demographic and Health Survey is the first Demographic and Health Surveys in Africa to incorporate the mental health diagnosis module. Therefore, this study assesses socio-economic, demographic characteristics and health conditions associated with depression in Kenya.MethodsThis secondary analysis uses data from the 2022 Kenya Demographic and Health Survey, in which participants were selected from households within designated demographic surveillance areas across Kenya. A two-stage cluster sampling method was applied to achieve national representativeness. The study examined associations between socio-demographic characteristics that included age, gender, education level, marital status, household wealth index, and urban/rural residence, as well as chronic diseases such as heart and lung diseases, hypertension and diabetes, and self-reported depression using logistic regression analysis. Both crude and adjusted odds ratios (ORs) for self-reported depression were assessed, with statistical significance set at a p-value of </p
<i>Investigating Chicago's Digital Divide through Participatory STEM Learning</i>
No full textThis multiphase dissertation project contests the boundaries of STEM education by centering the discursive relationship emergent between participatory learning and community self-determination. In the contexts of both my science classroom and summer technology program, I explore how teachers and students engage the structure-agency dialectic present within a participatory STEM project to address community issues at the intersections of canonical STEM knowledge, environmental justice, and digital technologies. The holistic set of data include curriculum documents, program recordings, and interviews with teachers, students, and community leaders. This video clip features a specific week in the summer technology program, in which West Side youth investigate how disparate internet speeds and prices from major internet service providers contribute to Chicago’s existing digital divide. Their findings informed the ways in which they developed and deployed the Westside Community Network, a community application (app) capable of circumnavigating broadband infrastructure disparities. By articulating the particularities of the community app and our program’s curriculum design, my research foregrounds the relationship between STEM learning and community contexts in ways that position youth as transformative intellectuals who enact their agentic power to transform oppressive structures and help their communities to self-determine.</p
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