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Divine Design: Revitalizing Church Website Usability
Get PDFThis thesis evaluates and proposes a redesign of the Greater Shiloh Missionary Baptist Church (GSMBC) website to enhance user experience. Usability testing and strategic design methodologies were used to identify limitations in navigation, content clarity, and visual appeal in the current website, impacting both congregants and non-congregants. An initial analysis of the website informed a comprehensive user experience (UX) test to gather feedback on key aspects of the site, focusing on usability, functionality, and emotional response. This test asked a group of users about the website’s navigability, understanding of the content, and overall interaction with the website. Special attention was paid to ensuring a diverse participant pool to capture varied experiences, although direct recruitment of individuals with visual impairments was beyond the study's scope. Data on vision impairment, education level, and income were collected to contextualize the findings and foster inclusivity. User-centric design principles derived from Maslow’s Hierarchy of User Experience and insights from “Design is Storytelling” were used to create a pleasurable, functional, and reliable prototype of a redesigned website. The redesign emphasizes responsiveness, recognizing that there are over 5.4 billion website visitors each year (ITU, 2023). The website prototype therefore optimizes user satisfaction and engagement and demonstrates how thoughtful digital design can enhance community outreach and involvement in religious organizations.Master of Arts in Digital Communicatio
Classifying COVID-19 hospitalizations in epidemiology cohort studies: The C4R study
Get PDFRATIONALE: Robust COVID-19 outcomes classification is important for ongoing epidemiology research on acute and post-acute COVID-19 conditions. Protocolized medical record review is an established method to validate endpoints for clinical trials and cardiovascular epidemiology cohorts; however, a protocol to adjudicate hospitalizations for COVID-19 among epidemiology cohorts was lacking. OBJECTIVES: We developed a protocol to ascertain and adjudicate hospitalized COVID-19 across a meta-cohort of 14 US prospective cohort studies. This report describes the first three years of protocol implementation (October 1, 2020-October 1, 2023) and evaluates its repeatability and performance compared to classification by administrative codes. METHODS: The protocol was adapted from cohort approaches to clinical cardiovascular events ascertainment and adjudication. Potential COVID-19 hospitalizations and deaths were identified by self-/proxy-report and, in some cases, active surveillance. Medical records were requested from hospitals and adjudicated for COVID-19 outcomes by clinically trained personnel according to a standardized rubric. Inter-rater agreement was assessed. The sensitivity and specificity of discharge diagnosis codes was compared to adjudicated diagnoses. MEASUREMENTS AND MAIN RESULTS: The study obtained medical records for 1,167 potential COVID-19 hospitalizations, which underwent protocolized adjudication. Adjudication confirmed COVID-19 infection was present for 1,030 (88%) events, of which COVID-19 was not the cause of hospitalization for 78 (8%). Of 952 hospitalizations determined by adjudicators to be caused by COVID-19, 319 (34%) participants were critically ill and 210 (22%) died. Pneumonia was confirmed in 822 (86%) and acute kidney injury in 350 (37%); other cardiovascular and thrombotic complications were rare (2-5%). Interrater reliability among adjudicators was high (kappa = 0.85-1.00) except for myocardial infarction (kappa = 0.60). Compared to adjudication, sensitivity of discharge diagnosis codes was higher for pneumonia (84%) and pulmonary embolism (81%) than for other complications (48-70%). CONCLUSIONS: Protocolized adjudication confirmed four out of five COVID-19 hospitalizations in a US meta-cohort and confirmed cases of pneumonia, pulmonary embolism, and other conditions that were not indicated by discharge diagnosis codes. These results highlight the importance of validating health outcomes for use in research on COVID-19 and post-COVID-19 conditions, and some limitations of claims-based data
Energy Justice in Puerto Rico
No full textIn the summer of 2024 (July-August), I traveled to San Juan, Puerto Rico as a Burch Fellow. I interned with Resilient Power Puerto Rico where I learned about energy justice initatives and resiliency planning strategies on the island. I would accompany my coworker to field site visits where we conducted energy audits at community centers, community libraries, and women's shelters located in Adjuntas, Dorado, Mayagüez, and Ponce. Then, I would co-create a solar system and resiliency proposal for these organizations. This experience helped solidify my thesis question for my collaboration with Dr. Noah Kittner at the Gillings School of Global Public Health, where I now research the impact of frequent blackouts on public health infrastructure in Puerto Rico.
Medical uncertainty in the shadow of Dobbs: Treating obstetric complications in a new reproductive frontier
Get PDFRecent changes to United States medical practice following the U.S. Supreme Court's decision in Dobbs v Jackson Woman's Health Organization have led to new forms of medical uncertainty arising from the interpretation and implementation of state law. Post-Dobbs legal restrictions are particularly challenging because they entail multiple forms of uncertainty that intensify when combined, with risks to pregnant patients and to the clinicians who care for them. In this article, we identify and describe three distinct types of uncertainty that obstetrician-gynecologists (OB-GYNs) in states with abortion bans encounter when caring for patients with an obstetric complication known as preterm prelabor (or premature) rupture of membranes (PPROM, i.e., 'water breaking'). PPROM represents a paradigmatic case in which prognostic, legal, and existential uncertainty coalesce, leading to stress and discomfort for both patients and the clinicians caring for them. Focusing on OB-GYNs, we describe each of these forms of medical uncertainty in turn, and then elaborate a case study to show how they operate in tandem over time. In doing so, we add to a growing body of literature highlighting the relationship between structural conditions shaping medicine and uncertainty in practice. Whereas evidence-based medicine is organized around the logic of reducing uncertainty, we find that doing so is far more difficult when the uncertainty arises from politics as opposed to clinical factors
Automatic Segmentation of the Cisternal Segment of Trigeminal Nerve on MRI Using Deep Learning
Get PDFPurpose: Accurate segmentation of the cisternal segment of the trigeminal nerve plays a critical role in identifying and treating different trigeminal nerve–related disorders, including trigeminal neuralgia (TN). However, the current manual segmentation process is prone to interobserver variability and consumes a significant amount of time. To overcome this challenge, we propose a deep learning–based approach, U‐Net, that automatically segments the cisternal segment of the trigeminal nerve. Methods: To evaluate the efficacy of our proposed approach, the U‐Net model was trained and validated on healthy control images and tested in on a separate dataset of TN patients. The methods such as Dice, Jaccard, positive predictive value (PPV), sensitivity (SEN), center‐of‐mass distance (CMD), and Hausdorff distance were used to assess segmentation performance. Results: Our approach achieved high accuracy in segmenting the cisternal segment of the trigeminal nerve, demonstrating robust performance and comparable results to those obtained by participating radiologists. Conclusion: The proposed deep learning–based approach, U‐Net, shows promise in improving the accuracy and efficiency of segmenting the cisternal segment of the trigeminal nerve. To the best of our knowledge, this is the first fully automated segmentation method for the trigeminal nerve in anatomic MRI, and it has the potential to aid in the diagnosis and treatment of various trigeminal nerve–related disorders, such as TN
Corrigendum to “Examining the relationship between discrimination, access to material resources, and black children's behavioral functioning during COVID-19” [Early Childhood Research Quarterly Volume 62, 1st Quarter 2023, Pages 335-346]
Get PDFCorrigendum to: "Examining the relationship between discrimination, access to material resources, and black children's behavioral functioning during COVID-19
Understanding the history of the late Roman synagogue at Huqoq in Israel’s Galilee through radiocarbon dating and observations on site formation
Get PDFGalilean-type synagogues are monumental, basilical structures found in northern Israel that have long been dated, mainly on stylistic grounds, to the 2nd - 3rd centuries CE. This chronology is influenced by historical considerations - specifically, the notion that monumental synagogues must have been constructed before Jews came under Christian rule in the early 4th century. However, the stratigraphic contexts of the pottery and coins associated with the foundation of these buildings suggest they represent an architectural innovation dating to the 4th (especially the later 4th) to 6th centuries CE. The Huqoq Excavation Project was initiated in 2011 with the goal of determining the construction date of a Galilean-type synagogue through controlled stratigraphic excavation, including the systematic collection of samples for radiocarbon dating along with micromorphological analysis of the fill deposits. Here we present the initial results of these analyses, which indicate that the radiocarbon ages conform with the pottery data to place the construction of the Huqoq synagogue in the late 4th - early 5th centuries (late Roman period). However, the ages of dated samples from thick fills overlying the floor, which were deposited when the synagogue was rebuilt and expanded in the early 14th century (late medieval/Mamluk period) do not reflect the stratigraphic sequence
The Combined Effects of Urine Zinc, Cadmium, Mercury, Lead, and Copper on Endometrial Cancer Staging
Get PDFEndometrial cancer (EC) is a growing public health concern. This secondary data study of a case series leveraged existing samples and data to explore the potential link between exposure to heavy metals/essential elements and stage of EC. We analyzed urine samples from women with EC, measuring levels of toxic metals (cadmium, mercury, and lead) and essential elements (zinc and copper). Our findings revealed that higher levels of mercury, cadmium, and lead are associated with more advanced EC stages. Conversely, zinc showed a protective effect, potentially mitigating EC stage progression. Copper levels did not show a clear association with EC stage. These results highlight the potential impact of environmental exposures on EC stage and the crucial need for advanced statistical methods to understand the combined effects of these pollutants on health and the need for public health interventions. Further research is needed to explore the mechanisms by which these metals influence EC stage and long-term outcomes
An untargeted metabolomic analysis of acute AFB1 treatment in liver, breast, and lung cells
Get PDFAflatoxin B1 (AFB1) is a class 1 carcinogen and mycotoxin known to contribute to the development of hepatocellular carcinoma (HCC), growth impairment, altered immune system modulation, and malnutrition. AFB1 is synthesized by Aspergillus flavus and is known to widely contaminate foodstuffs, particularly maize, wheat, and groundnuts. The mechanism in which AFB1 causes genetic mutations has been well studied, however its metabolomic effects remained largely unknown. A better understanding of how AFB1 disrupts metabolism would provide insight into how this mycotoxin leads to carcinogenesis, growth impairment, and/or immunomodulation, and may reveal potential targets for pharmacological or nutritional interventions to protect against these effects. The current study evaluated the metabolomic effects of various doses (2.5 μM, 5 μM, 10uM) of AFB1 treatment to HepG2 (liver), MDA-MB-231 (breast), and A549 (lung) cells. Treated and control cells’ metabolomic profiles were evaluated via ultra-high performance liquid chromatography-high resolution mass spectrometry (UHPLC-HRMS). Univariate and multivariate analyses revealed significant alterations in metabolite concentrations from each dose of AFB1 treatment in each cell type. Pathway analysis was then used to understand broader biochemical functions affected by AFB1 treatment in each cell type. HepG2 cell pathway analyses revealed significant pathway perturbations in lipid metabolism, carnitine synthesis, catecholamine biosynthesis, purine metabolism, and spermidine and spermine biosynthesis. Analysis of A549 cells found a greater emphasis of perturbations on various amino acids along with lipid synthesis-related pathways, and catecholamine biosynthesis. Finally, analysis of treated MDA-MB-231 cells found spermidine and spermine biosynthesis, carnitine synthesis, plasma membrane-related pathways (phosphatidylcholine synthesis and alpha linolenic acid and linoleic acid metabolism), and various amino acid metabolism pathways to be most affected. These highlighted pathways should be targeted in future investigations to evaluate their potential in mitigating or preventing the development of negative health effects associated with AFB1 exposure
“She’s Always Made Sure That We Had Black Doctors, Particularly Women Doctors If We Could… and How It Can Sometimes Be the Difference Between Life and Death.” Black College Women’s Reflections On Medical Racism As a Social Determinant of Health
Get PDFHistorical instances of medical racism and the impact of ongoing disparities are an understudied determinant of Black women’s sexual health. Here, we use a Black feminist approach to engage Black women in a qualitative exploration of the impact of medical racism on their health-related decision-making. Specifically, we explore the question, how does exposure to information on medical racism impact Black women today and inform their perceptions of healthcare? This qualitative study uses Black feminist approaches to study design including advisory boards, interviewer concordance, and focus group data collection with Black female college students who were in the developmental phase of emerging adulthood, ages 18–25. We also led seven virtual focus groups that focused on dialogue around agents of sexual socialization including knowledge of historical and ongoing medical racism. Four themes emerged from our thematic analysis. The first theme was compromised mental health. The second theme was a wealth and health paradox whereby income and education did not mitigate the impact of racism on health. The third theme was medical racism and distrust. And the fourth theme was around the role of Black Americans as guinea pigs, autonomous actors, and advocates in healthcare. Medical racism, whether it is experienced firsthand, vicariously, or as a part of one’s history, is a source of anxiety for Black women. This barrier to care must be addressed to promote health equity in the USA