Now showing items 21-40 of 36474

    • Quantitative Microbial Risk Assessment Using Azred Water Quality Models

      Choi, Christopher; Balagopal, Tulika C.; (The University of Arizona., 2011)
      Cryptosporidiosis is a common gastrointestinal disease that significantly impacts immune-compromised individuals. In this study, water quality analysis and doseresponse models are used to calculate the location-based risk of Cryptosporidium infection within 24 hours of an intrusion into a drinking water system. Current water quality models such as EP ANET are based upon two main assumptions: complete mixing occurs at pipe cross junctions, and axial dispersion of a solute does not occur along the length of a pipe. To improve the accuracy of EPANET, two newly developed models, AZRED I and II, consider these assumptions. EP ANET-generated simulations model plug flow-the movement of large contaminant concentration pulses with respect to time-while AZRED-generated simulations model solute dispersion, which results in lower contaminant concentrations over a longer period of time. The risk of infection was calculated for populations at four specific locations in a network using an exponential model. Results obtained using AZRED, when compared to results obtained from EPANET, predicted a higher risk of infection at downstream locations.
    • Quantitative T_2 Mapping in Cardiac MRI

      Altbach, Maria; Barr, Tomoe; Bilgin, Ali; Galons, J.P.; Kuo, Phillip (The University of Arizona., 2012)
      The thesis discusses a quantitative method to examine the myocardium using an MRdependant tissue parameter known as the spin-spin relaxation time, T 2. This parameter is related to cardiac pathologies, such as myocardial edema, or inflammation. The goal of my project was to optimize a data acquisition technique (double-inversion radial fast spin echo or DIR-RADFSE), previously developed in Dr. Altbach's lab, for cardiac MRI applications. The data collected with DIR-RADFSE can be used to calculate T2 via specialized reconstruction algorithms. First, the setups with DIR-RADFSE sequence were optimized with the goal of reducing artifacts due to aliasing, chemical shift, indirect echoes and cardiac motion (due to higher heart rates). Then, reproducibility studies were conducted on healthy controls to evaluate the reproducibility of the T2 values in the myocardium. The technique was also tested on patients who were undergoing a routine clinical examination. The results of this initial clinical study are presented in the thesis.
    • Recruitment of Tendon Crimp with Applied Tensile Strain

      Hansen, Kristi Ann; (The University of Arizona., 2000)
      The stress-strain behavior of ligaments and tendons begins with a toe region that is believed to result from the straightening of crimped collagen fibrils. Their physiological function is mostly confined to this toe region and changes in crimp morphology are believed to be associated with pathological conditions. A relatively new imaging technique, optical coherence tomography (OCT), provides a comparatively inexpensive method for nondestructive investigation of tissue ultrastructure with resolution on the order of 15 μm and the potential for use in a clinical setting. The objectives of this work were to measure the period of crimp pattern in rat tail tendon fascicles, and to measure changes in crimp period as a function of tensile strain using OCT. Fascicles from rat tail tendons were subjected to 0.5% strain increments up to 5% and imaged at each increment using OCT. The OCT images corresponded well to OM images taken between crossed polarizing lenses. Crimp pattern disappeared completely at strains below 3%, first near the surface of the fascicle and finally at the center. Average crimp period increased as strain increased, but individual, axially aligned periods increased and decreased due to non-uniform recruitment of crimp.
    • Incremental Data Mining for Active and Adaptive Knowledge Base for Patient Image Retrieval

      Sheng, Olivia L.; Lin, Lin; Sheng, Olivia; Williams, Stuart; Ovitt, Terry (The University of Arizona., 2001)
      Introduction: The general perception that the use of information technology (IT) in health care is 10 to 15 years behind that in other industrial sectors such as banking, manufacturing and airline is rapidly changing. Faced with an unprecedented era of competition and managed care, health providers are now exploring the opportunities for using IT to improve quality while simultaneously reduce the cost of health care. Clinical decision support systems and expert systems (CDSSs / ESs) focus on utilizing artificial intelligence and data mining techniques to provide fast decision support for physicians. Although several success stories about CDSSs / ESs have been reported [Freudenheim 92, Nash 94], these systems usually lack the ability to adapt to pattern changes that are embedded in new data. This is due to the fact that the traditional algorithms utilized by these systems cannot learn on an incremental basis, i.e., once they are built, they cannot adjust their structures in which the knowledge is imbedded. Lack of incremental learning ability is not a unique phenomenon in health care expert systems. In fact, most of the machine learning algorithms developed to date are limited in their ability to adjust learned rules based on new, incoming data. In the Internet Age, when new data keep coming in at a high speed, this is a serious limitation for decision support systems. The main objective of this dissertation is to develop a new incremental neural network technique in order to support decision support systems' adaptive needs. An Incremental Neural Net (INN) algorithm that utilizes hidden layer activations to incrementally learn new patterns from incoming data is proposed. We then applied it to the Image Retrieval Expert System (IRES), a clinical decision support system for radiologists in University Medical Center (UMC), University of Arizona. The performance comparison between the INN and traditional neural net approach are compared. This chapter is organized as follows: section 1.1 briefly introduces the concept of data mining and incremental learning, which serve as technical foundations for this dissertation. Section 1.2 introduces the background of IRES project and describes its adaptive need. Section 1.3 addresses research motivation and objectives. Section 1.4 provides an overview of this dissertation.
    • The Application of Liposomes in Synthetic Biology

      Romanowski, Marek; Brauneis, Jacqueline; (The University of Arizona., 2012)
      In the emerging field of synthetic biology, researchers are synthesizing artificial cells that are able to perform novel functions and produce useful products. However, the current methods for the synthesis of these cells are time-consuming and restrictive. This report proposes a novel approach to artificial cell synthesis by means of an assembly line embedded within a microfluidic chip in which components are loaded into an empty synthetic cell membrane. The components are able to be loaded via an optical trapping system capable of maneuvering liposomes coated in gold nano particles. This system will result in an increased production efficiency that can be completely controlled at a reasonable cost.
    • A Penetration and Safety Assay for Generic Ophthalmic Drugs

      Orsinger, Gabriel; (The University of Arizona., 2010)
      Generic topical ophthalmic medications are poorly regulated by the Food and Drug Administration, resulting in an uncertainty of generics' efficacy and safety and unnecessarily placing patients at risk. In 1999, more than 200 documented cases of corneal damage as severe as corneal melting were linked to the use of a generic formulation of diclofenac, which was consequently pulled from the market. These devastating iatrogenic effects demonstrate the need for stricter testing of generic ophthalmic drugs prior to reaching the public. This report addresses this urgent need by proposing an in vitro model for simultaneously predicting corneal penetration and epithelial toxicity of topical ophthalmic formulations. Penetration and safety of ophthalmic medications have been studied separately, but until now, the development of an assay to accurately predict both penetration and safety in parallel has been overlooked. In this report, recent and ongoing research will be reviewed to (1) elucidate the complexities of corneal penetration and the effects of topical ophthalmic formulations on corneal penetration, and (2) identify important characteristics of existing models to incorporate in the proposed in vitro penetration and safety assay. Critical features of the model proposed here include a trephinated porcine cornea from tissue discards affixed in a Franz diffusion cell, permitting concurrent drug penetration and epithelial health monitoring. A robust, cost-effective penetration and safety assay such as this would provide drug companies with a valuable tool to eliminate chances of future iatrogenic effects due to topical ophthalmic drugs.
    • Electrolyte Solutions to Improve the Performance of Electroactive Polymers used in Infusion Pumps

      Dean, Zachary Steven; (The University of Arizona., 2011)
      Tucson/San Diego-based company Medipacs, Inc. has developed a novel approach to their infusion pump design: the utilization of electroactive polymer materials to serve as mechanical actuators in portable, disposable infusion pumps. Already in working order, Medipacs' electroactive polymer's design is continually perfected in order to both maximize the polymer's mechanical output as well as uncover the full spectrum of design applications for the polymer. As Medipacs' polymer readily swells while submerged in an electrolyte solution at a low pH, the ions that make up the electrolyte solution are not the only important quality; the concentration of the electrolyte solution is also significant as too high or too low of an electrolyte concentration can hinder polymer expansion. The study at hand investigated not only the cause of a surprising improvement in polymer actuation during the utilization of a new (proprietary) electrolyte over the previously used electrolyte, sodium perchlorate, but also looked to further improve actuation through the investigation of additional electrolytes: citric acid, sodium hydrogen sulfate, and sodium nitrate. A passive swelling test that utilized pH changes to facilitate swelling, and an active swelling test that used an electrical current to facilitate swelling were both used; a polymer known to swell in an alkaline solution was also incorporated into the study for comparison. Preliminary results suggest that an electrolyte solution with many acid-dissociation constants facilitates the greatest swelling of Medipacs' polymer, although more experiments are needed to evaluate the ability to electrochemically control such electrolytes.
    • Towards a Classification System for the Shape, Location, and Orientation of Hill-Sachs Lesions

      Eskinazi; (The University of Arizona., 2011)
      A Hill-Sachs lesion (HSL) is a compression fracture on the humeral head created when the soft humeral head impacts the edge of the glenoid during shoulder dislocation. HSL incidence is reported in 47% of acute anterior glenohumeral dislocations and in 40-80% of patients with chronic instability. A Bankart lesion, the avulsion of the anterior/inferior labrum and inferior glenohumeral ligament from the glenoid rim, is often accompanied by a HSL. Soft tissue repairs are often unsuccessful when a significant bony defect is left untreated; it is our long-term goal to determine which bony defects should be treated to prevent failure of soft tissue repair. Surgeons have proposed the presence of "large" HSLs or the position and orientation of the HSL as causes for recurrent dislocation following Bankart repair. Unfortunately, in the orthopedic literature there is no system for classifying HSLs, or even for quantifying their size, position, and/or orientation which precludes the objective comparison of the work of various authors. The development of such a system is the necessary precursor to the production of any meaningful conclusions about the significance of the HSL. An inexpensive medical image segmentation process using active contours was implemented to build 3D reconstructions of the humeral head. Each of the active contour parameters was optimized for the clinical data set. Literature studies were conducted to come to a consensus on critical lesion traits and methods for computationally quantifying the lesion's traits. The long-term goal of this study is to compare clinical outcomes to the quantitative measures determined using this method.
    • Shear Stress Effects on Schlemm's Canal Cells

      Stamer, W. Daniel; Ashpole, Nicole; Stamer, W. Daniel; VandeGeest, Jonathan; Lynch, Ronald; Schwiegerling, Jim (The University of Arizona., 2012)
      Nitric Oxide (NO) is a radical produced by endothelial NO synthase (eNOS), which is regulated by shear stress in vascular endothelia. In humans, shear stress levels in Schlemm's Canal (SC) are calculated to be comparable to that of arteries, particularly at elevated intraocular pressure (IOP), a risk factor for glaucoma. To test if NO is part of an IOP regulatory loop, we investigated the relationship between NO and shear stress in SC cells. Cells were seeded into lbidi flow chambers and assayed for effects of continuous shear on cell alignment and NO production. Human umbilical vascular endothelial cells (HUVECS) were used as a positive control. Like HUVECS, SC cells aligned with the direction of flow. NO synthesis in both cell types doubled with an increase in shear from 0.1 to 10.0 dynes/cm2, suggesting that shear regulates NO production in SC cells and consequently may play a role in IOP regulation.
    • Biopolitics, Female Choice, and First Wave Feminism: English and American Fiction, 1871-1916

      Hogle, Jerrold E.; Kasper, Daniel Thomas; Zwinger, Lynda; Hurh, Paul; Lempert, Manya (The University of Arizona., 2019)
      “Biopolitics, Female Choice, and First Wave Feminism” argues that the shift allowing women to enter the public sphere hinged on integrating Charles Darwin’s theory of sexual selection into political discourse. Authors writing in genres as diverse as science fiction, psychological realism, the Gothic, and the imaginary journey deployed the logic of female choice in arguing for the emancipation of women, demonstrating that the circumscribed roles for women in Britain and the US were non-natural, cultural constructions. Moreover, basing their suffrage arguments on female sexuality and procreation meant embracing and explicating a line of political thought which reified nineteenth century notions of race hierarchy, which were themselves bolstered elsewhere by Darwin. Appropriating the power within sexual dynamics afforded to non-human species by scientific theory, white women characters adopted the assumptions of racial superiority that undergirded the popular understanding of evolutionary progress, using techniques of government revealed by Michel Foucault’s late work in order to persuade the men around them to support women’s suffrage. Plotting the arc of this persuasion—in novels from Edward Bulwer-Lytton, Henry James, Bram Stoker, and Charlotte Perkins Gilman—demonstrates the increasing freedom afforded to white women at the expense of reinforcing nonscientific Victorian notions of race and eugenics, justifying the adoption of biopolitics by twentieth century governments through a seemingly feminist political shift.
    • DVFS-Aware Asymmetric-Retention STT-RAM Caches for Energy-Efficient Multicore Processors

      Adegbija, Tosiron; Gajaria, Dhruv Mayur; Lysecky, Roman; Akoglu, Ali (The University of Arizona., 2019)
      Spin-transfer torque RAMs (STT-RAMs) have been studied as a promising alternative to SRAMs in emerging caches and main memories due to their low leakage power and high density. However, STT-RAMs, also have drawbacks of high dynamic write energy and long write latency. Relaxing the retention time of the non-volatile STT-RAM has been widely studied as a way to reduce STT-RAM's write energy and latency. However, since different applications may require different retention times, STT-RAM retention times must be critically explored to satisfy various applications' needs. This process can be challenging due to exploration overhead, and exacerbated by the fact that STT-RAM caches are emerging and are not readily available for design time exploration. This work explores using known statistics (e.g., SRAM statistics) to predict the appropriate STT-RAM retention times, in order to minimize exploration overhead. We propose an STT-RAM Cache Retention Time (SCART) model, which utilizes machine learning to enable design time or runtime prediction of best STT-RAM retention times for latency or energy optimization. Furthermore, we analyze the impacts of dynamic voltage and frequency scaling (DVFS)---a common optimization in modern processors---on STT-RAM L1 cache design. Our analysis reveals that, apart from the fact that different applications may require different retention times, the clock frequency, which is typically ignored in most STT-RAM studies, may also significantly impact applications' retention time needs. Based on our findings, we propose an asymmetric-retention core (ARC) design for multicore architectures. ARC features retention time heterogeneity to specialize STT-RAM retention times to applications' needs. We also propose a runtime prediction model to determine the best core on which to run an application, based on the applications' characteristics, their retention time requirements, and available DVFS settings. Results reveal that the proposed approach can reduce the average cache energy by 39.21% and overall processor energy by 13.66%, compared to an SRAM-based system, and by 20.19% and 7.66%, respectively, compared to a homogeneous STT-RAM cache design.
    • Two-Spirit Identity among Tribal Communities: The Effects of Intergenerational Trauma on Queer Native Young-Adult Well-Being

      Tippeconnic Fox, Mary Jo; Keovorabouth, Souksavanh Tom; Trosper, Ronald; Galarte, Francisco; Tsosie-Paddock, Aresta (The University of Arizona., 2019)
      Although many Native American nations have oral traditions featuring stories of Two-Spirit individuals who were highly respected in the community, many Two-Spirit youth have experienced trauma to their physical, mental, and spiritual well-being. Reports show that Navajo youth who identify with the LGBTQ+ or Two-Spirit community are three times more likely to attempt suicide than their non-Navajo counterparts (Navajo LGBTQ Report, 2015). This study focuses on Two-Spirit young adults (ages of 18 to 28) and documents and analyzes the relationship between their identities and the trauma that many of them experience. The dissemination of the findings brings social awareness about the lack of indigenous knowledge, even among Native American nations. The foundation of this study relies heavily on Indigenous methodology, with the use of storytelling specifically on creation stories and participants sharing their experiences. Within Native American communities, storytelling is an essential aspect of Native societal structure, and the use of storytelling is vital to the survival of Indigenous people (Brown and Strega, 2015; Wilson, 2008). This studies’ research questions are: How does intergenerational trauma impact two-spirit well-being? Do cultural connections and beliefs affect the well-being of two-spirit individuals? In which ways? Within the study, there will be limitations with the use of survey-only response that revolve around reliability, validity, and generalizability. The findings of the survey challenges Native American communities to create an environment of acceptance to lower rates of suicide, self/physical harm, and many other factors that impact two-spirit youth’s health.
    • Framing of China's Belt and Road Initiative by the U.S. and Indian News Media (2013-2018)

      Relly, Jeannine E.; Niu, Shanshan; Schwalbe, Carol; Lumsden, Linda (The University of Arizona., 2019)
      China’s Belt and Road Initiative (BRI) has attracted worldwide attention since it was proposed by China’s President Xi Jinping in 2013. There is a lack of research, however, focused on news framing of the initiative, which offers a blank slate on the study of the BRI as China’s top level national project. Using framing as a theoretical framework, the current study examined how U.S. and Indian news media framed China’s BRI between 2013 to 2018 based on a content analysis of 400 articles from four English-language news outlets: The Wall Street Journal, New York Times, Times of India, and Economic Times. The findings show that the economic project was the most frequently used frame, but the overall framing was still negative because of the threat, competition, and expansion frames. Indian and the U.S. media framed China’s BRI with many similarities and a few differences in length, topics, frames, dominant sources, and dominant tone with the consideration of each country’s stand on national interests and strategic foreign policies.
    • Advances in Microbiome Analysis: From the Variance Component Model to Deep Learning

      Zhou, Jin; Zhai, Jing; Roe, Denise J.; Hu, Chengcheng (The University of Arizona., 2019)
      Evidence linking microbiome to human health is rapidly growing, suggesting that the human microbiome may serve as novel biomarkers for disease. In microbiome profiling, the direct sequencing outputs are counts or compositions of bacterial taxa at different taxonomic levels. The key research questions in microbiome analysis are to identify the bacterial taxa associated with a clinical outcome and to leverage microbiome aiming to make an accurate prediction on host phenotypes. Although the next generation sequencing has produced extensive microbiome data, data analyses are hindered by several statistical challenges due to the unique characteristics of microbiome profile which includes that 1) the number of taxa greatly exceeds the sample size, 2) most taxa are in extremely low abundance and absent in many samples, and 3) the taxa are related to one another by an evolutionary tree. In this dissertation, three papers are presented to address these challenges. In the first paper, a regularized variance component model is developed for selecting important microbiome taxa. We consider regression analysis by treating bacterial taxa at different levels as multiple random effects. For each taxon, a kernel matrix is calculated based on distance measures in the phylogenetic tree and it acts as one variance component in the joint model. Then, taxonomic selection is achieved by the lasso (least absolute shrinkage and selection operator) penalty on variance components. Our method integrates biological information into the variable selection problem and greatly improves selection accuracies. Simulation studies demonstrate the superiority of our methods versus existing ones, for example, the group-lasso. This method is then applied to a longitudinal microbiome study of Human Immunodeficiency Virus (HIV) infected patients. We implement our method using the high performance computing language Julia. Software and detailed documentation are freely available at https://github.com/JingZhai63/VCselection. In the second paper, we thoroughly investigate the link between lung microbiome composition, pulmonary inflammation, and early lung dysfunction. First, the genus-level taxa are labeled as two pneumotypes: supraglottic and background predominant taxa (i.e., SPT and BPT as previously described by others). Next, multiple statistical approaches are used to characterize these two pneumotype taxa, including dissimilarity-overlap curve (DOC) microbiome dynamics analysis, weighted Spearman correlation analysis, network analysis, etc. We find that previously defined microbial taxa have different effect on inflammation markers and lung function in an HIV positive population. The dynamics of post-ART pneumotype SPT was host-dependent, indicating that the microbiome variability among individuals not only originates from the difference in microbiome species assemblage, but also stems from host specific factors, such as lifestyles. The complex lung function-microbiome-inflammatory network and microbiome dynamics pattern suggest that a healthy lung microbiome may play a critical role in preventing lung function decline of HIV infected individuals. The findings in the second paper suggest that, in addition to identify taxa related to disease, it is also important to uncover the microbiome-phenotype network by understanding microbiome as a whole. In the third paper, we present DeepBiome, a deep learning model, to uncover the network of microbiome and visualize its path to disease. The proposed DeepBiome takes microbiome abundance data as input and uses the phylogenetic tree as a prior knowledge to decide the optimal number of layers and neurons on each of it. By doing so, we are able to relieve the computation burden of tuning DNN hyperparameters. In addition, DeepBiome provides phylogeny regularized weight decay to improve prediction on host phenotypes during training. This deep learning framework not only can analyze a microbiome as a whole to provide a comprehensive network view and but also can identify taxa associate with outcome at each taxonomic level. DeepBiome is designed for both regression and classification problems to support a broader application in microbiome analysis. The simulation studies and real data application show that DeepBiome is a cutting-edge tool in the area of complex microbiome data analysis.
    • Deep Learning for Generative Adversarial Networks and Change Detection

      Tandon, Ravi; Adiga, Sudarshan; Ditzler, Gregory; Lazos, Loukas (The University of Arizona., 2019)
      The generalization capability of deep neural networks has led to an increase in its utilization for complex tasks across a wide array of applications, ranging from image classification, computer vision, cybersecurity, and healthcare. In this thesis, we look at applications of deep learning based techniques for change detection and generative modeling. The goal of this thesis is two-fold: (a) to provide quantitative measures for evaluating the performance of generative models, and; (b) to develop unsupervised algorithms to detect changes in time series data. Generative Adversarial Networks (GANs) are a popular framework that train two neural networks in an adversarial manner to generate synthetic samples that follow the distribution of input data. While the performance of GANs has been found to be better than other generative models in terms of the quality of the samples, they often suffer from the problem of mode collapse, i.e., synthetic samples tend to lack the diversity present in original data. Many approaches have been proposed to alleviate this phenomenon in GANs. The first contribution of this thesis are quantitative metrics that capture the extent of mode collapse, as well as the sample quality. The second contribution of this thesis is to devise an unsupervised algorithm for change detection. The proposed approach leverages deep learning based methods to estimate likelihood ratios between samples from two distributions. Subsequently, this methodology is used to devise an unsupervised change detection statistic. We also provide generalization of this framework to detect multiple changes, and for the online setting. We validate the performance of our approach using both synthetic and real-world datasets.
    • Palestinian Refugee Camps in the Middle East

      Hudson, Leila; Voronkova, Valeriia; Clancy-Smith, Julia; Betteridge, Anne (The University of Arizona., 2019)
      Beginning in 1948, the Arab-Israeli conflict caused the emergence of a large number of Palestinian refugees. There are three countries in the Middle East that host the majority of Palestinians on their territory. These are Lebanon, Jordan, and Syria. In the past 70 years some refugees have been able to assimilate in the host countries’ societies, while others have been living in poverty in the refugee camps. This paper analyzes the lives of refugees in the camps in Lebanon, Jordan, and Syria in order to reveal the contrasts between refugee camps in different countries and to compare their living conditions. In order to understand all the similarities and differences, I focus on the Shatila camp in Lebanon, because this camp has a unique history of self-governance. I also focus on the Yarmouk camp in Syria, which has a unique location for commercial purposes, as well as a few of the most known camps in Jordan. Our results showed that refugees’ living conditions in the camps are quite different from each other. The most significant factors that cause this difference are the host countries’ policies toward refugees and their economic opportunities and socio-political status. From a human rights perspective, this study emphasizes the need to pay attention to the Palestinian refugee issue in order to think about possible solutions to the problem.
    • The Implementation and Evaluation of a County-Wide Stock Inhaler for Schools Program in Pima County, Arizona

      Gerald, Lynn B.; Lowe, Ashley Anne; Gerald, Joe K.; Clemens, Conrad (The University of Arizona., 2019)
      Objective: Professional guidelines specify that children with asthma should always have access to quick relief medication. However, few children have access to such medication while at school. Stock inhaler programs allow schools to have a single, rescue inhaler that can be used by any child who experiences respiratory distress. The Pima County Stock Inhaler for Schools Program was developed by a stakeholder coalition after passage of Arizona H.B. 2208, “Stock Inhalers for Schools” in March 2017. The program provided schools with medication, a standardized protocol for respiratory distress, and technical support for implementation. The objective of this study was to evaluate the implementation of the program among schools across Pima County, Arizona during 2017-2018. Methods: A stakeholder coalition developed program materials including a standardized protocol that instructed trained personnel how to recognize and respond to respiratory distress. Additional template resources were created including a stock inhaler documentation log, a web-based training, and school enrollment forms. All 364 public, charter and private/parochial schools in Pima County, Arizona were invited to participate in the 2017-2018 Pima County Stock Inhaler for Schools Program. Outreach occurred during the summer of 2017 using various methods to inform schools of the program. Schools that enrolled in the program received a program toolkit including the following supplies: (1) 60-dose albuterol inhaler, supply of valved-holding chambers (LiteAire®), signed standing medical order by the Chief Medical Officer of Pima County, standardized protocol for albuterol administration, online training curriculum, template resources and on-going technical support from the program manager. The RE-AIM Framework was used to evaluate the county-wide intervention. Results: We examined program implementation among (n=230) public, charter, private/parochial schools who participated in the 2017-2018 Pima County Stock Inhaler for Schools Program. The program reached 82% of students in Pima County, Arizona. The stock inhaler was administered 1,032 times in 152 schools during the 2017-2018 school year. Eighty-four percent of children returned to class after albuterol administration. Trained personnel reported high confidence with administering the stock inhaler and using the standardized protocol during a respiratory event. Furthermore, 94.3% of trained personnel would recommend this program to other schools and 93.2% felt the stock inhaler program was beneficial to their school indicating high satisfaction with the program. Discussion: The Pima County Stock Inhaler for Schools Program demonstrated feasibility among schools that participated in the program. These findings provide evidence that after the successful passage of stock inhaler legislation, stakeholder coalitions can implement large-scale stock inhaler programs.
    • Blood Product Administration and Kidney Function as a Mortality Indicator for VA-ECMO: A Retrospective Review of a Single Institution

      Vanderah, Todd; Tran, Phat; Montoya, Jesse Alan; Cosgrove, Richard; Chen, Qin (The University of Arizona., 2019)
      Background Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is a rapidly growing treatment for critically ill patients. The management of this life-saving therapy is extremely complicated; requiring highly trained professionals in the intensive care unit. Since the epidemic of influenza A in 2009, the usage of ECMO has increased by a 1000 fold. Unfortunately, the research and data is not able to keep up. Herein, we aim to increase this data with our own and look for markers that show an increase risk of mortality. We especially want to take note of blood product usage, kidney function, and patient platelet counts as indicators for increased mortality. Methods This is a retrospective analysis of patients that underwent VA ECMO treatment at Banner University Medical Center – Tucson, during the time period of January 2010 – December 2015. We disqualified patients that were on VA ECMO for less than 22 hours, as we felt this was not long enough of a time period to allow the changes we were hoping to discern. Data from the remaining 70 patients (32F/38M), median age 44 (11 – 61.5) years, was obtained by chart review. Patients were separated into two groups: those who survived until discharge (survivors, N = 25), and those who did not (nonsurvivors, N = 45). Results Our VA ECMO survival rates are 35.7% for our included patients. Nonsurvivors had much higher rates of receiving CRRT (64.4% vs 20.0%, p < 0.001) and higher initial (22 vs 18, p = 0.030) and average (31 vs 21, p = .023) BUN values than the survivors. Non survivors also received much more pRBCs (3451 vs 2080 ml, p = 0.003), platelets (1900 vs 556 ml, p = 0.003) and FFP (1123 vs 240 ml, p = .001) over the course of their run than survivors. There was no significant difference in any measured platelet counts between patients. Conclusions Patients that receive increased blood product administration and reduced kidney function during VA ECMO are at an increased risk of mortality. Further studies are required to further elucidate markers of ECMO outcomes that can guide the practice.
    • Breaks, Samples, and Sites for Cyphers: Remixing the Administration of Writing

      Troutman, Stephanie; House, Eric; Miller-Cochran, Susan; Cardenas, Maritza; Petchauer, Emery (The University of Arizona., 2019)
      This dissertation forwards a DJ-based hip-hop methodology as an intervention within the discourses of Writing Program Administration (WPA). It is a response to calls from the larger field of rhetoric and composition as well as the sub field of WPA for work that theorizes through disciplinary issues of whiteness, suggesting that hip-hop as a culture founded within the same western discourse of the academy has the capacity to interrogate the practices that reproduce and uphold hegemony. I argue that hip-hop can only accomplish this when it is first theorized through a synthesis of hip-hop feminism and critical theory since its proximity to dominant discourse must be unpacked and theorized rather than abandoned. This project also centers on hip-hop’s remixing capabilities as it argues that critiques should include an element of extension and creation as a willful ignorance or removal from the effects of dominant culture might be theoretically impossible. Instead, it argues that the critiques of WPA discourse offers occasions for compositions that are sensitive to differences in cultural location. The central argument in Breaks, Samples, and Sites for Cyphers is that the methodologies that guide practice and production within WPA must consider the intricacies of cultural location. The discourse of WPA is often presented as a neutral endeavor with practices that discipline administrators, students, teachers, and staff so that they might uphold middle-class, white norms. A hip-hop methodology has the potential to disrupt this practice by offering remixes of writing and identity that are sensitive to a variety of social and political contexts. The DJ is then specifically utilized as an image of a critical writing administrator due to their ability to invite spacious compositions from a variety of identities, packaging and presenting those compositions in ways that might speak back towards legacies of whiteness within the field. In chapter two, I begin the discussion by defining my hip-hop methodology through a synthesis of hip-hop feminism and critical theory in order to explore hip-hop’s potential to call out and speak back towards a dominating discourse. I then center on the hip-hop DJ, recognizing that while they share hip-hop as a guiding epistemology, the practices within the culture all have their own guiding logics. I emphasize the DJ as they closely parallel the writing administrator through their emphasis on administering and inviting writing occasions. Chapter three focuses on composition curriculum realized through the WPA Outcomes Statement, a document created by the Council of Writing Program Administrators that focuses on naming and normalizing expectations for the first-year writing class. Through a hip-hop discourse analysis of the document, I argue for remixed definitions for writing and rhetoric within the class that are more sensitive of difference. I continue the dialogue of difference and identity in chapter four, arguing for cypher logics to impact the ways in which identity is handled within the field. I end the discussion in chapter five by pointing out that while hip-hop offers a generative intervention that can help in the critiquing of whiteness in WPA, it alone cannot be the chosen culture to do so. What is needed are continual theories and methodologies that come from various cultural locations that can all aid in the work of challenging and critiquing problematic discourses in rhetoric and composition.
    • "Hezbollah Ruined Everything, Even Death": Death Rituals and Martyr Making in the Lebanese Shiite Milieu

      Hudson, Leila; Hamzeh, Safa; Fortna, Benjamin C.; Günel, Gökçe (The University of Arizona., 2019)
      This study is concerned with two overlooked ritualization sites of the Lebanese Shiite community: the common and the military funeral. I ask, how have the death rituals (funerary, commemoration) changed over the last fifty years? How does the death ritual function in a particular sociopolitical environment? In Section One, I analyze a set of oral histories of Sultaneya villagers to focus on ritual. I do so to examine the change in death rituals, funerary and commemoration, over the last five decades (1969- 2019). I focus on the reform of the young pious Shiites of their parents’ ‘customs and traditions’. This I situate within the context of the Shiite Islamic movement that shaped today’s Shiite environment. In Section Two, I look at the military funeral of Hezbollah. I delineate the elements of this invented tradition and show how the military funeral appropriates Ashura symbols and rituals. I argue that this is so because the military funeral is found to differentiate between the bodies of the martyrs and everyone else, hence to sacralize them – the making of Hezbollah martyr is thus realized within this process.