Estimation of Additive Cure Model with Applications

Survival analysis plays a crucial role in medical research for understanding the time until an event of interest occurs, such as disease recurrence or death. An important branch of survival analysis models is cure models, assuming that a proportion of subjects will never experience the event of interest. The value of the proportion is called the cured rate and is usually associated with many covariates with complex effect relationships. Studying cure models under such non-linear covariate effects remains an active research area. This thesis aims to investigate advancements in additive cure models, focusing on their ability to capture additive complex relationships between covariates and survival outcomes with a curedfraction through non-linear modeling techniques, such as basic splines. Additive cure models offer a robust framework for analyzing survival data when a subset of individuals is cured and does not experience the event. The thesis will involve simulation studies to assess the accuracy of parameter estimation and model fit in various scenarios, and the application of additive cure models to real-world datasets from medical research studies. The findings will enhance the understanding and application of additive cure models in analyzing survivaldata with non-linear covariate effects, with implications for clinical decision-making and prognostic modeling. The insights gained from this research have implications for various fields, including epidemiology, clinical research, and public health, providing valuable tools for analyzing survival data and enhancing decision-making processes

Engineering Peace from Civil War: The Prospects of Institutional Peacebuilding and Multidimensional Inclusion

This dissertation incorporates quantitative and qualitative methods to investigate the impact of institutional engineering on levels of political violence in states emerging from civil war. Despite consensus on the conflict dampening potential of particular mechanisms, the promise of democratic peacebuilding has yet to be realized in many cases. Accounting for the divergence between expectations and outcomes, I assess the interactive effects of electoral system and power sharing arrangements on the propensity of former rebel movements and governments to pursue strategies of political violence or, conversely, compromise and cooperation. In contrast with existing research on democratic peacebuilding, which focuses largely on separate institutions and relies heavily on intensive, single case study methods, this project provides a variegated exploration into the interactive effects of particular institutional configurations. To facilitate a systematic, robust investigation, the research supplements the cross-sectional time-series methods, used to analyze a dataset of terminated intra-state conflicts after 1990, with two case studies

The Development of Culturally-Appropriate Educational Materials to Facilitate Comprehension and Adherence to Occupational Therapy Interventions

Title: The Development of Culturally-Appropriate Educational Materials to Facilitate Comprehension and Adherence to Occupational Therapy Interventions Purpose: The purpose of this capstone project is to enhance the engagement of the Hispanic population with occupational therapy (OT) services by developing translated educational resources that will support their ability to understand and implement their plan of care in a hospital. Methods: A literature review supported the need for improved access of culturally-appropriate healthcare material for the Hispanic community. A needs assessment served to interview staff members at the capstone facility to gain knowledge about the current practices and available resources offered intended to enhance the engagement of the Hispanic population with OT services. All handouts were developed in English, utilizing best practices of educational handout development, as described in literature review. The translation process involved a multi-step process and interprofessional collaboration with WellStar Language Access Department and Georgia State World (GSU) Language and Culture Department. Results: Four department binders were established for this doctoral capstone project. A total of fifteen educational handouts were developed in English covering a wide spectrum of topics. Of the fifteen developed handouts, eleven were translated into Spanish; the remaining four documents will be translated as part of the sustainability plan. The student delivered a presentation to the staff at the capstone facility and obtained feedback about the finalized materials, and it was evident the staff was enthusiastic about the outcome of the doctoral capstone project. The doctoral capstone project established interprofessional collaboration and fostered the relationship for continued partnership between WellStar and GSU. Conclusion: The doctoral capstone project addressed a gap in culturally-appropriate OT resources for Hispanic patients at the capstone facility. The development and translation of educational handouts represents a contribution to improving patient care and communication access within the hospital system

Tracking Childhood Vaccination Trends by Race: Analyzing MMR-Only, DTaP-Only, and Varicella-Only Vaccine Coverage Rates from 2016-2022

Declining vaccination rates due to factors like hesitancy and access issues during the coronavirus disease 2019 (COVID-19) pandemic, have spurred outbreaks of preventable diseases like measles and pertussis. This capstone analyzes vaccination coverage for MMR-only, DTaP-only, and Varicella-only shots among children from 2016 to 2022, focusing on racial disparities. Data from the National Immunization Surveys (NIS) informed the analysis, encompassing 118,323 children. Odds ratios from a multivariable logistic regression were used to perform this analysis, and statistical significance was determined using a 95% confidence interval (CI). Black children had lower odds of MMR and Varicella vaccination compared to White children (OR: 0.81 and 0.84), while children of Other + Multiple race showed similar trends (OR: 0.94 for both vaccines). For DTaP, Black children had lower odds (OR: 0.84), whereas no significant difference was found for Other + Multiple race children (OR: 0.98). Yearly analysis showed a 3% increase in odds for MMR and Varicella vaccination but there was a 7% decrease in the odds of receiving a DTaP vaccine. DTaP coverage fluctuated across racial groups. Overall, while MMR and Varicella coverage remained stable or increased, DTaP rates varied among White, Black and Other + Multiple race children

Efficient Algorithms for Large Scale Analysis of Viral Genome Sequencing Data

Extracting insights from the vast dataset of viral genome sequences collected throughout the COVID-19 pandemic requires the development of novel algorithms that are tailored to its unique properties. These properties, such as high sampling density, unambiguous knowledge of the phylogenetic root sequence, and completeness with respect to the virus’s evolutionary history in humans, make it distinct among viral genome datasets. This dissertation details the development and application of advanced computational methodologies to analyze the SARS-CoV-2 genomic dataset. We introduce a suite of computational techniques that are tailored to this data, beginning with SPHERE, an algorithm for scalable phylogeny reconstruction that adapts to the high density of the genomic data. The next is (ε, τ )-MSN, which forms genetic relatedness networks by joining all possible minimum spanning trees and sensibly augmenting the network with additional edges, to capture groups of similar sequences. Furthermore, we present an unsupervised learning approach for finding a clustering of genomic sequences that minimizes cluster entropy. We also propose a method for implementing evolutionary jumps within genetic algorithms, simulating the punctuated equilibrium phenomena observed in SARS-CoV-2 sequencing data, which was shown to improve the speed of convergence for hard instances of the 0-1 Knapsack Problem. Collectively, these works detail new, efficient ways in which to consider modeling and extracting information from large scale viral sequencing datasets

C(cubed)Sat: A Cosmic Climate Cuboid Nanosatellite for Monitoring Above-Earth Cosmic Activity

Amid more frequent extreme weather, a heavy focus is being placed on space weather monitoring by monitoring cosmic ray interactions, particularly muons. Muon particles are mainly created between the lower stratosphere and the upper troposphere by the interaction of the primary cosmic ray particles with molecules of the earth\u27s atmosphere. Current ground-based research revealed that muon flux is closely correlated with changes in Earth’s weather and solar-driven space weather events. One challenge is to unravel flux changes that are dominated by solar activities or fluctuations in the Earth’s weather system. This thesis presents work on the development of a mobile muon detector that uses cosmic-ray flux measurements above and on Earth to build climate dramatic event prediction models and serve as a direct measurement of solar modulation of the global muon flux. To complement this study, data collected through ground and commercial aircraft studies will be presented, ensuring consistent data collection

Investing in Remote Patient Monitoring to Improve Chronic Heart Condition Outcomes

Prior research has provided evidence that, on average, Remote Patient Monitoring (RPM) has a beneficial impact on hospital and patient outcomes. However, hospital investments in RPM have significant variation in effectiveness and only a few studies have examined the drivers and manifestations of these heterogeneous effects. Thus, RPM is an excellent case to better understand heterogeneity in adoption and outcomes of health IT as well as theorize the conditional nature of the effectiveness of a relational IT that connects firms, hospitals, and patients. Against this backdrop, this two-essay dissertation uses traditional econometric methods and causal machine learning to examine how different combinations of hospital and regional (county) characteristics condition RPM-related outcomes from a hospital and a patient point of view. The first essay offers a comprehensive understanding of how the outcomes associated with a relational health IT are conditional on a number of internal and external characteristics, whereas the second essay demonstrates multiple ways to identify and address the digital divide gap in outcomes across patient populations and the value of matching resources to patient subgroup needs. As a contribution to IS investment theory, the dissertation further considers the findings across the two essays to propose a conditional search mechanism that can help organizations maximize their return on IS investments. Overall, this research has important implications for policymakers deciding how to incentivize and support hospital adoption of RPM and for health care providers designing strategies for adoption and use of RPM for patients with heart failure

Molecular Characterization of the Neisseria gonorrhoeae Zur Regulon in Response to Zinc Starvation

Gonorrhea is a sexually transmitted infection, caused by the bacterial pathogen Neisseria gonorrhea (Ngo) and affects millions of individuals of all age groups across the globe every year. Infection with Ngo does not result in protection and no effective vaccine has been developed, leaving antibiotics as the only treatment option. With the emergence of strains showing high levels of antibiotic resistance, there is an urgent need for development of novel therapeutics for disease prevention. During pathogenesis the host employs nutritional immunity, to restrict important transition metals such as zinc away from Ngo. This process is counteracted in Ngo by the production of highly efficient zinc import TonB-dependent Transporters (TDTs) which are promising vaccine antigens and zinc shuttle ABC transporters found to be important for intracellular survival. In Ngo zinc homeostasis and transport proteins are regulated by the Zinc uptake regulator (Zur) which represses transcription in the presence of zinc and activates transcription in the absence of zinc. In this study, we performed RNA sequencing to identify the global profile of genes in Ngo under the control of Zur and found that it differentially regulates 26 genes in response to zinc levels. We report the activity of Zur activity as a global regulator, able to both repress and activate gene expression in the presence of zinc and identified a consensus region on their promoters. We went on to further characterize the promoter elements of the zinc import TDT, tdfJ, which results in dual regulation by zinc and iron. We characterize specificity and binding affinities for regulation of tdfJ by a second regulator, Ferric uptake regulator (Fur) in response to iron. The response of tdfJ to both iron and zinc and its potential to be an important invasin, makes it an attractive candidate to investigate female genital tract infections. The female genital tract is a conglomerate of these conditions and infections here are often asymptomatic. Taken together, this research provides important knowledge on the regulation of virulence mechanisms in response to zinc, which will aid in the development of therapeutics and an efficacious vaccine against a gonococcal infection

OT2B: The Creation of a Targeted Pre-Professional Club and Educational Intervention to Increase Awareness of and Interest in Occupational Therapy in a Diverse and Non-Traditional Undergraduate Student Population

Advocating for the profession of Occupational Therapy (OT) is important to help grow the profession, solidify professional identity, and to make the public aware of the services provided by OT. Advocating is also important to help increase the diversity of the profession, especially as there is a growing need for OT practitioners. Minority and non-traditional students often require more education about careers, and benefit from hands-on experiences and resources in pursuit of graduate school. Georgia Gwinnett College has a primarily minority and non-traditional student base, with many students interested in pursuing graduate school. Currently, there are few resources available for students interested in pursuing OT, and there is generally a lack of knowledge about the profession as a career option. An educational program was developed and administered to increase awareness of and interest in OT, and a pre-OT club was created to continue this effort and provide students with resources and support in their pursuit of OT. A pre- and post-test were administered before and after the informational lecture to 246 students, and results revealed a significant impact of the lecture on increasing awareness and understanding of, and interest in OT as a profession. This interest translated into 50 students signing up for the pre-OT club, including four students selected as officers. This program has the potential to increase awareness of OT and diversity of the profession, and it can be implemented in other colleges to benefit the profession of OT, and assist students in their pursuit of this impactful career

A Place to Age: How Older African Immigrants Understand Life and Living

My dissertation investigates the experiences of older African immigrants who immigrated to the U.S. after the U.S. Immigration Act 1990. Using in-depth interviews with 27 older adults (55+) from Sub-Saharan Africa living in Georgia, the dissertation focuses on the population of older African immigrants in the U.S. who continue their work lives or begin them in the U.S. I apply thematic analysis to highlight emerging themes. The life course perspective of the dissertation unveils the historical time and context of the country of origin, with the timing of personal lives often dictating the migration journey. The concepts of \u27double consciousness\u27 and \u27transnationalism\u27 shed light on the participants\u27 unique construction of racial or cultural boundaries between themselves and African Americans. The maintenance of immigrant cultures not only aids in their sense of belonging and cultural identity in the new home of Georgia but also enriches the cultural fabric of the U.S. Contrary to the aging in place ideal in America, older African immigrants did not show significant attachments to their homes in Georgia. The fact that they have homes in both the U.S. and their countries of origin and express desires for their final resting places in their country of origin underscores the linked lives, human agency, and the relationships they maintain in both places as lived experiences in a life course perspective of immigrant African older adults. Their ambivalence on the importance of home in both counties challenges the meaning and understanding of home, inviting a deeper appreciation of their unique circumstances. This study significantly enriches the literature on the meaning of identity, home, place, and migration. The findings offer valuable insights for policymakers, sociologists, anthropologists, gerontologists, and social workers, equipping them with a deeper understanding of older African immigrants, their experiences, and aging plans as they become part of the rapidly growing population of older adults in the U.S. This understanding can inform policies and interventions that cater to the unique needs and aspirations of this demographic, fostering a more inclusive and supportive society